Biomedical subjects

J Elisabeth Wells

Publications and source records attributed to J Elisabeth Wells.

At least 19 recordsLinked to original sources

PubMed2006

Te Rau Hinengaro: the New Zealand Mental Health Survey: overview of methods and findings.

OBJECTIVE: To estimate the prevalence and severity of anxiety, mood, substance and eating disorders in New Zealand, and associated disability and treatment. METHOD: A nationwide face-to-face household survey of residents aged 16 years and over was undertaken between 2003 and 2004. Lay interviewers administered a computerized fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Oversampling doubled the number of Māori and quadrupled the number of Pacific people. The outcomes reported are demographics, period prevalences, 12 month severity and correlates of disorder, and contact with the health sector, within the past 12 months. RESULTS: The response rate was 73.3%. There were 12,992 participants (2,595 Māori and 2,236 Pacific people). Period prevalences were as follows: 39.5% had met criteria for a DSM-IV mental disorder at any time in their life before interview, 20.7% had experienced disorder within the past 12 months and 11.6% within the past month. In the past 12 months, 4.7% of the population experienced serious disorder, 9.4% moderate disorder and 6.6% mild disorder. A visit for mental health problems was made to the health-care sector in the past 12 months by 58.0% of those with serious disorder, 36.5% with moderate disorder, 18.5% with mild disorder and 5.7% of those not diagnosed with a disorder. The prevalence of disorder and of serious disorder was higher for younger people and people with less education or lower household income. In contrast, these correlates had little relationship to treatment contact, after adjustment for severity. Compared with the composite Others group, Māori and Pacific people had higher prevalences of disorder, unadjusted for sociodemographic correlates, and were less likely to make treatment contact, in relation to need. CONCLUSIONS: Mental disorder is common in New Zealand. Many people with current disorder are not receiving treatment, even among those with serious disorder.

Algorithms↗

PubMed2006

Prevalence, interference with life and severity of 12 month DSM-IV disorders in Te Rau Hinengaro: the New Zealand Mental Health Survey.

OBJECTIVE: To estimate the 12 month prevalence of DSM-IV disorders in New Zealand, and associated interference with life and severity. METHOD: A nationally representative face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12,992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper the outcomes reported are 12 month prevalence, interference with life and severity for individual disorders. RESULTS: The prevalence of any disorder in the past 12 months was 20.7%. The prevalences for disorder groups were: anxiety disorders 14.8%, mood disorders 7.9%, substance use disorders 3.5%, eating disorders 0.5%. The highest prevalences for individual disorders were for specific phobia (7.3%), major depressive disorder (5.7%) and social phobia (5.1%). Interference with life was higher for mood disorders than for anxiety disorders. Drug dependence, bipolar disorder and dysthymia had the highest proportion of severe cases (over 50%), when severity was assessed over the disorder itself and all comorbid disorders. Overall, only 31.7% of cases were classified as mild with 45.6% moderate and 22.7% serious. CONCLUSIONS: Compared with other World Mental Health survey sites New Zealand has relatively high prevalences, although almost always a little lower than for the US. For all disorders, except specific phobia, interference with life was reported to be moderate, on average, which has lead to less than a third of cases being classified as mild. Most people who have ever met full DSM-IV criteria, including the impairment criterion, and who experience symptoms or an episode in the past 12 months find that their disorders impact on their lives to a non-trivial extent.

Catchment Area, Health↗

PubMed2006

Twelve-month and lifetime health service use in Te Rau Hinengaro: The New Zealand Mental Health Survey.

OBJECTIVE: To estimate the 12 month and lifetime use of health services for mental health problems. METHOD: A nationwide face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0) was used. There were 12 992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are 12 month and lifetime health service use for mental health and substance use problems. RESULTS: Of the population, 13.4% had a visit for a mental health reason in the 12 months before interview. Of all 12 month cases of mental disorder, 38.9% had a mental health visit to a health or non-health-care provider in the past 12 months. Of these 12 month cases, 16.4% had contact with a mental health specialist, 28.3% with a general medical provider, 4.8% within the human services sector and 6.9% with a complementary or alternative medicine practitioner. Most people with lifetime disorders eventually made contact if their disorder continued. However, the percentages seeking help at the age of onset were small for most disorders and several disorders had large percentages who never sought help. The median duration of delay until contact varies from 1 year for major depressive disorder to 38 years for specific phobias. CONCLUSIONS: A significant unmet need for treatment for people with mental disorder exists in the New Zealand community, as in other comparable countries.

