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Biomedical subjects

John Langley

Publications and source records attributed to John Langley.

At least 19 recordsLinked to original sources
PubMed2006

Work-related bystander deaths in New Zealand: a significant hidden problem.

OBJECTIVES: To estimate the extent of bystander work-related traffic fatal injury for New Zealand as well as the contribution of all bystander events to the total burden of work-related fatal traffic injury and work-related fatal injury in general. METHODS: Potential cases were identified from national administrative databases. The circumstances of the deaths in each incident were reviewed directly from coronial files to determine work-relatedness. RESULTS: For 1985-1998 we identified 1447 people whose death was associated with another person's work activity on a public road and who were not working at the time. This compares with 241 "working" and 192 "commuting" deaths on a public road for the same period. Bystanders thus represented approximately 75% of the work-related fatal traffic crash injury problem. We estimate that (on average) approximately 115 bystanders were killed each year and this represents approximately 52% of the total work-related fatality problem. CONCLUSIONS: Work-related bystander deaths are a major contributor to work-related injury in New Zealand, the majority occurring in the context of road traffic crashes. These deaths deserve more attention than they have received to date.

Accidents, Traffic↗
PubMed2006

Domestic violence as witnessed by New Zealand children.

BACKGROUND: This study reports on domestic violence in New Zealand families witnessed by members of the Dunedin Multidisciplinary Health and Development Study. METHOD: Questions on the witnessing of father to mother and mother to father physical violence and threats of harm up to the age of 18 were included in a retrospective family violence interview carried out when the cohort was interviewed at age 26. Study members who reported violence between parents were asked about the nature, context, and consequences of this violence. RESULTS: One-quarter (24%) of the sample reported violence or threats of violence directed from one parent to the other. Nine percent reported infrequent assaults while one in 10 reported more than five acts of physical violence. In violent families, 55% reported violence by fathers only, 28% by both partners, and 16% by mothers only. Almost 90% of the exposed group witnessed violence between natural parents, and 80% were exposed to violence before the age of 11. The gender of the study member or parent did not predict how upset study members were, but frequency of violence did. Witnesses were more likely than non-witnesses to have diagnoses of anxiety and depression at age 21. Socioeconomic status and age of parents were related to violence patterns, but not the mother's education or employment status. CONCLUSION: This study suggests that a quarter of young adults have been exposed to acts or threats of violence carried out by one parent toward another parent, and the majority found such witnessing to be a very upsetting experience. Public education programmes should emphasise that all violence carries risk of harm to all family members.

Adolescent↗
PubMed2006

On the receiving end: young adults describe their parents' use of physical punishment and other disciplinary measures during childhood.

AIM: To investigate the prevalence, nature, and context of physical punishment and other forms of parental discipline, as reported by study members (SMs) of the Dunedin Multidisciplinary Health and Development Study. METHODS: 962 26-year-old adults (born in Dunedin, New Zealand) were interviewed about their experiences of discipline in childhood. Study members were asked about the usual forms of punishment received in primary and secondary school years, as well as the worst punishment they ever received. Details regarding the study members' reactions to different punishments were collected. Variables related to the person administering the punishment were also investigated. RESULTS: Of the study members providing data, 80% reported receiving physical punishment at some time during childhood: 29% identifying smacking; 45% reporting being hit with an object; and 6% reporting extreme physical punishment as the most severe form. Physical punishment on a regular basis was reported by 71% of study members. Results varied by age with more study members reporting physical punishment in primary school years. However, the number of study members experiencing physical punishment in adolescence was still high, at 47%. Significant gender differences were found in reported punishment, with more girls smacked, and more boys hit with an object in primary school years. Punisher-related reports showed that mothers were significantly more likely to employ non-physical forms of punishment whereas fathers were significantly more likely to use extreme physical punishment. CONCLUSION: For many New Zealanders, experiences of physical punishment during childhood are very much the norm. These findings have implications for the young adults studied as they now enter the parenting years and for efforts aimed at prevention and early intervention for at-risk groups.

Adolescent↗
PubMed2006

The use of pencil lead as a matrix and calibrant for matrix-assisted laser desorption/ionisation.

