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Biomedical subjects

Sheila Williams

Publications and source records attributed to Sheila Williams.

At least 19 recordsLinked to original sources
PubMed2006

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↗
PubMed2006

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↗
PubMed2006

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↗
PubMed2006

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↗
PubMed2006

Comparison of new generation motion-resistant pulse oximeters.

AIM: To compare the performance of pulse oximeters during movement and brachial artery occlusion. METHODS: Three machines (MasimoSET, using MasimoSET LNOP Pdt paediatric sensor, Mars 2001 using Novametrix paediatric sensor no. 6455 and Nellcor 595 using Nellcor 595 Oximax-P paediatric sensor and Nellcor 595 MAX-FAST adhesive forehead reflectance sensor) were used simultaneously on the left hand and forehead. The subjects were 18 healthy children aged 6-10 years. Interventions were 20 sequential 90 degrees body turns from mimicking normal movements while asleep followed by step increases in brachial artery occlusion. Mean heart rate (HR) from the four machines was compared with ECG HR. Haemoglobin O(2) saturation was compared with a baseline saturation and the proportion of epochs with false (low) saturation values. RESULTS: The mean difference from ECG HR was not clinically significantly different for any machine but the limits of agreement were such that the Mars Model 2001 and Nellcor 595 (forehead) could have clinically important differences from ECG-derived HR (-20.04-15.00 and -14.95-14.04, respectively). Only the Nellcor 595 with finger probe had limits of agreement within the a priori set value of 4%. The prevalence of epochs with an haemoglobin O2 saturation of greater than 4% below baseline values was lowest for the Nellcor 595 finger probe (1.59%) and highest for the Nellcor forehead probe (20.45%). During brachial artery occlusion, all machines performed well up to within 20 mmHg of total occlusion. CONCLUSION: Current motion-resistant pulse oximeters performed well but only the Nellcor 595 with finger probe achieved our a priori set standards.

Blood Pressure↗
PubMed2005

Evaluation of diabetes care in the Otago region using a diabetes register, 1998-2003.

AIM: To assess changes in diabetes care between 1998 and 2003 using data from the Otago Diabetes Register. METHODS: A regional diabetes register was established in 1998 to monitor diabetes care in the Otago region, New Zealand. Cross-sectional data relating to process and outcome measures were collected annually from participating general practices, 93% of general practitioners in the region. Generalised estimating equations with robust standard errors were used to test for trends in clinical measures across the study period. RESULTS: Process measures improved dramatically over the 6-year period. The proportion of patients prescribed ACE inhibitors and other antihypertensives increased markedly (32.3-52.4% and 13.2-27.1%, respectively) and both mean systolic and diastolic blood pressure decreased significantly (140.6-137.0 mmHg, p < 0.001 and 78.6-77.0 mmHg, p < 0.001, respectively). The proportion prescribed lipid lowering medication more than trebled (12.4-40.0%), while mean lipid levels improved significantly (total cholesterol: 5.94-5.21 mmol/l, p < 0.001, HDL-cholesterol: 1.23-1.28 mmol/l, p < 0.001 and triglycerides: 2.17-1.94 mmol/l, p < 0.001). Mean weight increased significantly, as did HbA1c in all treatment groups except type 2 diabetic patients treated with combined insulin and oral hypoglycaemic agents. CONCLUSIONS: At a population level appreciable improvements in blood pressure and lipid control were observed, but not glycaemic control, probably due to insufficient attention to necessary lifestyle changes.

Aged↗
PubMed2005

Isocaloric substitution of plant sterol-enriched fat spread for carbohydrate-rich foods in a low-fat, fibre-rich diet decreases plasma low-density lipoprotein cholesterol and increases high-density lipoprotein concentrations.

