scholarly journals O5C.6 The health and wellbeing of new zealand veterans

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A47.1-A47
Author(s):  
David McBride ◽  
Dianne Gardner ◽  
Amy Richardson ◽  
Emma Wyeth ◽  
Ari Samaranayaka ◽  
...  

The psychological and physical health and wellbeing of New Zealand contemporary veteransBackgroundFor New Zealand veterans, operational service and transition to civilian life are critical life events. Most veterans do well, but a significant minority fare poorly. Adverse outcomes are associated with post-traumatic stress disorder, PTSD, and also the development of minor but multiple health complaints, ‘multiple symptom illness’ (MSI).AimThis project investigates factors associated with both wellbeing and ill health in NZ veterans, with the aim of developing a parsimonious instrument to detect ‘at risk’ veterans prior to, or at, transition.MethodsAn on-line cross-sectional survey.Wellbeing is measured by the EQ-5D, a health-related quality of life instrument assessing mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The adverse outcome is PTSD, identified using the PCL-M, an instrument reflecting DSM-IV PTSD symptoms.Risk factors include MSI conforming to the Centers for Disease Control definition as ‘the presence, for at least six months, of one or more chronic symptoms from at least two of three categories, namely fatigue, mood-cognition and musculoskeletal symptoms’. The General Health Questionnaire-28 (GHQ-28) screens for emotional distress and possible psychiatric morbidity. The Brief Trauma Questionnaire (BTQ), a 10-item self-report questionnaire derived from the Brief Trauma Interview, assesses the role of stressors contributing to PTSD.Protective factors include the 24-item Social Provisions Scale (SPS) assessing social relationships and various dimensions of social support.AnalysisLogistic regression will identify the model of best fit for PTSD (PCL-M) and wellbeing (EQ-5D) respectively.For MSI, a factor analysis will describe the pattern of symptom reporting. If this matches international experience, 3 factors will explain the majority of the variance in the data.ResultsAs at the 14th Nov 2018 we have 1592 completed questionnaires. Analysis will commence in mid-November 2018.

2002 ◽  
Vol 36 (4) ◽  
pp. 528-533 ◽  
Author(s):  
Peter S Sternhell ◽  
Melissa J Corr

Objective: To determine whether psychological morbidity is associated with poor compliance with antiretroviral medication in HIV-positive subjects. Method: This is a cross-sectional survey of patients attending a public HIV clinic in Sydney. Volunteers completed a survey which gathered data on substance use, psychological distress, attitudes to illness and medication, and self-reported medication adherence. Psychological morbidity was assessed using the 28 question General Health Questionnaire, GHQ-28, and adherence was assessed using a combination of direct self-report and indirect questions. Results: Forty-four per cent of subjects were identified as suffering psychological disorder on the GHQ. They reported significantly poorer adherence to antiretroviral medication than subjects not identified as ‘cases’ (odds ratio 4.5). Expressed scepticism about medication and previous use of psychotropics was also associated with poor adherence. Conclusions: Psychological morbidity is associated with poor adherence to antiretroviral medication. It is not known whether treatment of identified psychological morbidity leads to improved antiretroviral medication adherence and better medical outcome. A longitudinal study could help answer this question.


2003 ◽  
Vol 183 (4) ◽  
pp. 332-339 ◽  
Author(s):  
Jeremy Coid ◽  
Ann Petruckevitch ◽  
Wai-Shan Chung ◽  
Jo Richardson ◽  
Stirling Moorey ◽  
...  

BackgroundAbusive experiences in childhood and adulthood increase risks of psychiatric morbidity in women and independently increase risks of further abuse over the lifetime. It is unclear which experiences are most damaging.AimsTo measure lifetime prevalence of abusive experiences and psychiatric morbidity, and to analyse associations in women primary care attenders.MethodA cross-sectional, self-report survey of 1207 women attending 13 surgeries in the London borough of Hackney, UK. Independent associations between demographic measures, abusive experiences and psychiatric outcome were established using logistic regression.ResultsChildhood sexual abuse had few associations with adult mental health measures, in contrast to physical abuse. Sexual assault in adulthood was associated with substance misuse; rape with anxiety, depression and post-traumatic stress disorder but not substance misuse. Domestic violence showed strongest associations with most mental health measures, increased for experiences in the past year.ConclusionsAbuse in childhood and adulthood have differential effects on mental health; effects are increased by recency and severity. Women should be routinely questioned about ongoing and recent experiences as well as childhood.


BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016837 ◽  
Author(s):  
Erin Cvejic ◽  
Gordon Parker ◽  
Samuel B Harvey ◽  
Zachery Steel ◽  
Dusan Hadzi-Pavlovic ◽  
...  

IntroductionClinical training in the undergraduate medical course places multiple stressors on trainees, which have been held to lead to heightened distress, depression, suicide, substance misuse/abuse and poor mental health outcomes. To date, evidence for morbidity in trainees is largely derived from cross-sectional survey-based research. This limits the accuracy of estimates and the extent to which predispositional vulnerabilities (biological and/or psychological), contextual triggers and longer-term consequences can be validly identified. Longitudinal clinical assessments embedded within a biopsychosocial framework are needed before effective preventative and treatment strategies can be put in place.Methods and analysisThis study is an observational longitudinal cohort study of 330 students enrolled in the undergraduate medicine course at the University of New South Wales (UNSW) Sydney, Australia. Students will be recruited in their fourth year of study and undergo annual assessments for 4 consecutive years as they progress through increasingly demanding clinical training, including internship. Assessments will include clinical interviews for psychiatric morbidity, and self-report questionnaires to obtain health, psychosocial, performance and functioning information. Objective measures of cognitive performance, sleep/activity patterns as well as autonomic and immune function (via peripheral blood samples) will be obtained. These data will be used to determine the prevalence, incidence and severity of mental disorder, elucidate contextual and biological triggers and mechanisms underpinning psychopathology and examine the impact of psychopathology on performance and professional functioning.Ethics and disseminationEthics approval has been granted by the UNSW human research ethics committee (reference HC16340). The findings will be disseminated through peer-reviewed publications and conference presentations, and distributed to key stakeholders within the medical education sector. The outcomes will also inform targeted preventative and treatment strategies to enhance stress resilience in trainee doctors.


2007 ◽  
Vol 41 (11) ◽  
pp. 917-925 ◽  
Author(s):  
Louise Nash ◽  
Michele Daly ◽  
Maree Johnson ◽  
Garry Walter ◽  
Merrilyn Walton ◽  
...  

Objective: To describe the differences in psychological morbidity between Australian general practitioners (GPs) who have experienced a medico-legal matter and those who have not. Methods: A total of 1499 GPs were initially invited to participate in the study. Two hundred and sixty requested not to participate, with 1239 subsequently being sent a survey. There were 566 respondents (45.7% response rate to survey). There were two sources of data. First, a cross-sectional survey sought demographic information, personality traits via the Eysenck Personality Questionnaire (EPQ), history of a medico-legal matter with any medical defence organization, and measures of psychological morbidity, including the General Health Questionnaire (GHQ), Sheehan Disability Scale (SDS), and Alcohol Use Disorders Identification Test. Second, information was extracted from the United Medical Protection database on medico-legal matters. Results: Fifty-nine per cent of respondents to the survey reported ever having a medico-legal matter, with 13% having a current medico-legal matter. Those with a current matter reported increased levels of disability (in work, social or family life) and higher prevalence of psychiatric morbidity (45% vs 27% GHQ ‘case identification’ rates), compared to those with no current matter. Those respondents with a history of past medico-legal matters reported increased levels of disability (SDS) and depression subscores (GHQ). Male respondents drank significantly more alcohol than female respondents, and male respondents with current or past medico-legal matters had significantly higher levels of alcohol use than male respondents with no experience of medico-legal matters. Conclusions: Doctors who have current and past medico-legal matters have a higher level of psychological morbidity. The study design was unable to distinguish cause or effect. A longitudinal study is planned to investigate this. The findings have significant implications for medical training, doctor support systems and medical insurance groups.


