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Author (up) Abas, M.; Vanderpyl, J.; Prou, T.L.; Kydd, R.; Emery, B.; Foliaki, S.A. url 
  Title Psychiatric hospitalization: reasons for admission and alternatives to admission in South Auckland, New Zealand Type Journal Article
  Year 2003 Publication Australian & New Zealand Journal of Psychiatry Abbreviated Journal  
  Volume 37 Issue 5 Pages 620-625  
  Keywords admission; acute inpatient units; Psychiatry; Psychiatric units; psychosis; involuntary admission; Social deprivation; medication; perscriptions; medication conconrdance; discharge; nurse-staffed accomodation; community treatment  
  Abstract Objective: To describe reasons for admission and alternatives to admission in a government funded acute inpatient unit.Method: Reasons for admission and alternatives to admission were rated for a consecutive sample of 255 admissions to an acute psychiatric unit in Auckland, using interviews with staff and case note review.Result: Most patients had a functional psychosis and were admitted involuntarily. Forty percent came from areas of marked social deprivation. The major reasons for admission were for reinstatement of medication (mainly linked to non-concordance with prescribed medication), intensive observation, risk to self and risk to others. Only 12% of admissions could have been diverted, of whom most would have required daily home treatment. For those still admitted at 5 weeks, 26% could have been discharged, mainly to 24 h nurse-staffed accommodation. If the alternatives had all been available, simulated bed-day savings were 11 bed years per year. Simulated bed day savings were greater through implementing early discharge than by diverting new admissions.Conclusion: Greater availability of assertive community treatment and of interventions to improve medication concordance may have prevented a small number of admissions. For patients admitted longer than 5 weeks, it appeared that greater availability of 24 h nurse-staffed accommodation would have allowed considerable bed-day savings.  
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  Call Number TRM @ admin @ Abas,M.etal-Psychiatrichospitalization:reasonsforadmissionandalternativestoadmissioninSouthAuckland,NewZealand Serial 21  
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Author (up) Abas, M.; Vanderpyl, J.; Robinson, E.; Crampton, P. doi 
  Title More deprived areas need greater resources for mental health Type Journal Article
  Year 2003 Publication Australian & New Zealand Journal of Psychiatry. Abbreviated Journal  
  Volume 37 Issue 4 Pages 437-444  
  Keywords health services needs and demands, health services research, hospitals psychiatric, mental health services, socio-economic factors  
  Abstract Objective: This study set out to investigate the relationship in New Zealand between the newly developed small area index of socio-economic deprivation, NZDep96, and measures of psychiatric bed utilisation. It aims to contribute to the debate on resource allocation and to estimate the distribution of beds required in relation to levels of deprivation. Method: A cohort study of 872 persons admitted to the psychiatric in-patient unit within Counties Manukau, involving 1299 episodes of in-patient care between 1998 and 2000. The annual period prevalence of admission and the rate of total occupied bed days were calculated for the different deciles of deprivation, standardized for age and gender.Results: There was a three-fold gradient in admission prevalence and in total occupied bed days between persons living in the most and least deprived areas.Conclusions: Mental health services need to be organized and funded in ways that take account of the high use of in-patient care among those living in deprived areas. Further research is required to explore the relationship between socio-economic deprivation and use of community mental health services.  