Pencil lead is shown to be an effective matrix and calibrant in matrix-assisted laser desorption/ionisation (MALDI) mass spectrometry. Various groups of analytes, including peptides, polymers and actinide metals, can be readily ionised using MALDI when deposited onto a pencil lead matrix. The matrix is seen to have advantages in sample preparation relating to its hydrophobic properties and almost complete suppression of the matrix during analysis. Using pencil lead as a matrix is a quick and convenient method of qualitative analysis and has been shown to be quantitative for the isotope ratio analysis of actinide metals.

Actinoid Series Elements↗
PubMed2006

Adolescent personality disorders in adolescent medicine.

Both BPD and ASPD are disorders whose complex presentations pose numerous clinical challenges to all health care professionals. However, early careful diagnosis and management can diminish the long-term morbidity of these illnesses and offer the hope of a better outcome. As data emerge regarding the long-term prognosis and effective treatment of PDs, clinicians are cautioned to avoid the traditional teaching that the dysfunctional patterns will necessarily continue into adulthood.

Adolescent↗
PubMed2005

Work-related fatal traffic crashes in New Zealand: 1985-1998.

AIM: To identify and describe all work-related traffic fatalities in New Zealand between 1985 and 1998 inclusive. METHODS: Potential cases were identified from databases held by three national agencies. The circumstances of the deaths in each fatal incident were reviewed directly from coronial files to determine work-relatedness. RESULTS: The rate of work-related fatal injury involving vehicles on a public road was 2.01 per 100,000 workers per year. The rate for worker deaths was 1.11 and that for commuting deaths was 0.89 per 100,000 workers per year. CONCLUSIONS: There is a substantial number of work-related crash fatalities each year and these represent a sizeable portion of the total burden of work-related fatalities.

Accidents, Traffic↗
PubMed2005

Computerised screening for hazardous drinking in primary care.

INTRODUCTION: Brief interventions undertaken in primary care settings have been shown consistently to reduce hazardous drinking, but they are not commonly offered in practice. The aims were to determine the uptake by young people of an offer of screening in a primary care setting; to identify patients' drinking risk levels; and to estimate the proportion who would consent to computerised brief intervention and follow-up. METHODS: Participants were 1120 patients attending a university student health service that were invited for screening while in the waiting room. Participants were also asked for their consent to be contacted for follow-up assessment 1, 6, and 12 months later. RESULTS: 1,010 patients (90%) accepted the invitation for screening. Of these, 35 (4%) failed to complete screening, thus leaving 975 with complete Alcohol Use Disorders Identification Test (AUDIT) data. Sixty percent of women and 73% of men screened positive. Twenty-three patients (4%) eligible for intervention declined follow-up assessments. DISCUSSION: The study demonstrates that the primary care setting can be used to facilitate access via computer to a large number of individuals whose drinking is hazardous. Limitations of the study include the use of an educated segment of the population who may be more receptive to computerised screening than other groups. Strengths of the study include the high rate of participation and the naturalistic setting in which the data were collected.

Adolescent↗
PubMed2005

Episode-centred analysis of drinking to intoxication in university students.

AIMS: To demonstrate the use of an internet-based retrospective diary to measure intoxication and to describe the epidemiology of intoxication in a university community. METHODS: A probability sample of 1564 New Zealand university students completed an Internet-based survey (82% response), including a retrospective diary in which the volume consumed on each of the preceding seven days and the duration of each episode were recorded, along with the respondent's gender, weight, and their typical quantity/frequency of consumption, as a measure of tolerance. These parameters were used to compute an estimated blood alcohol concentration (EBAC) for each episode. RESULTS: Using an EBAC of 0.08 g/100 ml as a criterion for intoxication produced lower estimates of incidence than binge drinking guidelines (>40 g for women, >60 g for men), or subjective reports. EBACs of 0.08 g per cent were exceeded at least weekly by 37% of women and 39% of men. Teenage females had higher EBACs than teenage males, despite lower consumption. Intoxication was positively associated with lower age, European or Maori ethnicity relative to Asian, Pacific, or other ethnicities, and with residential halls relative to other living arrangements. Faculty of study was inconsistently related to intoxication. DISCUSSION: Frequent drinking to intoxication is normative behaviour in this population group. Of particular concern are intoxication levels in females aged 16-21 years and in males throughout their 20s. The web-based retrospective diary is a useful means of measuring intoxication by self-report. Where time permits it can be enhanced by specification of drinking locations and beverage-specific questions.

