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Biomedical subjects

Rob McGee

Publications and source records attributed to Rob McGee.

At least 19 recordsLinked to original sources

Brief report: Disposable income, and spending on fast food, alcohol, cigarettes, and gambling by New Zealand secondary school students.

We describe self-reported sources of income and expenditure, and the association between part-time employment and spending on fast food, alcohol, cigarettes, and gambling for a sample of 3434 New Zealand (NZ) secondary school students (mean age 15.0 years). Disposable income was usually received from parents and guardians, but nearly 40% of students also reported receiving money from part-time employment. The proportion of students employed increased as socioeconomic rating increased, and was associated with increased purchasing of fast food and alcohol, and increased spending on cigarettes and gambling. Spending by youth has obvious public health implications, particularly when it is concentrated on products that have a negative health impact.

Adolescent↗

Health outcomes in adolescence: associations with family, friends and school engagement.

AIM: To examine the associations between connectedness to family and friends, and school engagement, and selected health compromising and health promoting behaviours in a sample of New Zealand adolescents. METHODS: A web-based survey was designed and administered to a random sample of 652 Year 11 students aged 16 years from all Dunedin (NZ) high schools between 30th July and 31st October 2001. Connectedness to family and friends, and school engagement were assessed, together with reports of various health compromising and health promoting behaviours. Logistic regression was used to determine the extent to which these family, friends and school variables were related to health compromising and health promoting behaviours. RESULTS: School engagement was strongly related to both low levels of health compromising and high levels of health promoting behaviours. Connectedness to family was associated primarily with fewer reports of suicidal ideation and increased reports of physical activity. Connectedness to friends was associated in the main with increased reports of health compromising behaviours. CONCLUSION: This study reinforces the importance of school and family as support networks for young people. School may well play an especially important role in health promotion among young people. The mechanisms by which engagement with school operates need to be explored further.

Adolescent↗

Predictors of persistent smoking and quitting among women smokers.

This study examined predictors of persistent tobacco smoking and smoking cessation in a longitudinal study of women's health. The sample consisted of 575 women, with an average age of 34 years at baseline. Follow-up occurred some 13 years later. Two models of smoking behavior were examined, the first identifying correlates of daily smoking at baseline and the second identifying predictors of subsequent quitting at follow-up among those smoking at baseline. Poor maternal education, being young at birth of first child, high level of anxiety, having a partner who smoked, and high tea/coffee consumption were all associated with smoking at baseline. Being a young mother and number of cigarettes smoked at baseline predicted subsequent persistent smoking while high levels of anxiety significantly predicted subsequent quitting.

Adult↗

Parental tobacco smoking behaviour and their children's smoking and cessation in adulthood.

AIMS: To examine the extent to which childhood exposure to parental tobacco smoking, smoking cessation and parental disapproval of smoking predicts daily smoking and attempts to quit in adulthood. DESIGN: A longitudinal prospective design was used to examine the possible association between parental smoking variables in childhood and adolescence and subsequent smoking and cessation by age 26 years. PARTICIPANTS: Interview data were collected as part of a longitudinal study of some 950 individuals followed from birth to age 26 years. Outcome measures were daily smoking and self-reported attempts to quit smoking. FINDINGS: Less daily smoking among the participants at age 26 was related more strongly to parental smoking cessation in the adolescent years than the childhood years. By contrast, inconsistent advice about smoking in childhood and adolescence predicted later daily smoking. Cessation attempts to age 26 were unrelated to earlier parental quitting but were related to consistent advice in adolescence from both parents about smoking. CONCLUSIONS: Encouraging parents to voice consistent messages about their disapproval of smoking has a significant role to play in discouraging smoking in their adult children and promoting attempt to quit where their children are smokers.

Adolescent↗

Tobacco imagery on New Zealand television 2002-2004.

Considerable emphasis has been placed on the importance of tobacco imagery in the movies as one of the "drivers" of smoking among young people. Findings are presented from a content analysis of 98 hours of prime-time programming on New Zealand television 2004, identifying 152 scenes with tobacco imagery, and selected characteristics of those scenes. About one in four programmes contained tobacco imagery, most of which might be regarded as "neutral or positive". This amounted to about two scenes containing such imagery for every hour of programming. A comparison with our earlier content analysis of programming in 2002 indicated little change in the level of tobacco imagery. The effect of this imagery in contributing to young viewers taking up smoking, and sustaining the addiction among those already smoking, deserves more research attention.