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  Notes Approved yes  
  Call Number TRM @ admin Serial 22  
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Author (up) Adolescent Health Research Group pdf 
  Title A health profile of New Zealand youth who attend secondary school Type Journal Article
  Year 2003 Publication New Zealand Medical Journal Abbreviated Journal  
  Volume 116 Issue 1171 Pages  
  Keywords youth; children; protective factors; secondary school; alcohol; drink driving; Suici* (suicide, suicidal); depression; Mental health; Youth Development Strategy Aotearoa; Youth Health Action Plan  
  Abstract Aim: To determine the prevalence of selected health behaviours and protective factors in a representative population of New Zealand youth who attend secondary school. Methods: The study sample comprised 12 934 Year 9 to 13 youth from 133 randomly selected secondary schools across New Zealand in 2001. A cross-sectional, anonymous, self-report survey was conducted, incorporating 523 questions in a multimedia computer assisted self-interview (M-CASI) format. Results: The school response rate was 85.7% and the student response rate was 75.0%, resulting in an overall response rate of 64.3%. The final dataset comprised 9570 students (males 46.2%, females 53.8%) belonging to diverse ethnic groups (Maori 24.7%, NZ European 55.3%, Pacific 8.2%, and Asian 7.2%). Most students (males 94.2%, females 90.3%) rate their health as good or better, and 90% report the presence of a caring adult in their family or at school. More than one quarter of students (males 27.2%, females 27.6%) report riding in a car driven by a potentially intoxicated driver within the last four weeks. Students report high levels of suicidal thoughts (males 16.9%, females 29.2%), suicide attempts (males 4.7%, females 10.6%), and depressive symptoms (males 8.9%, females 18.3%). Conclusions: This survey finds that most school students are healthy, but there are areas of serious concern including driving behaviours and mental health. Students report a high prevalence of positive connections with family and school; these connections are known sources of resiliency in the lives of young people. Findings of the current study support the implementation of the New Zealand Government’s newly released youth policies: the Youth Development Strategy Aotearoa and the Youth Health Action Plan.  
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  Corporate Author Thesis Ph.D. thesis  
  Publisher Place of Publication Editor  
  Notes Approved no  
  Call Number Serial 31  
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Author (up) Ajwani, S.; Blakely, T.; Robson, B.; Tobias, M.; Bonne, M. pdf 
  Title Decades of Disparity. Ethnic Mortality Trends in New Zealand 1980 – 1990 Type Report
  Year 2003 Publication Abbreviated Journal  
  Volume Issue Pages  
  Keywords Pacific* (pacifica, pacific islanders); Publich Health Intelligence Group; Our Health, Our Future; Hauora Pakiri, Koiora Roa; Mortality; Life Expectancy; Census; Ethnicity; Chronic Disease; Unintentional Injury; Suicide; Access to Healthcare; Quality of Healthcare  
  Abstract ARTICLE SUMMARY: Please note this is the summary provided for on the Ministry of Health Website and may not be written by the author.The Public Health Intelligence Group of the Ministry of Health publishes a series of occasional bulletins on the health status of New Zealanders, updating and extending the comprehensive review carried out in 1999 and reported in Our Health Our Future – Hauora Pakiri, Koiora Roa.The sixteenth bulletin in this series, Decades of Disparity: Ethnic mortality trends in New Zealand 1980 – 1999, recalculates ethnic mortality rates and life expectancies over the 1980s and 1990s using a record linkage process that matches census and mortality records to adjust for numerator – denominator bias. For the first time, undercounting of Maori and Pacific deaths in the mortality time series is compensated for, and the results are concerning: disparities in survival chances between Maori and Pacific ethnic groups and other New Zealanders have widened substantially over the past twenty years.The report provides adjusted ethnic mortality rates by gender, age group and major causes of death for this twenty year period. It also provides estimates of ethnic life expectancies, and examines the contribution of different age and cause groups to the disparities in life expectancy over this period.  