Adolescent↗

PubMed2006

Lifetime prevalence and projected lifetime risk of DSM-IV disorders in Te Rau Hinengaro: the New Zealand Mental Health Survey.

OBJECTIVE: To estimate the lifetime prevalence and projected lifetime risk at age 75 years of DSM-IV disorders in New Zealand. METHOD: A nationwide face-to-face household survey carried out in 2003-2004. A fully structured diagnostic interview, the World Health Organization Composite International Diagnostic Interview (CIDI 3.0), was used. There were 12,992 completed interviews from participants aged 16 years and over. The overall response rate was 73.3%. In this paper, the outcomes reported are lifetime prevalence and projected lifetime risk at age 75 years. RESULTS: The lifetime prevalence of any disorder was 39.5%. The lifetime prevalences for disorder groups were: anxiety disorders, 24.9%; mood disorders, 20.2%; substance use disorders, 12.3%; and eating disorders, 1.7%. The prevalences for all disorders were higher in the younger age groups. Females had higher prevalences of anxiety, mood and eating disorders compared with males; males had higher prevalences of substance use disorders. The estimated projected lifetime risk of any disorder at age 75 years was 46.6% with the median age of onset being 18 years. Adjustment for age, sex, education and household income did not remove all differences between Māori and the composite other ethnic group in the risk of disorder (hazard ratio = 1.1-1.4). After adjustment, hazard ratios for Pacific people ranged from 0.8 to 2.5. CONCLUSIONS: These results confirm those of other studies: mental disorders are relatively common and tend to have early onset. Females are more likely to experience anxiety, mood and eating disorders than males, who experience more substance use disorders. Adjustment for socioeconomic factors and demography does not explain all ethnic differences, although remaining differences are small relative to cohort and even sex differences.

Adolescent↗

PubMed2006

Mental disorder comorbidity in Te Rau Hinengaro: the New Zealand Mental Health Survey.

OBJECTIVE: To show the extent and patterning of 12 month mental disorder comorbidity in the New Zealand population, and its association with case severity, suicidality and health service utilization. METHOD: A nationwide face-to-face household survey was carried out in October 2003 to December 2004 with 12,992 participants aged 16 years and over, achieving a response rate of 73.3%. The measurement of mental disorder was with the World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Comorbidity was analysed with hierarchy, consistent with a clinical approach to disorder count. RESULTS: Comorbidity occurred among 37% of 12 month cases. Anxiety and mood disorders were most frequently comorbid. Strong bivariate associations occurred between alcohol and drug use disorders and, to a lesser extent, between substance use disorders and some anxiety and mood disorders. Comorbidity was associated with case severity, with suicidal behaviour (especially suicide attempts) and with health sector use (especially mental health service use). CONCLUSION: The widespread nature of mental disorder comorbidity has implications for the configuration of mental health services and for clinical practice.

Adolescent↗

PubMed2006

Mental-physical comorbidity in Te Rau Hinengaro: the New Zealand Mental Health Survey.

OBJECTIVE: To estimate the prevalence of chronic physical conditions, and the risk factors for those conditions, among those with 12 month mental disorder; to estimate the prevalence of 12 month mental disorder among those with chronic physical conditions. METHOD: A nationally representative face-to-face household survey was carried out in October 2003 to December 2004 with 12,992 participants aged 16 years and over, achieving a response rate of 73.3%. Mental disorders were measured with the World Mental Health version of the Composite International Diagnostic Interview (CIDI 3.0). Physical conditions were self-reported. All associations are reported adjusted for age and sex. RESULTS: People with (any) mental disorder, relative to those without mental disorder, had higher prevalences of several chronic physical conditions (chronic pain, cardiovascular disease, high blood pressure and respiratory conditions) and chronic condition risk factors (smoking, overweight/obesity, hazardous alcohol use). Around a quarter of people with chronic physical conditions had a comorbid mental disorder compared with 15% of the population without chronic conditions. Significant relationships occurred between some mental disorders and obesity, cardiovascular disease and diabetes for females, but not for males. CONCLUSIONS: This paper provides evidence of substantial comorbidity between mental disorders and chronic physical conditions in New Zealand. This should be borne in mind by clinicians working in both mental health and medical services.

Adolescent↗

PubMed2006

Disability in Te Rau Hinengaro: the New Zealand Mental Health Survey.

