Biomedical subjects

Megan Pledger

Publications and source records attributed to Megan Pledger.

13 recordsLinked to original sources

PubMed2006

Trends in alcohol-related harms and offences in a liberalized alcohol environment.

AIM: To assess alcohol-related harms and offences in New Zealand from 1990 to 2003, a period of alcohol policy liberalization, that included the lowering of the purchase age from 20 to 18 years in 1999. DESIGN, SETTING AND PARTICIPANTS: Time trend analyses were carried out on routinely collected data for prosecutions for driving with excess alcohol; alcohol-involved vehicle crashes (all and fatal) and prosecutions for disorder offences. These were carried out separately for those aged 14-15, 16-17, 18-19, 20-24 and 25 years and over. MEASUREMENTS: Rates of: prosecutions for driving with excess alcohol (1990-2003); rates of alcohol- involved vehicle crashes (all and fatal) (1990-2003); and rates of prosecutions for disorder offences (1994-2003). FINDINGS: Effects of alcohol policy liberalization: positive trends were found in the rates of prosecutions for disorder in the 16-17, 18-19, 20-24 and 25 + age groups; with 18-19-year-olds and 16-17-year-olds having the largest rates and largest positive trend in rates. For 16-17-year-olds, there was a positive trend in the rates of prosecutions for excess breath alcohol. Negative trends in rates were found for alcohol-related crashes (all and fatal) among all age groups. Negative trends for those over 16-17 years were found for prosecutions for driving with excess breath alcohol (this was prior to the lowering of the purchase age). Effects of lowering the minimum purchase age: the lowering of minimum purchase age coincided with an increase in the trend of alcohol-related crashes for 18-19-year-olds; the next largest increase was among the 20-24-year-olds (all other age groups also increased but at a much lower rate). A similar result was found for driving with excess alcohol for those aged 18-19 (and those aged 20-24 years). An increase in the rates of prosecutions for disorder offences occurred for the 14-15-year-old group following the lowering of the purchase age. CONCLUSION: The liberalization of alcohol throughout the 1990s may have influenced younger people more, as reflected in increases in their disorder offences and drink driving. The lowering of the minimum purchase age may have led to an increase in drink-driving among the 18-19-year-olds (those directly affected by the change in purchase age).

Accidents, Traffic↗

PubMed2005

New Zealand Pacific peoples' drinking style: too much or nothing at all?

AIMS: To describe the alcohol consumption patterns and related harms of some Pacific peoples (Samoan, Cook Islands Maori, Tongan, Niuean, Fijian, and Tokelauan) living in Aotearoa (New Zealand), and to draw comparisons with measures from the general New Zealand population. METHODS: The Pacific Drugs and Alcohol Consumption Survey (PDACS) was carried out with 1103 randomly selected Pacific peoples aged between 13 and 65 years old who were resident in households throughout New Zealand. The survey used computer-assisted telephone interviewing (CATI) and computer assisted cell-phone interviewing (CACI). The interviews were carried out in 2002/03. We descriptively compare findings from the PDACS with those from the 2000 National Alcohol Survey (NAS). RESULTS: Fifty-seven percent of Pacific peoples were drinkers (males 61%, females 51%), compared with 85% of the general New Zealand population (males 88%, females 83%). The average annual consumption of absolute alcohol was 21 litres for Pacific drinkers (males 28 litres, females 14 litres) compared with 11 litres for general New Zealand population drinkers (males 16 litres, females 7 litres). The typical occasional quantity consumed by Pacific drinkers was eight drinks (males: nine drinks, females: five drinks) compared with four drinks for drinkers in the general New Zealand population (males: five drinks, females: around four drinks). Thirty-three percent of Pacific drinkers consumed enough to feel drunk at least weekly (males 41%, females 25%) compared with 9% of drinker in the general New Zealand population (males 13%, females 6%). Eighteen percent of Pacific males and 10% of Pacific females reported being physically assaulted by someone who had been drinking compared with 8% and 5% of national males and females respectively. Twenty-three percent of Pacific males and 16% of Pacific females got drunk when there was an important reason to stay sober, compared with 8% and 5% of general New Zealand males and females respectively. Nineteen percent of Pacific males and 21% of Pacific females reported being involved in a serious argument after they had been drinking compared with 12% and 8% of general New Zealand males and females respectively. CONCLUSIONS: The proportion of Pacific drinkers is less than the proportion of drinkers in the general New Zealand population. However, Pacific drinkers consume larger annual volumes and typical occasion amounts of absolute alcohol than drinkers in the general New Zealand population. Pacific peoples drinking patterns appear to be more harmful with greater proportions of Pacific peoples reporting violence and injury from other peoples' drinking, and greater proportions of Pacific drinkers reporting problems from violence and serious arguments as a result of their own drinking compared with the general New Zealand population and general New Zealand population drinkers.