2015 ◽  
Vol 21 (3) ◽  
pp. 347 ◽  
Author(s):  
Elizabeth Halcomb ◽  
Deborah Davies ◽  
Yenna Salamonson

An important consideration in health service delivery is ensuring that services meet consumer needs. Whilst nursing services in primary care have grown internationally, there has been limited exploration of consumer satisfaction with these services. This paper reports a descriptive survey that sought to evaluate consumers’ perceptions of New Zealand practice nurses (PNs). One thousand, five hundred and five patients who received nursing services at one of 20 participating New Zealand general practices completed a survey tool between December 2010 and December 2011. The 64-item self-report survey tool contained the 21-item General Practice Nurse Satisfaction (GPNS) scale. Data were analysed using both descriptive and inferential statistics. Internal consistency of the GPNS scale was high (Cronbach’s α 0.97). Participants aged over 60 years and those of European descent were significantly less satisfied with the PN (P = 0.001). Controlling for these characteristics, participants who had visited the PN more than four times previously were 1.34 times (adjusted odds ratio 1.34 (95% CI: 1.06–1.70) more satisfied than the comparison group (up to 4 previous visits to PN). In addition to the further validation of the psychometric properties of the GPNS scale in a different setting, the study also revealed a high level of satisfaction with PNs, with increased satisfaction with an increased number of visits. Nevertheless, the lower levels of satisfaction with PNs in the older age group as well as those of European descent, warrants further examination. The study also highlights the need for PNs and consumers to discuss consumer’s expectations of services and create a shared understanding of treatment goals.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e034929 ◽  
Author(s):  
Rahul Rao ◽  
Ioannis Bakolis ◽  
Jayati Das-Munshi ◽  
Daniel Poulter ◽  
Nicole Votruba ◽  
...  

ObjectivesThis study examined the prevalence of risky drinking by members of parliament (MPs), as well as the relationship between risky drinking and age, years spent as an MP, working outside parliament, awareness of the Parliamentary Health and Wellbeing Service, and probable mental ill health.DesignA survey questionnaire assessed alcohol consumption using the Alcohol Use Disorders Identification Test (AUDIT). Risky drinking was identified by combining categories of increasing (hazardous), higher (harmful) and probable dependent drinking for those with a total score of 8 or more. Comparator groups from the 2014 Adult Psychiatric Morbidity Survey (APMS) were used as controls.SettingUK House of Commons.Participants650 MPs.ResultsCompared with all 650 MPs, participants (n=146) were more likely to be female (p<0.05) or have an educational qualification (p<0.05). Weighted proportions on AUDIT items were higher than the APMS comparator group for participants who had a drink four or more times a week, 10 or more drinks on a typical drinking day, six or more drinks in one occasion, or felt guilty because of drinking (p<0.01). Weighted percentages for risky drinking were higher in MPs compared with the whole English population (p<0.05), but similar when compared with socioeconomic comparator groups. The odds of risky drinking were 2.74 times greater for MPs who had an additional work role outside parliament compared with those who did not (95% CI 0.98 to 7.65) and 2.4 times greater for MPs with probable mental ill health compared with those with no evidence of probable mental ill health (95% CI 0.78 to 7.43).ConclusionsA low level of awareness of the Parliamentary Health and Wellbeing Service has implications for improving the detection of risky drinking and improving access to this service by MPs. Possible increased likelihood of risky drinking in MPs who also had an additional work role outside Parliament and among those with probable mental ill health requires further exploration.


2001 ◽  
Vol 15 (6) ◽  
pp. 414-421 ◽  
Author(s):  
Pebbles Fagan ◽  
Marla Eisenberg ◽  
Anne M. Stoddard ◽  
Lindsay Frazier ◽  
Glorian Sorensen

Purpose. To examine the relationships between worksite interpersonal influences and smoking and quitting behavior among adolescent workers. Design. The cross-sectional survey assessed factors influencing tobacco use behavior. Setting. During the fall of 1998, data were collected from 10 grocery stores in Massachusetts that were owned and managed by the same company. Subjects. Eligible participants included 474 working adolescents ages 15 to 18. Eighty-three percent of workers (n = 379) completed the survey. Measures. The self-report questionnaire assessed social influences, social norms, social support, friendship networks, stage of smoking and quitting behavior, employment patterns, and demographic factors. Results. Thirty-five percent of respondents were never smokers, 21% experimental, 5% occasional, 18% regular, and 23% former smokers. Using analysis of variance (ANOVA), results indicate that regular smokers were 30% more likely than experimental or occasional smokers to report coworker encouragement to quit (p = .0002). Compared with regular smokers, never smokers were 15% more likely to report greater nonacceptability of smoking (p = .01). χ2 tests of association revealed no differences in friendship networks by stage of smoking. Conclusions. These data provide evidence for the need to further explore social factors inside and outside the work environment that influence smoking and quitting behavior among working teens. Interpretations of the data are limited because of cross-sectional and self-report data collection methods used in one segment of the retail sector.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041609
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Farag Shuweihdi ◽  
Mitch Waterman ◽  
Allan House