Adolescent↗

Is there a relation between school smoking policies and youth cigarette smoking knowledge and behaviors?

To comply with workplace legislation, New Zealand schools are required to have policies regarding tobacco smoking. Many schools also have policies to prevent tobacco use by students, including education programmes, cessation support and punishment for students found smoking. This paper investigated the associations between school policies and the prevalence of students' cigarette smoking. Furthermore, we investigated the association between school policy and students' tobacco purchasing behavior, knowledge of health effects from tobacco use and likelihood of influencing others not to smoke. Data were obtained from a self-report survey administered to 2,658 New Zealand secondary school students and staff from 63 schools selected using a multi-stage sampling procedure. Components of school policy were not significantly associated with smoking outcomes, health knowledge or health behavior, and weakly related to a punishment emphasis and students advising others to not smoke. Similarly, weak associations were found between not advising others to not smoke and policies with a punishment emphasis as well as smoke-free environments. The results suggest that having a school tobacco policy was unrelated to the prevalence of tobacco use among students, tobacco purchasing behavior and knowledge of the negative health effects of tobacco.

Adolescent↗

Access to tobacco products by New Zealand youth.

AIMS: To describe the sources of cigarettes for under-age youth who had smoked in the previous month, the frequency of their purchases and the revenue generated. METHODS: A self-report questionnaire was administered to 3434 secondary school students from 82 schools, randomly selected using multi-stage cluster sampling. RESULTS: Over one-third of the students who smoked had purchased tobacco products from commercial sources in the month before the survey; most frequently from dairies and service stations. For more than one-third of smokers (35.7%), being younger than 18 years was not a barrier to purchasing tobacco products. During 2002, the retail value of tobacco sales to those 14-16 years, alone, was estimated to be in excess of 18 million dollars, with around 12.5 million dollars of this going to the Government as taxes. CONCLUSIONS: Policies that restrict youth access to tobacco products can only be effective if they are rigorously enforced. Many young New Zealanders have no difficulty in purchasing tobacco products, thereby generating significant revenue. Total sales to all smokers under 18 years would be likely to exceed of 24 million dollars, with around 17 million dollars in taxes. Current legislation and enforcement is not a sufficient deterrent to ensure retailer compliance with age restrictions. It would be appropriate to use at least some of the revenue from under-age sales to fund health promotion programmes to reduce tobacco smoking and other health-compromising behaviours among youth. Nationally collated data on monitoring visits, prosecutions, and fines for under-age sales are currently not readily available, thereby limiting opportunities for evaluation.

Adolescent↗

Participation in clubs and groups from childhood to adolescence and its effects on attachment and self-esteem.

We examined social participation in organized clubs and groups from childhood to adolescence in a sample of young people from Dunedin, New Zealand. Groups were broadly categorized as "sports" and "cultural/youth" groups. While the results indicated high levels of participation in childhood with a decline over the ensuing adolescent years, path analyses suggested strong continuities in participation over time. Both family "active-recreational" orientation (ARO) and "intellectual-cultural" orientation (ICO) predicted participation, and mediated the effects of disadvantage on participation. Participation was significantly related to adolescent attachment to parents, friends and school/workplace, as well as self-perceived strengths, after controlling for early family disadvantage and social support, peer attachment and literacy. The effect of participation in adolescence is to widen the "social convoy" to which young people are exposed as well as strengthening relationships within that convoy.

Adolescent↗

Weapon carrying in a sample of high school students in New Zealand.

OBJECTIVE: To examine self-report of carrying weapons and correlates in a sample of New Zealand high school students. METHOD: A sample of 652 Year 11 students from all Dunedin high schools completed a web-based version of the US Youth Risk Behaviour Survey. This included questions on weapon carrying, fighting, and feeling unsafe at school, as well as measures of family and peer/friend connectedness and perception of school climate. RESULTS: Reports of ever carrying a weapon and carrying one in the last 30 days were relatively common, being 27.5% and 19.3% respectively. Weapon carrying in the last 30 days was strongly associated with being male, fighting in the last year, missing school due to feeling unsafe, and a poorer perception of school climate. CONCLUSIONS: Many high school students report weapon carrying, which in turn was associated with other aspects of physical aggression. Further study of the lethality of weapons being carried and the context in which they might be used is clearly warranted.