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  Corporate Author Thesis Ph.D. thesis  
  Publisher Ministry of Health and University of Otago Place of Publication Editor  
  Notes The copyright owner of this website is the Ministry of Health, which is part of the New Zealand Crown. Ministry of Health work on this website may be reproduced in any number of copies and in any format or medium provided that: – the content is not changed – it is not sold- the material is not used to promote or endorse any product or service- it is not used in an inappropriate or misleading context having regard to the nature of the material – any disclaimers included on the published information are reproduced on the material – a copyright acknowledgment to the New Zealand Ministry of Health is included. Any reproduction of the work must respect the moral rights of the author of the work as set out in Part IV of the Copyright Act 1994. Approved no  
  Call Number TRM @ admin @ Ajwani,S.etal-DecadesofDisparity.EthnicMortalityTrendsinNewZealand1980-1990 Serial 491  
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Author (up) Ashton C.M., Haidet, P., Paterniti, D.A., Collins, T.C., Howard, S.G., O'Malley, K., Petersen, L.A.,Sharf, B.F., Suarez-Almazor, M.E., Wray, N.P., Street Jnr, R.L. pdf 
  Title Racial and Ethnic Disparities in the Use of Health Sciences Type Journal Article
  Year 2003 Publication Journal of General Internal Medicine Abbreviated Journal J Gen Intern Med  
  Volume Issue Pages 8 pp  
  Keywords communication, racial disparities, race, healthcare utilization  
  Abstract African Americans and Latinos use service that require a doctor's order at lower rates than do whites. Racial bias and patient preference contribute to disparities, but their effects appear small. Communication during the medical interaction plays a central role in decision making about subsequent interventions and health behaviours. Research has shown that Doctors have poorer communication with minority patients than with others, but problems in doctor-patient communication have received little attention as a potential cause, a remediable one, of health disparities. We evaluate the evidence that poor communication is a cause of disparities and propose some remedies drawn from the communication sciences.  
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  Notes Approved yes  
  Call Number TRM @ admin @ Serial 1194  
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Author (up) Belsky, J.; Jaffee, S.R.; Caspi, A.; Moffitt, T.; Silva, P.A. url 
  Title Intergenerational relationships in young adulthood and their life course, mental health, and personality correlates Type Journal Article
  Year 2003 Publication Journal of Family Psychology Abbreviated Journal  
  Volume 17 Issue 4 Pages 460-471  
  Keywords Mental Health Issues; Young Adults; intergenerational relationships; maternal interaction; paternal interaction; whanau; parent-child relationship; Child development  
  Abstract To evaluate effects of life-course events and experiences of young adults, as well as personality and mental-health history on intergenerational relationships in young adulthood, the authors examined dyadic relationship data drawn from a sample of more than 900 New Zealand 26-year-olds and their mothers and fathers. Results indicated that intergenerational relations were more positive when young adults were childless, not unemployed, married, and living away from home, but these factors did not interact with family relationship history in predicting relationship outcomes. Intergenerational relationships were less positive when children scored low on positive emotionality and constraint and high on negative emotionality and mental disorders, though these attributes did not account for the effect of life-course factors. Results are discussed in terms of the openness of the parent-child relationship in adulthood to further development.  
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  Notes Approved yes  
  Call Number TRM @ admin @ Belsky,J.,Jaffee,S.R.,Caspi,A.,Moffitt,T.,&SilvaP.A.(2003).Intergenerationalrelationshipsinyoungadulthoodandtheirlifecourse,mentalhealth,andpersonalitycorrelates Serial 66  
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Author (up) Blakely, T.; Atkinson, J.; O’Dea, D. url 
  Title No association of income inequality with adult mortality within New Zealand: A multi-level study of 1.4 million 25-64 year olds Type Journal Article
  Year 2003 Publication Journal of Epidemiology & Community Health Abbreviated Journal  
  Volume 57 Issue 4 Pages 279-284  
  Keywords Demographic Factors; Medical Health; Regional income inequality; household income; Socioeconomic deprivation; mortality; Unintentional Injury  
  Abstract STUDY OBJECTIVE: To determine the association of regional income inequality within New Zealand with mortality among 25-64 year olds.DESIGN: Individual census and mortality records were linked over the 1991-94 period. Income inequality (Gini coefficients) and average household income variables were calculated for 35 regions. “Individual level” variables were sex, age, ethnicity, household income, rurality, and small area socioeconomic deprivation. Logistic regression was used for the analyses. Sensitivity analyses for the level of regional aggregation were conducted.PARTICIPANTS: 1.4 million New Zealand census respondents aged 25-64 years followed up for mortality for three years. Main results: Controlling for age, ethnicity, rurality, household income, and regional mean income, there was no association of income inequality with all cause mortality for either men (OR=1.007 for a 0.01 increase in the Gini, 95% confidence intervals 0.989 to 1.024) or women (OR=1.004, 0. 983 to 1.026). By cause of death (cancer, cardiovascular disease, unintentional injury, and suicide) there was some suggestion of a positive association for female unintentional injury (OR=1.068, 0.952 to 1.198) and suicide (OR=1.087, 0.957 to 1.234) but the 95% confidence intervals all included 1.0. Failure to control for ethnicity at the individual level resulted in some association of increasing regional income inequality with increasing mortality risk. Using fewer (n=14) or more (n=73) regional divisions did not substantially change the findings.CONCLUSION: There is no convincing evidence of an association of income inequality within New Zealand with adult mortality. Previous ecological analyses within New Zealand suggesting an association of income inequality with mortality were confounded by ethnicity at the individual level. However, this study does not refute the possibility that income inequality at the national level affects health.  
