Another Y2K problem: New Zealand's ageing drivers.
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Accidents, Traffic↗
Biomedical subjects
N Long
Publications and source records attributed to N Long.
Relationship of pediatric overall performance category and pediatric cerebral performance category scores at pediatric intensive care unit discharge with outcome measures collected at hospital discharge and 1- and 6-month follow-up assessments.
OBJECTIVE: Given the current focus on outcomes, there is a crucial need for easily utilized measures that can effectively quantify morbidity or disability after a child's critical illness or injury. The purpose of this study is to significantly extend the research on two such promising measures: the Pediatric Overall Performance Category (POPC) and the Pediatric Cerebral Performance Category (PCPC). DESIGN: Cross-sectional analysis of a sample of pediatric intensive care unit (PICU) discharges and a prospective follow-up of this cohort of children. SETTING: Arkansas Children's Hospital. PATIENTS: Two hundred children (ranging in age from birth to 21 yrs) discharged from a PICU. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were collected at PICU discharge, hospital discharge, and 1- and 6-month follow-up assessments after hospital discharge. Measures utilized included the POPC (at PICU discharge), PCPC (at PICU discharge), Stanford-Binet Intelligence Scale, fourth edition (at hospital discharge), Bayley Scales of Infant Development, second edition (at hospital discharge), and the Vineland Adaptive Behavior Scales (at 1 and 6 months after discharge). Stanford-Binet Intelligence Quotients and Bayley Mental Developmental Index scores were significantly different across PCPC categories (p < .0001). Bayley Psychomotor Developmental Index scores and Vineland Adaptive Behavior Scales scores varied significantly across POPC categories (p < .0001). The test for linear trend was also significant for each of the comparisons. CONCLUSIONS: The results of this study offer additional support for the use of the PCPC and POPC. These brief and easily completed measures can provide useful information regarding probable outcomes for pediatric intensive care patients when more extensive psychometric testing is not feasible or desirable.
Adolescent↗
Posttraumatic stress disorder and interpersonal functioning in Vietnam War veterans: a mediational model.
This study examines the association between posttraumatic stress disorder (PTSD) and interpersonal functioning in a New Zealand community sample of 756 Vietnam War veterans. The results support previous research findings showing that PTSD adversely affects veterans' interpersonal relationships, family functioning, and marital/dyadic adjustment and show that the effects of PTSD on family functioning and dyadic adjustment are mediated by severity of interpersonal problems. It is suggested that higher levels of PTSD affect the ability of veterans to initiate and maintain interpersonal relationships and that these interpersonal problems are evident in poorer levels of family functioning and poorer dyadic adjustment.
Combat Disorders↗
Dose-rate effects of ethylene oxide exposure on developmental toxicity.
In risk assessment, evaluating a health effect at a duration of exposure that is untested involves assuming that equivalent multiples of concentration (C) and duration (T) of exposure have the same effect. The limitations of this approach (attributed to F. Haber, Zur Geschichte des Gaskrieges [On the history of gas warfare], in Funf Vortrage aus den Jahren 1920-1923 [Five lectures from the years 1920-1923], 1924, Springer, Berlin, pp. 76-92), have been noted in several studies. The study presented in this paper was designed to specifically look at dose-rate (C x T) effects, and it forms an ideal case study to implement statistical models and to examine the statistical issues in risk assessment. Pregnant female C57BL/6J mice were exposed, on gestational day 7, to ethylene oxide (EtO) via inhalation for 1.5, 3, or 6 h at exposures that result in C x T multiples of 2100 or 2700 ppm-h. EtO was selected because of its short half-life, documented developmental toxicity, and relevance to exposures that occur in occupational settings. Concurrent experiments were run with animals exposed to air for similar periods. Statistical analysis using models developed to assess dose-rate effects revealed significant effects with respect to fetal death and resorptions, malformations, crown-to-rump length, and fetal weight. Animals exposed to short, high exposures of EtO on day 7 of gestation were found to have more adverse effects than animals exposed to the same C x T multiple but at longer, lower exposures. The implication for risk assessment is that applying Haber's Law could potentially lead to an underestimation of risk at a shorter duration of exposure and an overestimation of risk at a longer duration of exposure. Further research, toxicological and statistical, are required to understand the mechanism of the dose-rate effects, and how to incorporate the mechanistic information into the risk assessment decision process.