Adolescent↗
PubMed2005

Effects of service delivery versus changes in incidence on trends in injury: a demonstration using hospitalised traumatic brain injury.

Though injury incidence and hospitalisations are likely to be correlated, a range of factors other than incidence of injury in a population may influence trends in hospitalised injuries. These include technical changes in the hospital data's coverage, and real changes in the incidence of hospitalisations independent of the population incidence. This paper addresses the latter using the example of traumatic brain injury (TBI) hospitalisations in New Zealand. Data were New Zealand public hospitals inpatient discharges. Five measures of TBI severity were used. The relative rate of minor to serious TBI hospitalisations declined by approximately 2-6% per year from 1988 to 1998. This decline is observed across different mechanisms and the two severity measures used in the detailed analysis. The relative decline in minor to serious TBI is likely to be related to a change in the probability of admission rather than a change in the population TBI incidence. As most TBI hospitalisations are minor this suggests the trend in TBI hospitalisations was significantly influenced by factors other than changes in population incidence. Any analysis of routinely collected secondary injury data needs to consider case selection carefully, especially if trends are being examined. Applying a severity threshold should give more reliable trends.

Adolescent↗
PubMed2005

Mental disorder and violent victimization in a total birth cohort.

OBJECTIVE: We examined the association between mental disorder and violent victimization in a general population sample. METHODS: We performed a multivariate analysis of violent victimization in a 12-month period on a total birth cohort with follow-up data that assessed, during their 21st year, males and females born in Dunedin, New Zealand, in the early 1970s. RESULTS: Compared with people with no mental disorder, (1) people with anxiety disorders experienced more sexual assaults, (2) people with schizophreniform disorders experienced more threatened and completed physical assaults, (3) people with alcohol dependence disorders experienced more completed physical assaults, and (4) people with marijuana dependence disorders experienced more attempted physical assaults. These results held after control for psychiatric comorbidity, demographic characteristics, and the study participants' own violent behavior. CONCLUSION: Mentally disordered young adults tend to experience more violent victimization in the community than those without a mental disorder.

Adult↗
PubMed2004

Dog bite injuries.

AIMS: To describe the extent of the dog bite problem in New Zealand for the period 1989 to 2001. METHODS: Fatalities and cases requiring public-hospital treatment identified from the New Zealand Health Information Service databases. RESULTS: There was one fatality and 3119 hospitalisations, an average of 240 per year. Those most at risk were males and children under 9 years of age. The incidence rate of dog bites has continued to increase from that reported previously. There has been a increase in recent years but it is difficult to determine whether this is real effect or an artefact of coding. CONCLUSIONS: Dog bite injuries represent a significant public health problem in New Zealand. Ongoing monitoring is required to determine if dog control policies are having the intended effect.

Adolescent↗
PubMed2004

The New Zealand child work-related fatal injury study: 1985-1998.

AIMS: To estimate the numbers and rates of work-related fatal injury for children under the age of 15 years. METHODS: Potential cases of work-related injury deaths of persons aged <15 years of age were identified from the national electronic mortality data-files for the period 1985-1998 inclusive. The circumstances of the death in each fatality incident were reviewed directly from coronial files to determine work-relatedness. RESULTS: A total of 87 workplace work-related fatalities were identified. The vast majority of children identified were fatally injured while a bystander to another person's work. Workplace bystander involvement was found to vary by age, with the majority of workers identified aged 10-14 years old. With a third of all fatalities, the agricultural industry was the most common industry for workplace work-related fatalities in children. In the period 1985-94, children <15 years of age were found to account for 46% of New Zealand's total workplace bystander deaths. CONCLUSIONS: Children contribute significantly to the overall burden of work-related fatal injury in New Zealand, especially as bystanders to other people's work. The high contribution to bystander deaths by children aged <15 years suggests that hazard control in certain work settings is lacking.