OBJECTIVE: To show the disability associated with 1 month mental disorders and chronic physical conditions for the New Zealand population, controlling for comorbidity, age and sex. METHOD: A nationally representative face-to-face household survey was carried out from October 2003 to December 2004 with 12,992 participants aged 16 years and over, achieving a response rate of 73.3%. Mental disorders were measured with the World Mental Health (WMH) Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0). Disability was measured with the WMH Survey Initiative version of the World Health Organization Disability Assessment Schedule (WMH WHO-DAS) in the long-form subsample (n = 7435). Outcomes include five WMH WHO-DAS domain scores for those with 1 month mental disorders and with chronic physical conditions. RESULTS: Mood disorders were associated with more disability than anxiety or substance use disorders. Experiencing multiple mental disorders was associated with substantial role impairment. Mental disorders and chronic physical conditions were associated with similar degrees of disability on average. The combination of mental and physical disorders had additive effects on associated disability. CONCLUSIONS: Mood disorders are disabling. The investigation of disability in relation to 1 month rather than 12 month disorders is likely to provide a clearer indication of the disability associated with mood disorders. Although some researchers have queried whether negative mood can lead to 'over-reporting' of disability, recent conceptualizations of disability provide a perspective which may ease such concerns. Comorbidity, of mental disorders or of mental and physical disorders, is disabling.

Adolescent↗

PubMed2006

Suicidal behaviour in Te Rau Hinengaro: the New Zealand Mental Health Survey.

OBJECTIVE: To describe prevalence and correlates of suicidal behaviour in the New Zealand population aged 16 years and over. METHOD: Data are from Te Rau Hinengaro: The New Zealand Mental Health Survey, a nationally representative household survey conducted from October 2003 to December 2004 in a sample of 12,992 participants aged 16 years and over to study prevalences and correlates of mental disorders assessed using the World Mental Health Composite International Diagnostic Interview. Lifetime and 12 month prevalences and onset distributions for suicidal ideation, plans and attempts, and sociodemographic and mental disorder correlates of these behaviours were examined. RESULTS: Lifetime prevalences were 15.7% for suicidal ideation, 5.5% for suicide plan and 4.5% for suicide attempt, and were consistently significantly higher in females than in males. Twelve-month prevalences were 3.2% for ideation, 1.0% for plan and 0.4% for attempt. Risk of ideation in the past 12 months was higher in females, younger people, people with lower educational qualifications, and people with low household income. Risk of making a plan or attempt was higher in younger people and in people with low household income. After adjustment for sociodemographic factors, there were no ethnic differences in ideation, although Māori and Pacific people had elevated risks of plans and attempts compared with non-Māori non-Pacific people. Individuals with a mental disorder had elevated risks of ideation (11.8%), plan (4.1%) and attempt (1.6%) compared with those without mental disorder. Risks of suicidal ideation, plan and attempt were associated with mood disorder, substance use disorder and anxiety disorder. Major depression was the specific disorder most strongly associated with suicidal ideation, plan and attempt. Less than half of those who reported suicidal behaviours within the past 12 months had made visits to health professionals within that period. Less than one-third of those who had made attempts had received treatment from a psychiatrist. CONCLUSIONS: Risks of making a suicide plan or attempt were associated with mental disorder and sociodemographic disadvantage. Most people with suicidal behaviours had not seen a health professional for mental health problems during the time that they were suicidal.

Adolescent↗

PubMed2006

Ethnic comparisons of the 12 month prevalence of mental disorders and treatment contact in Te Rau Hinengaro: the New Zealand Mental Health Survey.