Administration, Inhalation↗
Gradual painless visual loss: chronic optic neuropathies.
The clinician must be the ultimate medical detective when dealing with chronic optic neuropathies. History taking is crucial. Clinical examination may require supplementation with visual field testing, fluorescein angiography, ocular and orbital ultrasound imaging, CT and MR imaging, blood test data, and cerebrospinal fluid or tissue biopsy data to determine the specific diagnosis. This supplementation is labor-intensive and time-consuming; the visual loss usually will progress throughout the process, frustrating and frightening the patient and physician. The final common pathway is gradual optic atrophy; the appearance of the optic nerve is rarely adequate to determine the cause of the visual loss. This article includes tables that review diagnostic aids and therapies, and lists the frequency with which several disease entities were encountered over 15 years in one tertiary care neuro-ophthalmic practice. If a specific cause is discernible, then a specific therapy may be available. This approach has the best chance of saving the patient's vision with the least toxicity caused by erroneous trials. By necessity, the work-up for these patients is expensive, but the cost of not pursuing the cause is irrevocable, permanent blindness.
Aged↗
Mental health, physical health, and stressors reported by New Zealand Defence Force peacekeepers: a longitudinal study.
The psychological effect of peacekeeping duties on 277 New Zealand Defence Force personnel was investigated using a longitudinal, cross-sectional study. Self-report data were collected in five stages from before deployment to approximately 6 months after return. Multiple measures of mental health, physical health, and stressors were used. Results revealed that the most stressful periods of the deployment, and those with the greatest effect on overall health and well-being, appear to be the predeployment and follow-up stages. These findings demonstrate the need for effective predeployment training and postdeployment debriefing and support.
Adult↗
Group hydrotherapy versus group land-based treatment for chronic low back pain.
Sixty subjects with chronic low back pain (LBP) were sequentially allocated to either hydrotherapy treatment or land treatment groups in order of presentation. Subjects acted as their own controls for a period of three weeks, after which they attended their respective group sessions twice weekly for six weeks. Twenty-eight subjects from each group attended all treatment and assessment sessions. Results indicated that both groups improved significantly in functional ability and in decreasing pain levels. Thoracolumbar mobility did not improve significantly in either group. Overall there was no significant difference found between the two types of treatment, although results should be viewed as encouraging for the advocates of both hydrotherapy and land-based exercise as a treatment for chronic LBP.
Activities of Daily Living↗
Relevance of oral intake and necessity to void as ambulatory surgical discharge criteria.
Discharge criteria used in the outpatient setting of a 500-bed academic medical center were evaluated by nursing staff in two ambulatory units to determine validity in identifying patient readiness for discharge. Criteria categories include temperature, circulation, activity and mental status, pain, bleeding, voiding, and oral intake. The hospital course and post-discharge course of a convenience sample of 248 ambulatory subjects was drawn from consecutive patients. Post-discharge recovery outcomes identified by the telephone assessment included recovery, complications, necessity of further medical treatment, and the need to return to a medical facility. The descriptive results showed the safety of the seven discharge criteria. Voiding and oral intake were related to prolonged stays in the ambulatory units. Approval was granted by the Hospital Policy Board to relax discharge criteria, and make voiding and oral intake optional for patients. A stage II follow-up study of 1,582 patient subjects was conducted using the new criteria of voluntary voiding and oral intake. The average ambulatory stay was reduced 50 minutes after voiding and oral intake were made optional.
Ambulatory Surgical Procedures↗
Race, combat, and PTSD in a community sample of New Zealand Vietnam War veterans.