Accidents, Occupational↗
PubMed2004

Motorcycle rider conspicuity and crash related injury: case-control study.

OBJECTIVE: To investigate whether the risk of motorcycle crash related injuries is associated with the conspicuity of the driver or vehicle. DESIGN: Population based case-control study. SETTING: Auckland region of New Zealand from February 1993 to February 1996. PARTICIPANTS: 463 motorcycle drivers (cases) involved in crashes leading to hospital treatment or death; 1233 motorcycle drivers (controls) recruited from randomly selected roadside survey sites. MAIN OUTCOME MEASURES: Estimates of relative risk of motorcycle crash related injury and population attributable risk associated with conspicuity measures, including the use of reflective or fluorescent clothing, headlight operation, and colour of helmet, clothing, and motorcycle. RESULTS: Crash related injuries occurred mainly in urban zones with 50 km/h speed limit (66%), during the day (63%), and in fine weather (72%). After adjustment for potential confounders, drivers wearing any reflective or fluorescent clothing had a 37% lower risk (multivariate odds ratio 0.63, 95% confidence interval 0.42 to 0.94) than other drivers. Compared with wearing a black helmet, use of a white helmet was associated with a 24% lower risk (multivariate odds ratio 0.76, 0.57 to 0.99). Self reported light coloured helmet versus dark coloured helmet was associated with a 19% lower risk. Three quarters of motorcycle riders had their headlight turned on during the day, and this was associated with a 27% lower risk (multivariate odds ratio 0.73, 0.53 to 1.00). No association occurred between risk and the frontal colour of drivers' clothing or motorcycle. If these odds ratios are unconfounded, the population attributable risks are 33% for wearing no reflective or fluorescent clothing, 18% for a non-white helmet, 11% for a dark coloured helmet, and 7% for no daytime headlight operation. CONCLUSIONS: Low conspicuity may increase the risk of motorcycle crash related injury. Increasing the use of reflective or fluorescent clothing, white or light coloured helmets, and daytime headlights are simple, cheap interventions that could considerably reduce motorcycle crash related injury and death.

Accidents, Traffic↗
PubMed2004

Challenges for surveillance for injury prevention.

Injury surveillance has, and will continue to have, a critical role to play in reducing injury. If injury surveillance is going to realise its full potential in reducing injury, however, there are a number of challenges we need to address. These include: (1) agreeing on what is an injury, (2) focusing on important injuries, (3) improving surveillance of important injury events, and (4) improving surveillance of risk and protective factors.

Health Priorities↗
PubMed2004

Assessment of nonresponse bias in an internet survey of alcohol use.

BACKGROUND: Decreasing survey response rates are a growing concern in epidemiological research, principally because prevalence estimates may be biased by selective nonresponse. Internet-based methods have the potential to yield higher-quality data with lower nonresponse rates and at a lower cost than traditional methods. Little research exists on nonresponse bias in Internet surveys of alcohol use. This investigation draws on a study of the implementation of an Internet-based alcohol survey involving a random sample of 1910 university students with a response rate of 82% (n = 1564). Our aim was to identify nonresponse bias and to quantify its effects on estimates of alcohol consumption, the incidence of alcohol-related problems, and the prevalence of hazardous drinking. METHODS: Survey nonresponse has been characterized in terms of a continuum of resistance model, in which the propensity of individuals to respond is inferred from the level of effort required to elicit a response. Two methods were used to test this model: comparison of the demographic characteristics of the target sample with those of the respondents and comparison of alcohol variables for those who responded late with those who responded early. RESULTS: The results attained with method 1 showed that bias varied as a function of gender, age, ethnicity, and living arrangement. The results attained with method 2 showed that the incidence of alcohol-related problems and hazardous drinking prevalence varied as a function of response latency. If only the early and intermediate respondents had participated, the incidence of alcohol-related problems and the prevalence of hazardous drinking would each have been underestimated by 3%. CONCLUSIONS: The findings reported here are consistent with the continuum of resistance model but show that the bias resulting from nonresponse is arguably too small to be of concern with respect to estimating consumption levels, the incidence of alcohol-related problems, and the prevalence of hazardous drinking.

Adolescent↗