OBJECTIVE: To compare ethnic groups for the 12 month prevalence of mental disorders and 12 month treatment contact in Te Rau Hinengaro: The New Zealand Mental Health Survey. METHOD: Te Rau Hinengaro: The New Zealand Mental Health Survey, undertaken in 2003 and 2004, was a nationally representative face-to-face household survey of 12,992 New Zealand adults aged 16 years and over, including Māori (n = 2595), Pacific people (n = 2236) and a composite Other ethnic group (predominantly European) (n = 8161). Ethnicity was measured using the 2001 census ethnicity question. A fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview (CIDI 3.0) was used to measure disorder. The overall response rate was 73.3%. RESULTS: The 12 month prevalence of any mental disorder was highest in Māori (29.5%; 26.6, 32.4), followed by Pacific people (24.4%; 21.2, 27.6) and Others (19.3%; 18.0, 20.6). Adjustment for age, sex, education and household income reduced differences: Māori (23.9%; 21.3, 26.4), Pacific (19.2%; 16.4, 22.1) and Other (20.3%; 18.9, 21.6). A similar pattern was seen for serious disorder and most individual disorders or disorder groups. After adjustment, Māori were most different from Pacific people and Others for substance use disorder. Both Māori and Pacific people had a higher prevalence of bipolar disorder than Others. Pacific people had the lowest prevalence of major depressive disorder. Among those with disorder, the proportion with a visit for mental health problems to any service was highest among Others (41.1%; 38.1, 44.1), with Māori (32.5%; 28.3, 36.7) intermediate and Pacific (25.4%, 19.4, 31.4) lowest. Adjustment did not alter ethnic differences in service contact. CONCLUSION: Māori, and to a lesser extent Pacific people, have a higher prevalence of 12 month mental disorders than Others. Differences are reduced after adjusting for sociodemographic correlates. Relative to need, Pacific people in particular and Māori are less likely than Others to have contact with services (health or non-health), regardless of sociodemographic circumstances.

Adolescent↗

PubMed2005

Stability and instability in alcohol diagnosis from ages 18 to 21 and ages 21 to 25 years.

BACKGROUND: Only in recent years have longitudinal studies of adolescents diagnosed alcohol use disorders and these have not distinguished between abuse and dependence. This study describes the course of disorder from age 18 to age 25 for abuse and dependence and investigates the extent to which continuities in disorder can be explained by background factors. METHODS: A birth cohort of 1,265 individuals from Christchurch, New Zealand, followed annually to age 16 years then at 18, 21 and 25 years (1,003 at age 25). DSM-IV diagnoses were made from reports of alcohol symptoms at 18, 21 and 25 years. RESULTS: The most stable diagnosis was that of no diagnosis, with 83-91% staying the same from one interview to the next. There were high rates of remission to no disorder; 57-75% for those with initial abuse and 50-54% of those with initial dependence. Nonetheless prior diagnosis was a strong predictor of subsequent diagnosis (ORs of 3.7-27.6). Adjustment for background risk factors reduced these odds ratios but all remained significant and substantial (minimum 2.6). CONCLUSIONS: The dual finding of substantial discontinuity and substantial continuity indicates that both public health and treatment interventions are warranted.

Adolescent↗

PubMed2005

Triphasic MRI of pelvic organ descent: sources of measurement error.

PURPOSE: To identify sources of error when measuring pelvic organ displacement during straining using triphasic dynamic magnetic resonance imaging (MRI). MATERIALS AND METHODS: Ten healthy nulliparous woman underwent triphasic dynamic 1.5 T pelvic MRI twice with 1 week between studies. The bladder was filled with 200 ml of a saline solution, the vagina and rectum were opacified with ultrasound gel. T2 weighted images in the sagittal plane were analysed twice by each of the two observers in a blinded fashion. Horizontal and vertical displacement of the bladder neck, bladder base, introitus vaginae, posterior fornix, cul-de sac, pouch of Douglas, anterior rectal wall, anorectal junction and change of the vaginal axis were measured eight times in each volunteer (two images, each read twice by two observers). Variance components were calculated for subject, observer, week, interactions of these three factors, and pure error. An overall standard error of measurement was calculated for a single observation by one observer on a film from one woman at one visit. RESULTS: For the majority of anatomical reference points, the range of displacements measured was wide and the overall measurement error was large. Intra-observer error and week-to-week variation within a subject were important sources of measurement error. CONCLUSION: Important sources of measurement error when using triphasic dynamic MRI to measure pelvic organ displacement during straining were identified. Recommendations to minimize those errors are made.

Adolescent↗

PubMed2005

Using a diary to quantify learning activities.

BACKGROUND: Diaries of actual learning activities can fill the gap between the planned curriculum and students' opinions and outcomes. We report the development and validity of such a method, estimate sources of variation and model sampling strategies to determine efficient ways to obtain information about a curriculum or about individual students. METHODS: Following development and piloting, the diary was administered to fourth- and fifth-year medical students. Each student was asked to complete a diary on 3 randomly selected days of the academic year. Sources of variance and generalisability were determined using variance components analysis. Validity was explored by comparing activities with what is known about the curriculum, assessment, timetables and the 2 classes of students. RESULTS: Response rate was 83% (287/345). Learning activities varied as expected with timing of assessments, and on weekdays compared with weekends. For most activities, 14 days per student would be needed to obtain generalisable information about an individual student. The variation between days is greater than the variation between students, meaning that sampling for information on a curriculum should include all students and all days of the year but the number of diaries per student could be kept low depending on the desired power to detect any differences. CONCLUSION: Such an evaluation method is feasible and can provide reliable and valid information about study activities. Reasons for good compliance are discussed. Sampling strategies should be tailored to the purpose of the study.