Adolescent↗

PubMed2005

Evaluation of a regional community action intervention in New Zealand to improve age checks for young people purchasing alcohol.

This paper describes the evaluation of a regional community action intervention to reduce access to alcohol from off-license premises by minors. The intervention focussed on: (1) monitoring alcohol sales made without age identification from off-licenses; (2) utilizing data on alcohol sales for media advocacy and direct contact with alcohol retailers and (3) working with key enforcement staff to encourage increased monitoring and enforcement of minimum purchase age legislation for off-licenses. Evaluation of this intervention used a case study design. Purchase survey data was obtained before and after intervention. Media items were monitored and included pre- and post-intervention phases. Interviews, with key enforcement staff, and document review were undertaken post-intervention. Purchase survey data showed a significant decrease (p < 0.05) in sales of alcohol made to young people without age identification pre- and post-intervention. Pre-intervention: 60% of visits resulted in a sale made without age identification; post-intervention this proportion was 46%. Principal component analysis of newsprint media indicated increased coverage of items advocating improved age checking for off-licenses following intervention. Interview data and document review indicate that some enforcement staff in the region implemented increased enforcement strategies including, controlled purchase operations and increased visits to off-licenses due to the intervention. Evaluation findings indicate that collaborative and intersectoral community action interventions implemented regionally can be effective in redirecting resources to achieve preventive outcomes at a population level.

Adolescent↗

PubMed2005

Estimating the dollar value of the illicit market for cannabis in New Zealand.

New data collected on the procurement and purchase of cannabis in the 2001 New Zealand National Drug Survey are used to estimate the dollar value of the illicit market for cannabis as well conduct other economic analyses of the illicit purchase of cannabis in New Zealand. Eighty-four per cent of last-year cannabis users received at least some of their cannabis 'free', 38% 'bought' at least some of their cannabis, while only 8% grew any of their supply. By proportion of the total dollar value of the cannabis market, sales of 'tinnies' (1.5 g) had the biggest share of the market (30%), followed closely by 50 NZ dollars bags (4 g) (29%) and ounces (28 g) (26%). The average price paid per gram of cannabis fell steadily from 20.50 NZ dollars per gram for a joint to 5.63 per gram for a pound (NZ dollars). The distribution of spending on cannabis was positively skewed (average 1313 NZ dollars, median 400 NZ dollars, mode 100, range 5 - 55,200, interquartile range 100 - 1200) (NZ dollars). The bottom 50% of cannabis buyers spent a median amount on cannabis of 100 NZ dollars a year while the top 5% spent a median amount of 7425 a year (NZ dollars). The dollar value of the illicit cannabis market was estimated to be 190 million (131 - 249 million) (NZ dollars). Three limitations are acknowledged with the market estimate calculated: (i) the truncated age range of the survey data (13 - 45 years); (ii) the likely underestimation of heavy cannabis use in household drug surveys; (iii) a degree of 'double-counting' when the same cannabis is bought and sold a number of times.

Adolescent↗

PubMed2004

Diurnal, weekly, and seasonal variations in stroke occurrence in a population-based study in Auckland, New Zealand.