Adolescent↗

Is cigarette smoking associated with suicidal ideation among young people?

OBJECTIVE: The authors examined the association between suicidal ideation in early adulthood and daily tobacco smoking in a community sample of adolescents. METHOD: Participants were enrolled in a longitudinal study of health and development. The factors of disadvantage, impulsiveness, stress, depressed mood, tobacco smoking, other substance use, and parental attachment were included in multivariate modelling of suicidal ideation. RESULTS: Data on tobacco use were available for 764 participants. Early tobacco smoking was significantly predictive of later suicidal ideation, but there was no longer a significant relationship when high levels of stress and depression and low levels of parental attachment in adolescence were included in the multivariate model. CONCLUSIONS: Tobacco smoking in adolescence does not appear to elevate the risk of later suicidal ideation.

Adolescent↗

An assessment of the validity and reliability of dental self-report items used in a National Child Nutrition Survey.

OBJECTIVES: To examine the clinical validity and reliability of dental self-report items used in a National Child Nutrition Survey. METHODS: The study involved completion of dental self-report questionnaires by 6-9-year-old children who attended one of the three schools with ethnic distributions, similar to schools in the national survey, and their care-givers. Children were then dentally examined. RESULTS: Two hundred and four children (response rate 74.2%) returned questionnaires and were dentally examined. The highest degree of child and care-giver concordance for the self-reported dental items was for the "has had an extraction due to dental caries" item (kappa = 0.92), while the lowest was for the "brushes twice or more per day" item (kappa = 0.61). The prevalence of dental caries in the deciduous dentition was 67.6%. The mean dfs, mean DFS and mean number of missing primary teeth because of caries were 6.15 (SD 6.51), 0.83 (SD 1.28) and 0.30 (SD 0.82), respectively. Caries severity was higher in children who reported brushing infrequently, having received a filling, having had an extraction because of caries, having been kept awake at night because of dental pain or having had a general anaesthetic for dental treatment. Values for self-report and clinical reliability were above 0.80 in all instances. CONCLUSIONS: The dental self-report items showed a high level of concordance between child and care-giver, and appeared to be clinically valid. The findings suggest that using dental self-report measures for children may be valuable in dental epidemiological investigations.

Analysis of Variance↗

Observations of summer sun protection among children in New Zealand: 1998-2000.

AIMS: To examine sun protection among New Zealand children (ten years and under) at beaches and playgrounds. METHODS: In the summers of 1998, 1999 and 2000, observations were made of 753 children at selected beaches and playgrounds in Dunedin and Hawkes Bay to determine the extent of sun protection. Parents/carers were also interviewed about sun protection. RESULTS: Across most body sites, levels of protection were high. Clothing and SPF15+ sunscreen were used most often, while the use of shade was relatively low. About four in every ten parents/caregivers were aware of the UV index or burn-time. Level of sun protection among children at beaches was best predicted by parent/carer's own level of protection, the child's perceived susceptibility to burning, and being a preschooler. CONCLUSIONS: Observed levels of sun protection among the children were high and most likely reflected an increased awareness among parents and carers of the social acceptability of protective behaviours. Nevertheless, opportunities to seek shade were limited, and the provision of shade at beaches and playgrounds represents an important next step in a community wide approach to sun protection.

Adult↗

Application of a falls prevention program for older people to primary health care practice.

BACKGROUND: Our research group has established the effectiveness of an individually tailored home exercise program to prevent falls and fall injuries in older people in four controlled trials. In one of these trials we evaluated the applicability of the exercise program to routine primary health care practice and the feasibility of nurses implementing the program. METHODS: People aged 80 years and older, registered with general practices in three exercise (n = 330 participants) and four control centers (n = 120 participants) in New Zealand, were invited to take part by their doctor. We investigated program reach, uptake, and compliance. We carried out physical assessments at baseline and after 1 year to assess the impact of the program. RESULTS: Most (85%) doctors agreed to take part and they approved 71% of patients to undertake the exercise program. Overall 47% of people invited agreed to participate and 70% of the exercise participants remained exercising at 1 year. Balance score and chair stand time improved by a similar amount in each exercise center compared with the control centers. CONCLUSIONS: This falls prevention program is acceptable to older people and their doctors. Nurses trained by a physiotherapist can deliver the home exercise program effectively in routine primary health care practice.