BACKGROUND AND AIM: The aim of the study was to determine the effects on plasma cholesterol of replacing a plant sterol-enriched fat spread with carbohydrate-rich foods relative to a diet high in saturated fat. METHODS AND RESULTS: Twenty-nine men and women, from the general community, with mean age (SD) 48 (14)y, body mass index 29.0 (6.2)kg/m(2), and plasma total cholesterol concentration 6.48 (0.97)mmol/L completed the randomised, crossover dietary intervention. There were three diets: New Zealand diet (NZ diet) high in total (34%kJ) and saturated (15%kJ) fat, a cholesterol-lowering fibre-rich diet reduced in total (30%kJ) and saturated fat (8%kJ) but including a plant sterol spread (PS diet), and the same cholesterol-lowering diet with the plant sterol spread isocalorically replaced with carbohydrate (CHO diet); total fat, 26%kJ; saturated fat 7%kJ. All foods were provided and each diet was followed for four weeks. Mean (SD) plasma low-density lipoprotein cholesterol concentration declined from 4.68 (0.91)mmol/L on the high saturated fat diet to 4.12 (0.83)mmol/L (P<0.001) on the carbohydrate diet and 3.76 (0.84)mmol/L (P<0.001) on the plant sterol diet. The 20% decrease on the plant sterol diet was significantly greater (P<0.001) than the 12% decrease on the carbohydrate diet. Relative to the NZ diet, mean (95% CI) plasma high-density lipoprotein cholesterol concentration changed by -0.11 (-0.16, -0.06)mmol/L on the CHO diet but was not different at the end of the PS diet, -0.03 (-0.09, 0.02). CONCLUSION: Including a plant sterol-enriched fat spread in a cholesterol-lowering diet produces a more favourable plasma lipid profile than the same diet made lower in total and saturated fat by replacing the spread with carbohydrate-rich foods.

Adult↗
PubMed2005

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↗
PubMed2005

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↗
PubMed2005

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↗
PubMed2005

Factors influencing reported rates of treated end-stage renal disease.

Rates of treated end-stage renal disease have risen relentlessly throughout the Western world over the past 30 years, with little indication of a slowing in the rate. This increase has a number of causes, such as important trends in disease prevalence, changing population structure, and changing treatment patterns. A number of biases also affect measured rates of renal replacement therapy. These biases include lead-time and length bias, as well as classification bias. A further important effect will be changes in competing risks, in particular, changing mortality from cardiovascular disease. We examine the effects of these factors by analyzing data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Rates of treated ESRD have risen steadily over the past 30 years, which appears to be the result of several factors. Rates among older people have increased particularly, as have rates among Australian and New Zealand indigenous peoples. Higher rates are also seen among some immigrant groups. Accentuating the effect of these changing rates are changes in the structure of the population and the tendency to commence treatment earlier. The increase in rates of ESRD treatment is often ascribed to an explosion of kidney disease. Although a major contribution comes from increasing disease prevalence, understanding the implications of this increase requires comprehension of a number of other factors.

Australia↗
PubMed2005

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↗
PubMed2005

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↗
PubMed2005

International Child Care Practices study: breastfeeding and pacifier use.

Although the Baby-Friendly Hospital Initiative advises that no pacifiers be given to breastfeeding infants, both breastfeeding and pacifier use may protect against sudden infant death syndrome. The International Child Care Practice Study data set on child care practices associated with sudden infant death syndrome risk from 21 centers in 17 countries was used to describe infant-feeding practices and pacifier use and assess factors associated with breastfeeding. At approximately 3 months of age, rates of breastfeeding only (4%-80%) and pacifier use(12.5%-71%) varied between centers. Pacifier use was negatively associated with breastfeeding, and a dose-response effect was noted. Other negative (multiple birth, smoking by mother) and positive (intention to breastfeed, bed sharing, mothers' education) associations with breastfeeding only were identified. Although causality should not be inferred, these associations are consistent with previous studies. Advice on pacifiers should include potential benefits as well as risks.

Breast Feeding↗
PubMed2004

Insulin resistance in a rural Maori community.