AIMS: To determine (via a population-based study in Auckland, New Zealand) if there are diurnal, weekly, or seasonal variations in the occurrence of stroke. METHODS: All new stroke events in Auckland residents were traced. Time of onset of the stroke was defined as the time when neurological symptoms were first noticed. The day of the week and month of onset were analysed for all strokes. RESULTS: 1711 patients were registered over 1 year. The rate ratios for the onset of stroke in each 6-hourly interval compared with reference interval (1800-2359 hours) were 0.74 (95% CI: 0.61-1.10) for 0000-0559 hours, 2.88 (95% CI: 2.48-3.34) for 0600-1159 hours and 1.74 (95% CI: 1.49-2.05) for 1200-1759 hours. Rate ratios of the seasonal occurrence of stroke compared with spring were 0.75 (95% CI: 0.65-0.86) for summer, 0.83 (95% CI: 0.73-0.95) for autumn and 1.08 (95% CI: 0.96-1.23) for winter. No weekly pattern of stroke occurrence was observed. CONCLUSIONS: Strokes were less likely to occur during the summer and autumn than in the winter or spring. There was an increase in the occurrence of stroke in the late morning. The results have implications for the provision of acute stroke services in the community and in hospital.

Humans↗

PubMed2004

Patterns of amphetamine use in New Zealand: findings from the 2001 National Drug Survey.

AIMS: To measure the level of heavy amphetamine use, poly drug use, and intravenous drug use by amphetamine users in New Zealand. METHODS: Using a Computer Assisted Telephone Interview (CATI) system, a national sample of approximately 5500 people (aged 15-45 years) were interviewed about their recreational drug use. RESULTS: Five percent of the sample (4.3-5.7) had used stimulants (uppers, speed, amphetamine, methamphetamine) in the last year. Eighty-one percent of these users used stimulants once-a-month or less frequently. Twenty-two percent used half a gram of stimulants or more on a typical occasion. Stimulant users used an average of 6.4 drug types in the last year (range 1-17, standard deviation [SD] 2.8) and 4.2 drug types in the last month (range 0-13, SD 2.1). Three percent of last-year stimulant users (0.7-4.6) had used a needle to inject drugs in the previous year. CONCLUSIONS: About one in five amphetamine users used quantities of amphetamine in a single session that have been identified in previous research as being hazardous levels. High levels of poly drug use among amphetamine users indicate users may be at risk of problems from a range of drug types and combinations of drug types, and not just from amphetamine alone. Ongoing monitoring is required to identify if increased amphetamine use is a source of increased intravenous drug use.

Adolescent↗

PubMed2004

Gender convergence in alcohol consumption and related problems: issues and outcomes from comparisons of New Zealand survey data.

AIMS: This paper aims to compare women's and men's alcohol consumption patterns and alcohol-related problems in New Zealand in 1995 and 2000, by age groups. Secondary aims are to consider the findings in relation to debates on the gender convergence hypothesis regarding the link between gender convergence in alcohol consumption and possible explanations, such as social role convergence and policy changes. DESIGN: Data were collected in two general population surveys conducted in New Zealand in 1995 (n = 4232) and 2000 (n = 5113) using the same questionnaire. MEASUREMENTS: Quantity consumed on a typical drinking occasion, volume of absolute alcohol consumed per annum, proportions drinking 20+ litres per annum, proportion of total consumption consumed in heavy drinking occasions, frequency of consumption, proportion who drink enough to feel drunk at least once a week, proportions reporting three or more alcohol-related problems and attitudes to intoxication. FINDINGS: Evidence for gender convergence was found across a range of measures of alcohol consumption and alcohol-related problems. In the 20-39-year age group quantities of alcohol consumed on a typical occasion and the related measures of volume, drunkenness and problems all showed convergence. In the groups over 40 years of age convergence occurred in relation to frequency of drinking. In the groups below 20 years, which consumed relatively high quantities and where the differences in consumption between gender groups were relatively small, further convergence did not occur. CONCLUSIONS: Gender convergence took place in New Zealand from 1995 to 2000.

Adolescent↗

PubMed2003

Ecstasy use in New Zealand: findings from the 1998 and 2001 National Drug Surveys.