Attitude of Health Personnel↗

PubMed2005

Gender differences in bipolar disorder: age of onset, course, comorbidity, and symptom presentation.

OBJECTIVE: To determine whether men and women with bipolar disorder differ in age of onset, course of illness, number of suicide attempts, comorbidity rates and symptom presentation. METHOD: Data were collected from 211 (121 women; 90 men) adults using the Diagnostic Interview for Genetic Studies, medical records, and additional information gathered from relatives. RESULTS: Most gender comparisons showed no evidence of differences. Nonetheless, more men than women reported mania at the onset of bipolar I disorder. Men also had higher rates of comorbid alcohol abuse/dependence, cannabis abuse/dependence, pathological gambling and conduct disorder. Men were more likely to report 'behavioural problems' and 'being unable to hold a conversation' during mania. Women reported higher rates of comorbid eating disorders, and weight change, appetite change and middle insomnia during depression. CONCLUSIONS: Men and women were generally similar in their symptom presentation, age of onset of bipolar disorder, and in the total number of mood episodes. However, they differed in the type of episode at onset and comorbidity patterns.

Bipolar Disorder↗

PubMed2004

Randomised controlled trial of intravenous antibiotic treatment for cellulitis at home compared with hospital.

OBJECTIVES: To compare the efficacy, safety, and acceptability of treatment with intravenous antibiotics for cellulitis at home and in hospital. DESIGN: Prospective randomised controlled trial. SETTING: Christchurch, New Zealand. PARTICIPANTS: 200 patients presenting or referred to the only emergency department in Christchurch who were thought to require intravenous antibiotic treatment for cellulitis and who did not have any contraindications to home care were randomly assigned to receive treatment either at home or in hospital. MAIN OUTCOME MEASURES: Days to no advancement of cellulitis was the primary outcome measure. Days on intravenous and oral antibiotics, days in hospital or in the home care programme, complications, degree of functioning and pain, and satisfaction with site of care were also recorded. RESULTS: The two treatment groups did not differ significantly for the primary outcome of days to no advancement of cellulitis, with a mean of 1.50 days (SD 0.11) for the group receiving treatment at home and 1.49 days (SD 0.10) for the group receiving treatment in hospital (mean difference 0.01 days, 95% confidence interval -0.3 to 0.28). None of the other outcome measures differed significantly except for patients' satisfaction, which was greater in patients treated at home. CONCLUSIONS: Treatment of cellulitis requiring intravenous antibiotics can be safely delivered at home. Patients prefer home treatment, but in this study only about one third of patients presenting at hospital for intravenous treatment of cellulitis were considered suitable for home treatment.

Adolescent↗

PubMed2004

Functional assessment of bacterial colonization in patients with ileal pouch-anal anastomosis and Brooke ileostomy.

PURPOSE: This study was designed to determine whether patients with an ileal pouch-anal anastomosis have increased gastrointestinal bacterial colonization as assessed functionally compared with patients with Brooke ileostomy and to determine the effect of pouch bacterial colonization on pouch function. METHODS: Gastrointestinal bacterial colonization in 27 patients with an ileal pouch-anal anastomosis and 20 patients with a Brooke ileostomy was assessed using the 14C-glycocholate and glucose-hydrogen breath tests. Bacterial colonization was correlated with pouch function and pouch satisfaction. RESULTS: Patients with ileal pouch-anal anastomosis had increased levels of gastrointestinal bacterial colonization as measured using the 14C-glycocholate method compared with patients with Brooke ileostomy (P = 0.03). Only three patients had a positive result on the glucose hydrogen breath test, two patients with ileal pouch-anal anastomosis, and one with ileostomy; however, the ileal pouch-anal anastomosis patients did have higher levels on this test. Pouch satisfaction and pouch symptoms of urgency were not correlated with levels of bacterial colonization, whereas there was a nonsignificant trend with continence. CONCLUSIONS: We showed increased levels of gastrointestinal bacterial colonization with ileal pouch-anal anastomosis compared with Brooke ileostomy. The increase in bacteria is not limited to the pouch but also are found in the proximal small bowel. There was no correlation between bacterial colonization and urgency, continence, and pouch satisfaction. Reasons for this are discussed.