The association between posttraumatic stress disorder (PTSD), combat exposure, and race was examined in a New Zealand community sample of 756 Vietnam War veterans. Maori veterans reported higher levels of PTSD than their non-Maori counterparts. However, the race effect was shown to be mediated by combat exposure level, rank, and combat role. These findings support differential experience explanations for the relationship between postwar adjustment and race, suggesting that higher levels of psychological symptoms reported by minority group veterans can be accounted for by their experience of higher levels of combat stressors.
Adaptation, Psychological↗
Prevalence of posttraumatic stress disorder, depression and anxiety in a community sample of New Zealand Vietnam War veterans.
OBJECTIVE: The aim of the paper is to investigate the prevalence of posttraumatic stress disorder (PTSD), depression and anxiety in a community sample of New Zealand Vietnam War veterans. METHOD: Data were collected as part of a national survey on the health and mental health of New Zealand Vietnam veterans. Five hundred and seventy-three randomly selected male Vietnam veterans participated in a postal survey. The questionnaire contained a number of demographic, biographical and psychological measures. RESULTS: The results revealed that 10% of the veterans could be classified as PTSD cases and that these veterans exhibited high levels of depression and anxiety. In PTSD cases, 15% were also classified with anxiety, 6% with depression, and 73% were classified with both anxiety and depression. In PTSD cases 94% were classified with more than one additional disorder. In non-PTSD cases 27% were classified with anxiety, and 1% with depression, while 12% experienced both anxiety and depression. CONCLUSIONS: The consequences of comorbidity for research and treatment are discussed and it is suggested that health professionals should be attentive to military experience as a predictor of these disorders.
Adult↗
The impact of the Bosnian conflict on the health and mental health of New Zealanders.
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Bosnia and Herzegovina↗
Effect of the Gulf War on reactivation of adverse combat-related memories in Vietnam veterans.
Symptoms of combat related posttraumatic stress disorder (PTSD) have been reported extensively in Vietnam veterans. A few of these studies have reported situations in which PTSD has been reactivated in veterans with a history of PTSD. The present study reports the effects of media coverage of the Gulf War on a community sample of New Zealand Vietnam veterans. Levels of PTSD, distress, and well-being were assessed before and after the outbreak of hostilities. Most veterans closely followed the media presentation of the war and reported revived memories of Vietnam. Increased memories of Vietnam were associated with higher levels of PTSD and distress. It is suggested that veterans have heightened susceptibility to combat related stimuli because of their previous combat experience and that these stimuli can reactivate PTSD symptoms and distress. Implications of this finding for other groups in the community who harbour residual PTSD effects are discussed.
Adult↗
Mental and physical health status in a community sample of New Zealand Vietnam War veterans.
The data presented in this paper were obtained by a survey involving 573 New Zealand Vietnam veterans. It represents the first comprehensive report on the mental and physical health of a community sample of these ex-service personnel. Although most of these veterans were reasonably healthy for their age, a small proportion was substantially worse off than their Vietnam veteran peers, reporting relatively low levels of psychological wellbeing, relatively high levels of psychological distress and post-traumatic stress disorder, a greater number and severity of physical health symptoms, lower self-rated health status, and making more frequent contacts with health care providers.
Australia↗
The health and mental health of New Zealand Vietnam war veterans with posttraumatic stress disorder.
AIM: To examine the extent of posttraumatic stress disorder (PTSD) in a sample of New Zealand Vietnam veterans and to compare the pattern of health and mental health between veterans classified as posttraumatic stress disorder cases and non-cases. METHOD: Five hundred and seventy-three randomly selected male Vietnam veterans participated in a mailed survey. The questionnaire assessed several mental health dimensions and a number of components of physical health. Demographic and military service details were also gathered. RESULTS: The study classified 12% of the sample of veterans as suffering from posttraumatic stress disorder. The posttraumatic stress disorder group differed from the non-posttraumatic stress disorder group on all measures of physical and mental health. They reported higher symptom scores, more disability days, lower self rated health and made more frequent contacts with health care providers. They also experienced greater anxiety, depression and loss of control, and lower wellbeing. Significant differences on some demographic and military service measures were also found between the groups. CONCLUSIONS: A number of New Zealand Vietnam veterans may be classified as exhibiting the symptoms of posttraumatic stress disorder, with the proportion being comparable to rates found in US studies. Veterans with posttraumatic stress disorder experience significantly poorer physical and mental health. Combat experience in Vietnam appears to contribute to posttraumatic stress disorder level. It is suggested that posttraumatic stress disorder may be under-utilised as a diagnostic category because it may coexist with depression or anxiety states and that physicians should be attentive to military service as an indicator of posttraumatic stress disorder.