AIM: To determine the prevalence of insulin resistance, impaired fasting glycaemia, impaired glucose tolerance, and diabetes mellitus in a rural Maori community, and to compare different methods for identifying individuals with insulin resistance. METHODS: 589 randomly selected individuals from the Ngati Porou Hauora Register aged 25 years and over and resident on New Zealand's East Coast north of Gisborne were invited to participate in the study. A questionnaire was administered, anthropometric measures made, and blood samples taken for an oral glucose tolerance test and biochemical analysis. Impaired fasting glycaemia, impaired glucose tolerance, and diabetes mellitus were defined according to World Health Organization (WHO) diagnostic criteria, and among those persons with normal glucose tolerance, insulin resistance was calculated according to the McAuley formula and three other recognised methods for calculating insulin sensitivity. RESULTS: The overall age-standardised prevalence of diabetes (both known and newly diagnosed) was 10.6% and the age-standardised prevalence of insulin resistance was 37.0%. Age-specific diabetes rates were high among the older age groups, peaking at 34.1% for 60-69 year olds, whereas age-specific insulin resistance rates were high among the young age groups with the highest rate (44.3%) occurring among 30-39 year olds. Persons identifying as insulin-resistant reported higher rates of gout and family history of diabetes--and were found to have a higher waist circumference, blood pressure, and lower high-density lipoprotein (HDL) cholesterol than those without a glucose metabolism disorder. CONCLUSION: Diabetes is a common disorder among this population, but insulin resistance is even more prevalent, especially among young age groups. This is considerable cause for concern given that insulin resistance is believed to be the underlying cause of most cases of type 2 diabetes mellitus, and is confirmed by these data to be associated with a high degree of cardiovascular risk.

Adult↗
PubMed2004

Under-reporting of diabetes on death certificates among a population with diabetes in Otago Province, New Zealand.

AIMS: To estimate the degree of under-reporting of diabetes on death certificates, and to describe the population of patients enrolled on the Otago Diabetes Register known to have died during the 6-year period to 31 December 2003. METHODS: The Otago Diabetes Register was established in 1998, as part of the Otago Diabetes Project, to monitor and evaluate diabetes care in the Otago region, New Zealand. Demographic and clinical data, including vital status, type of diabetes and year of diagnosis, diabetes complications, diabetes medication and clinical examination, and biochemistry test results were collected annually from general practice medical records. Copies of death certificate information were obtained from the national Births, Deaths and Marriages office, Department of Internal Affairs for 508 enrolled diabetic patients known to have died before 31 December 2003. Causes of death were coded using ICD-10. Date, place, and causes of death were added to the Otago Diabetes Register. RESULTS: The mean age at death was 78 years (SD=9.7) and the average duration of diagnosed diabetes was 12.1 (SD=8.6) years. Diabetes was mentioned on the death certificates of just over half (55.1%) of the 508 diabetic patients. More of those using insulin only, or oral hypoglycaemic and insulin therapies combined, before death had diabetes mentioned on their death certificate, 67.8% and 81.0%, respectively, compared with those taking oral hypoglycaemics only (55.7%) or diet only treatment (38.0%). Almost 50% of deaths were due to a circulatory system disorder, either cardiovascular or cerebrovascular disease. Five men with type 1 diabetes, all aged less than 50 years, died from diabetic ketoacidosis or hypoglycaemia. CONCLUSION: Diabetes is under-reported on death certificates in New Zealand. Improvements in the completion of death certificates are necessary, if the impact of the diabetes epidemic on mortality is to be monitored appropriately.

Aged↗
PubMed2004

The hypertriglyceridaemic waist in New Zealand Maori.

The objective of this study was to find a simple practical method of predicting insulin resistance in New Zealand Maori. Thirty-six Maori participants had insulin sensitivity measured using a euglycaemic insulin clamp. Several clinical and easily measured laboratory variables were compared, singly and in combination, with this measure of insulin sensitivity usually regarded as the gold standard. The combination of either fasting insulin and triglycerides or waist circumference and triglycerides, were the best simple methods for predicting insulin resistance in Maori. As insulin assays are not always available and are often not standardised, measurement of waist circumference and triglycerides provides a practical method for predicting insulin sensitivity in New Zealand Maori.

Adult↗