AIMS: To examine changes in the use of ecstasy, current conditions of supply, harms resulting from use, and the demographics of users. METHODS: National Drug Surveys were conducted in 1998 and 2001. In each survey, a representative national sample of approximately 5500 people aged 15-45 years were asked about their drug use, including ecstasy use, using a Computer Assisted Telephone Interview (CATI) system. Response rates of 79% and 80% respectively were achieved. RESULTS: Last-year use of ecstasy increased from 1.5% in 1998, to 3.4% in 2001. Large increases were found among men aged 20-24 (4.3% to 12.5%), and 25-29 (3.2% to 8.8%). In 2001, 43% of users thought ecstasy was easier to obtain and 29% thought the price was lower compared with a year earlier. About one in ten ecstasy users reported problems related to 'energy and vitality', 'financial position', 'health', and 'outlook on life'. Ecstasy users were predominantly male, aged 20-29, European and single, but were from a broad range of occupational and income-earning groups. CONCLUSIONS: The use of ecstasy in New Zealand increased between 1998 and 2001. Conditions of supply became easier. Users reported problems related to use in a range of areas of their lives. There was little evidence to suggest ecstasy use was limited to high-income-earning professionals.

Adolescent↗

PubMed2003

Socioeconomic status and drinking patterns in young adults.

AIMS: To investigate the relationship between several indicators of socioeconomic status and drinking patterns in young adulthood. DESIGN: Data collected in a longitudinal study of young adults was analysed using repeated-measures models to examine the relationship between income, occupational activity and educational achievement and patterns of drinking. SETTING: These data were collected as part of a longitudinal study ofa birth cohort of New Zealanders. They were interviewed for the most part in a central location using a face-to-face method and a computer-assisted alcohol interview. PARTICIPANTS: The participants were members of the Dunedin Multidisciplinary Health and Development study aged 18, 21 and 26 years. Nine hundred and sixty-nine study members contributed to the analysis. Study members have been found to be broadly representative of the New Zealand population and cross national studies suggest findings are generalizable to other similar market economies. MEASUREMENTS: Three indicators of socioeconomic status were used; educational achievement, occupational activity and income. The educational achievement indicator at age 18 had three levels that ranged from no school qualifications to higher school qualifications. For age 21 two additional categories of tertiary educational achievement were included to make five categories and for age 26 higher tertiary degrees were included in the measure to make six categories. Five categories of occupational activity were used. Income data was also used. Two measures of alcohol consumption were used. These were the frequency of drinking and the typical quantity of alcohol consumed per drinking occasion in the past year. FINDINGS: Frequency of drinking increased over these early adult years and the quantities consumed peaked at age 21 and decreased thereafter for both males and females. Frequency of drinking was influenced by income with the higher income respondents drinking more often and this was persistent overtime. Quantity of drinking was most influenced by educational achievement. The less well-educated young adult drank significantly more during a drinking occasion and at all ages. There was also a relationship between educational achievement and frequency of drinking for males at age 18 and a relationship between women's occupational activity and the quantities they consumed. CONCLUSIONS: The finding that the dimensions of drinking operate differently explains the lack of consistency in previous research, which has investigated socioeconomic status and the volumes of alcohol consumed. The findings of higher quantities consumed among those of lower social status may explain some of the reduced life expectancy found among those with lower socioeconomic status.

Adolescent↗

PubMed2003

A pilot study of a computer-assisted cell-phone interview (CACI) methodology to survey respondents in households without telephones about alcohol use.

An intrinsic drawback with the use of a computer-assisted telephone interview (CATI) survey methodology is that people who live in households without a connected landline telephone are excluded from the survey sample. This paper presents a pilot of the feasibility of a computer-assisted cell-phone interview (CACI) methodology designed to survey people living in households without a telephone about alcohol use and be compatible with a larger telephone based alcohol sample. The CACI method was found to be an efficient and cost competitive method to reach non-telephone households. Telephone ownership was found to make a difference to the typical occasion amount of alcohol consumed, with respondents from households without telephones drinking significantly more than those with telephones even when consumption levels were controlled for socio-economic status. Although high levels of telephone ownership in the general population mean these differences may not have any impact on population alcohol measures they may be important in sub-populations where telephone ownership is lower.