ObjectivesTo identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana.DesignA cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data.SettingThree contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks).ParticipantsA regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13–21 years.Outcome measuresParticipants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities.ResultsThe lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56).ConclusionsSelf-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037362
Author(s):  
Ben Wamamili ◽  
Mark Wallace-Bell ◽  
Ann Richardson ◽  
Randolph C Grace ◽  
Pat Coope

ObjectiveIn March 2011, New Zealand (NZ) launched an aspirational goal to reduce smoking prevalence to 5% or less by 2025 (Smokefree 2025 goal). Little is known about university students’ awareness of, support for and perceptions about this goal. We sought to narrow the knowledge gap.SettingUniversity students in NZ.MethodsWe analysed data from a 2018 cross-sectional survey of university students across NZ. Logistic regression analysis examined the associations between responses about the Smokefree goal with smoking and vaping, while controlling for age, sex and ethnicity. Confidence intervals (95% CI) were reported where appropriate.ParticipantsThe sample comprised 1476 students: 919 (62.3%) aged 18 to 20 and 557 (37.7%) aged 21 to 24 years; 569 (38.6%) male and 907 (61.4%) female; 117 (7.9%) Māori and 1359 (92.1%) non-Māori. Of these, 10.5% currently smoked (ie, smoked at least monthly) and 6.1% currently vaped (ie, used an e-cigarette or vaped at least once a month).ResultsOverall awareness of the Smokefree goal was 47.5% (95% CI: 44.9 to 50.1); support 96.9% (95% CI: 95.8 to 97.8); belief that it can be achieved 88.8% (95% CI: 86.8 to 90.7) and belief that e-cigarettes/vaping can help achieve it 88.1% (95% CI: 86.0 to 89.9).Dual users of tobacco cigarettes and e-cigarettes had greater odds of being aware of the Smokefree goal (OR=3.07, 95% CI: 1.19 to 7.92), current smokers had lower odds of supporting it (OR=0.13, 95% CI: 0.06 to 0.27) and of believing that it can be achieved (OR=0.15, 95% CI: 0.09 to 0.24) and current vapers had greater odds of believing that e-cigarettes/vaping can help to achieve it (OR=8.57, 95% CI: 1.18 to 62.52) compared with non-users.ConclusionsThe results suggest strong overall support for the Smokefree goal and belief that it can be achieved and that e-cigarettes/vaping can help achieve it. Smoking and vaping were associated with high awareness of the Smokefree goal, but lower support and optimism that it can be achieved.


Author(s):  
Sadaf Sanaat ◽  
D Linn Holness ◽  
Victoria H Arrandale

Abstract Objectives In recent years, nail salons have become more abundant than ever. The majority are small businesses, often employing immigrant women. Nail technicians have many exposures at work including chemical, biological, physical, and ergonomic hazards but few data exist on their symptoms or occupational health and safety practices, particularly in the Canadian context. The aim of this study was to learn about nail technicians, their work, and their health and safety practices. Methods Nail technicians were recruited from nail salons in Toronto, Ontario. Participants completed an anonymous survey with questions about demographics, work tasks, workplace health and safety practices, and symptoms (skin, respiratory, and musculoskeletal). Results A total of 155 nail technicians (95% female) participated in the survey. The majority of nail technicians performed manicures (99%) and pedicures (96%) and applied shellac polishes (86%). Only a third (34%) applied acrylic artificial nails. The reported use of personal protective equipment (PPE) was very high; 88% reported using a mask at work and 96% reporting using gloves. The most common symptoms reported by technicians were neck (44%) and back pain (38%). Skin and respiratory symptoms were less common with 6% of technicians reporting cough, 8% wheeze, and 5% a current rash. Technicians working over 30 h per week reported more neck pain (52 vs. 32%, P = 0.02). Technicians who reported using shellac polishes were more likely to report a runny nose (25 vs. 0%, P = 0.01). Conclusions Nail technicians in Toronto, Canada are experiencing work-related symptoms. Musculoskeletal symptoms were the most common symptoms reported. Much of the focus on nail salons and health has been on chemical exposures, but ergonomic hazards should not be overlooked. Efforts to increase knowledge and improve occupational health in nail salons should include information on multiple possible workplace hazards and how to reduce impacts of exposure.


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