Accidental Falls↗

The long-term significance of teacher-rated hyperactivity and reading ability in childhood: findings from two longitudinal studies.

BACKGROUND: The aims of this study were twofold: first, to examine behavioural and academic outcomes of children with hyperactivity, using data from two longitudinal studies; and second, to examine comparable psychosocial outcomes for children with early reading difficulties. METHODS: Measures of teacher-rated persistent hyperactivity, and reading ability obtained during early primary school were available for children from the Australian Temperament Project and the Dunedin Multidisciplinary Health and Development Study. Both samples were followed up to assess behavioural and academic outcomes during the adolescent and early adult years. Family background, antisocial behaviour and literacy were controlled in the first set of analyses to examine the influence of early hyperactivity. RESULTS: There were strong linear relationships between early hyperactivity and later adverse outcomes. Adjustment for other childhood variables suggested that early hyperactivity was associated with continuing school difficulties, problems with attention and poor reading in adolescence. Early reading difficulties, after controlling for early hyperactivity, predicted continuing reading problems in high school and leaving school with no qualifications. CONCLUSIONS: The findings suggest that there are dual pathways from early inattentive behaviours to later inattention and reading problems, and from early reading difficulties to substantial impairments in later academic outcomes.

Attention Deficit Disorder with Hyperactivity↗

Purchasing of cigarettes by New Zealand secondary students in 2000.

OBJECTIVE: To examine the prevalence of under-age sales of cigarettes to New Zealand secondary school students in 2000 and to identify correlates of buying cigarettes. METHOD: A randomly selected sample of 53 secondary schools from five geographic regions took part, and 2,896 Year 10 and Year 12 students completed a self-report questionnaire. RESULTS: Some 30.3% reported smoking during the past 30 days and 61.8% of these students usually obtained cigarettes by purchasing from shops, from other students or from someone else buying them on their behalf. Local corner stores and service stations were the most popular source. Buying cigarettes was associated with more frequent smoking, more money to spend, a higher school decile rating and higher proportion of schoolmates also purchasing. CONCLUSIONS: Prohibition of cigarette sales to minors needs much greater attention in NZ than it is receiving at present if smoking among young people is to be reduced.

Adolescent↗

High prevalence, persistent hazardous drinking among New Zealand tertiary students.

AIMS: To determine the prevalence of hazardous drinking and alcohol-related negative consequences in New Zealand tertiary students, and to identify predictors of hazardous drinking across a 6-month period. METHODS: A total of 1480 tertiary students living in halls of residence was surveyed at the start of the academic year, and a subsample of 967 students was followed up 6 months later. Questionnaire items included quantity and frequency of drinking, alcohol-related problems, use of other substances, and the Alcohol Use Disorders Identification Test (AUDIT). Drinking at follow-up was modelled using demographic characteristics, mental well-being, other substance use, alcohol-related problems, and hall drinking norms, measured at baseline. RESULTS: Among drinkers, mean (+/- SD) weekly consumption was 243 +/- 241 and 135 +/- 157 g of ethanol for males and females respectively. The majority of male (60.0%) and female (58.2%) drinkers typically consumed more than national safe drinking guidelines. Mean (+/- SD) AUDIT scores were 10.9 +/- 7.6 for males and 7.6 +/- 5.9 for females. After controlling for AUDIT scores at baseline, increased AUDIT scores at follow-up were higher with lower age, Maori ethnicity, smoking, cannabis use, high levels of alcohol-related negative consequences, and higher levels of drinking in the student's hall of residence. CONCLUSIONS: Hazardous drinking is widespread and persistent among students living in the halls of residence. There is a need for university alcohol policies and intervention approaches among New Zealand tertiary students.

Adolescent↗