Adult↗
Labeling relaxation procedures: impact on adolescent's self-report of effectiveness.
Adolescents are being taught relaxation techniques by health-care professionals with increased frequency. The present study examined the effect, on self-reported relaxation, of labeling passive relaxation techniques as "hypnotic relaxation" or as "relaxation training." Subjects were 64 adolescent college students who scored above the 50th percentile, from a subject pool of 189 potential subjects, on the Spielberger Trait Anxiety Inventory. A two by two by two factorial design was utilized with sex, label (hypnotic relaxation versus relaxation training) and relaxation technique (hypnotic induction versus autogenic training) as the independent variables. Under the guise of an investigation of the physiologic correlates of relaxation, subjects were assigned at random to one of four groups. Manipulations of label and relaxation technique were presented on tape via an intercom system. The dependent variable, perceived degree of relaxation, was obtained using a form presented as a "double check" of the accuracy of the physiologic monitoring equipment to which subjects seemingly were attached. Results indicate that the label attached to relaxation techniques can have a significant effect on an individual's subjective report of relaxation depending on the subject's sex.
Adolescent↗
A short-term longitudinal examination of young adolescent functioning following divorce: the role of family factors.
The purposes of this study were to examine young adolescent functioning over a 2-year period after divorce and to assess the role of two family factors, interpersonal conflict and the parent-adolescent relationship, in predicting such functioning. One hundred and twelve young adolescents, their mothers, and their social studies teachers served as participants. One-half of the adolescent were from recently divorced families and one-half were from married families. Mothers completed measures concerning interparental conflict and the parent-adolescent relationship, adolescents completed a measure of the relationship, and teachers completed measures assessing four areas of adolescent functioning. The results indicated that adolescents from divorced families were functioning less well than those from married families. There were no changes in adolescent functioning and the parent-adolescent relationship from the first to second year postdivorce. High levels of interparental conflict in divorced families were associated with more parent-adolescent relationship problems. In turn parent-adolescent relationships problems served as the best predictor of concurrent and subsequent difficulty in adolescent functioning.
Adolescent↗
Children in context: the role of the family in child psychotherapy.
Over the past several decades, both individual and family-oriented approaches to child therapy have been shown to be of moderate success in reducing children's psychological and behavioral problems. However, the data from comparative outcome research do not yet allow us to determine whether one approach is superior to the other in a broad sense; nor has the research addressed the more prudent question of whether there are specific conditions under which one approach may be preferable to the other. In this article, family factors related to child psychopathology are identified, and it is argued that researchers and clinicians interested in the question of family involvement should increase their focus on the presence of family process variables that may be actively contributing to the child's difficulties. Research issues and clinical guidelines are outlined.
Affective Symptoms↗
Preventing parental child abduction: analysis of a national project.
Recent data from a study indicate that child abduction by a parent is up to six times more frequent than previous estimates had suggested. Relative to parental child abductions, stranger abductions occur on a very infrequent basis. While much attention has been placed on prevention programs for stranger abductions, prevention programs for parental child abduction have been nonexistent. The present study analyzes data from a national hotline program that targeted prevention of parental child abduction. Data were collected on 86 consecutive telephone calls from parents contemplating abduction of their child(ren). These data provide information on demographic variables, level of interparental conflict/violence, reasons for contemplating abduction, and abduction plans. Data are also presented that indicate a mediation program may be effective in preventing some cases of parental child abduction. However, such a mediation program is a very difficult course of action and impacts only a small percentage of parental child abduction cases.
Adolescent↗