Anal Canal↗

PubMed2004

How accurate is recall of key symptoms of depression? A comparison of recall and longitudinal reports.

BACKGROUND: Assessment of lifetime major depression is usually made from a single interview. Most previous studies have investigated reliability. Comparison of recall of key symptoms and longitudinal reports shows the accuracy of recall, not just reliability. METHOD: At age 25, 1003 members of the Christchurch Health and Development Study cohort were asked to recall key symptoms of depression (sadness, loss of interest) up to age 21. This recall was compared with longitudinal reports at ages 15, 16, 18 and 21 years. Diagnosis was by DSM-III-R and DSM-IV criteria. RESULTS: Only 4% of those without previous reports recalled key symptoms. Of those with a diagnosis of depression up to age 21, 44% recalled a key symptom. Measures of severity of an episode (number of symptoms, impairment, duration, suicidally) and chronicity (years with a diagnosis, years with suicidal ideation) all strongly predicted recall. Current key symptoms increased recall, even after taking account of severity and chronicity. Being female and receiving treatment also predicted recall, although odds ratios were reduced to 1.6-1.7 when all other predictors were included. Comparison of risk factors for key symptoms showed similar results from longitudinal reports and recall. Sexual abuse, neuroticism, lack of parental attachment, gender, physical abuse and maternal depression were major risk factors in both sets of analyses. CONCLUSIONS: Forgetting of prior episodes of depression was common. Severity, chronicity, current depression, gender and treatment predicted recall. Lifetime prevalence based on recall will be markedly underestimated but the identification of major risk factors may be relatively little impaired.

Adolescent↗

PubMed2004

Drinking patterns in mid-adolescence and psychosocial outcomes in late adolescence and early adulthood.

AIMS: To describe the pattern of drinking at age 16 and to relate this to outcomes at 16-21 years and 21-25 years across a number of psychosocial domains. DESIGN: A prospective birth cohort study with annual follow-up until age 16 then at 18, 21 and 25 years. SETTING: Christchurch, New Zealand. PARTICIPANTS: Of 1265 subjects, 953 were interviewed at age 16. MEASUREMENTS: Multiple measures of family background were collected from birth to 16 years. Alcohol consumption was measured in terms of frequency, usual or last quantity drunk and most drunk per occasion. Problems were also recorded. Questions about psychiatric symptoms enabled Diagnostic and Statistical Manual (DSM) criteria to be applied. Detailed reports on educational outcomes, employment, sexual behaviours and offending were collected. FINDINGS: Four latent classes were required to describe drinking at age 16, but these appeared to lie along a single dimension which strongly predicted outcomes at ages 16-21 and 21-25 across all domains (alcohol-related, substance dependence, mental health, education, sexual relationships and offending). After controlling for background and correlates only a small number of outcomes were still related consistently to drinking at age 16 over both periods: most alcohol-related outcomes, the number of sexual partners and the extent of violent offending. CONCLUSIONS: Drinking at age 16 is a clear indicator of future life-course over most domains in late adolescence and early adulthood. Many of these associations are due to other covariates. Outcomes specific to drinking at age 16 are alcohol outcomes, number of sexual partners and violence.

Adolescent↗

PubMed2004

Are differences between graduates and undergraduates in a medical course due to age or prior degree?

BACKGROUND: The number of medical programmes targeted at graduates is increasing and there are reports of beneficial outcomes. However, many new graduate medical schools have simultaneously changed their admission criteria and curricula. This study aimed to determine whether there were differences between graduates and undergraduates on the same medical course and to establish which differences might be due to having a prior degree, the course itself or age at entry to medical school. METHODS: A questionnaire-based survey was administered to all students in Years 2-5. It included the Study Process Questionnaire, the Achievement Motivation Profile and Likert scale questions on career. RESULTS: Questionnaires were completed by 587 students (response rate 80.3%), of whom 143 had a prior degree. Whilst having a prior degree was associated with many outcomes, for most this disappeared, and the overall predictive ability of the model improved when age was included. Age at entry to medical school brought certainty and motivation about career choice, a prior degree had some effect on approaches to studying and co-operativeness, while the course itself had effects on most outcomes, some of which were positive and some negative. CONCLUSION: Graduates bring a distinct quality to a course but many of these relate to a student's age. Older age at entry may be more important than having a prior degree.

Adolescent↗