Adolescent↗

PubMed2003

Shoulder pain in people with a stroke: a population-based study.

OBJECTIVE: To measure the occurrence of shoulder pain after stroke. To identify the factors that predict risk of shoulder pain after stroke. DESIGN: Auckland Stroke Study, population-based case-cohort study. SETTING AND SUBJECTS: All cases of stroke, including those managed outside hospital, over a 12-month period ending February 1992 were considered in Auckland. OUTCOME MEASURES: Self-reported shoulder pain at one week, one month and six months after the onset of stroke for each person. RESULTS: A total of 1,761 stroke events were identified. Self-reported shoulder pain among survivors increased from 256/1474 (17%) at one week, to 261/1,336 (20%) at one month and 284/1,201 (23%) at six months. Shoulder pain was positively associated with motor deficit, side of deficit and severity of deficit. In those surviving to six months after stroke, the risk of shoulder pain was higher in those with severe upper limb motor deficit (odds ratio (OR) 4.94; 95% confidence interval (CI) 3.06-7.98) and in diabetics (OR 1.57, 95% CI 1.15-2.14). Risk of shoulder pain increased with time and was lower for those in institutional care. CONCLUSION: Shoulder pain after stroke is common, especially in patients with severe sensorimotor deficits, diabetics and those living at home. Appropriate management may reduce the rate of occurrence.

Adolescent↗

PubMed2002

Trajectories of drinking from 18 to 26 years: identification and prediction.

OBJECTIVE: To identify developmental trajectories of drinking between the ages of 18 and 26 years and to identify variables, amenable to policy influence, which predict these trajectories. DESIGN: Longitudinal data were analysed using latent class mixture modelling. SETTING: Participants were interviewed in a central location. PARTICIPANTS: Provincial city birth cohort, cross-national studies suggest findings are generalizable to other similar market economies. MEASUREMENTS: The frequency of drinking over the past year and the typical quantity consumed per drinking occasion were computed from five location-specific questions. Measures used to predict membership of trajectory groups were ease of access to alcohol, drinking on licensed premises, response to alcohol advertising, educational achievement, parental consumption, age of onset of regular drinking and living arrangements. RESULTS: Three trajectories of quantities consumed showed reduced consumption after age 21 but one trajectory showed marked increases. Three trajectories of frequency of drinking increased or remained stable over time. Access to licensed premises at age 18 had the most significant impact on membership of the trajectory groups and educational achievement had a significant impact on membership of the heavier quantity trajectory groups. Parental alcohol consumption, access to alcohol at 15 years, liking for alcohol advertising, living arrangement and age of onset of regular drinking also influenced trajectory membership. CONCLUSIONS: Quantity and frequency of drinking in adolescence and early adulthood had different trajectories. Membership of heavier drinking groups was affected by environmental influences which are subject to policy change, particularly that of earlier access to licensed premises. In a small group high-quantity consumption did not decrease at age 26.

Adolescent↗

PubMed2002

Survey data need not underestimate alcohol consumption.

BACKGROUND: There are two main ways to assess alcohol consumption in a population: per capita estimates, usually derived from data on taxable alcohol available for consumption, and population-based surveys. Population-based survey estimates of alcohol consumption are often compared with estimates based on taxable alcohol available for consumption as a measure of validity. Discrepancies between these two measures occur, with the majority of population-based surveys substantially underestimating taxable alcohol available for consumption. METHODS: This article argues, however, that high proportions of taxable alcohol available for consumption can be accounted for by population-based surveys and reports a method of data collection for a national alcohol survey that has accounted for 94% of the taxable alcohol in New Zealand. RESULTS: The ability of the survey methodology to account for this proportion of taxable alcohol is likely due to the within-location beverage-specific alcohol consumption measures used in the survey, the process of recording the quantity of alcohol consumed, the use of a computer-assisted telephone interview system, and the population coverage achieved. CONCLUSIONS: Population-based surveys using the methodology outlined in this article may account for, if not exceed, the high proportions of taxable alcohol available for consumption estimates for some populations.

Adolescent↗