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  Call Number TRM @ admin @ Blakely,T.,Atkinson,J,.&O’Dea,D.(2003).NoassociationofincomeinequalitywithadultmortalitywithinNewZealand Serial 72  
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Author (up) Boyce, P.; Carter, G.; Penrose-Wall, J.; Wilhelm, K.; Goldney, R. url 
  Title Summary Australian and New Zealand clinical practice guideline for the management of adult deliberate self-harm Type Journal Article
  Year 2003 Publication Australasian Psychiatry Abbreviated Journal  
  Volume 11 Issue 2 Pages 150-155  
  Keywords Best Practice; Consumer / Practitioner Related Assessment Tools; Measuring Service Delivery Outcomes; Mental Health Services; Psychiatry; Royal Australian and New Zealand College of Psychiatrists; Ranzcp; Clinical Practice Guidelines; deliberate self-harm; self-harm; alcohol * (dependance, abuse, counselling); drug* (dependence, abuse, counselling); personality disorder; Therapy; Suici* (suicide, suicidal); ongoing psychiatric management; poisoning; follow-up treatment; Cognitive-behavioural therapy; Cbt; Dialectical behavioural therapy; Dbt; pharmacological treatment; Lithium; bi-polar disorder; clozapine; schizophrenia; schizophrenic disorder  
  Abstract Objective: To provide a summary of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) Clinical Practice Guideline for the Management of Deliberate Self-Harm.Conclusions: This guideline covers self-harm regardless of intent. It is an evidence-based guideline developed from a systematic review of epidemiological, treatment and medico-legal literature. All patients presenting to hospital after deliberate self-harm should be comprehensively assessed to detect and treat the high rates of mental disorders, alcohol and other drug problems and personality disorders in this group. General hospital management aims to ensure safety from further self-harm, assess and treat injuries; prevent disablement and death as a result of injuries or poisoning and manage suicide risk by ensuring prompt psychiatric referral and mobilizing social supports. Psychological management aims to detect and treat underlying mental disorders, reduce distress and enhance coping skills and thereby, reduce repeat episodes and habituation of self-harm. Managing suicide risk is a continuous responsibility and suicide vulnerability may persist long-term in some patients. There is little firm guidance from the literature on treatment efficacy to guide ongoing psychiatric management. Studies are often compromised because between 41 and 70% of patients do not attend follow up. The mainstay of psychological care remains the treatment of underlying Axis I and Axis II disorders. Cognitive−behavioural therapy (CBT) and problem-orientated approaches appear promising for reducing repeated self-harm for most patient groups but no single treatment has confirmed superiority. Dialectical behaviour therapy (DBT) appears to confer most benefit. Self-harm may follow some forms of in-depth therapy in some vulnerable individuals. There is no one recommended pharmacological treatment specifically to reduce self-harming behaviours. Lithium may have antiself-harm properties for some groups with bipolar disorder. There is emerging evidence for self-harm reduction using clozapine for patients with schizophrenia and schizoaffective disorder.  
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  Call Number TRM @ admin @ RANZCPClinicalPracticeGuidelineTeamforDeliberateSelf-Harm.(2003).SummaryAustralianandNewZealandclinicalpracticeguidelineforthemanagementofadultdeliberateself-harm Serial 78  
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Author (up) Brewin, M.; Peters, T. url 
  Title An investigation of child restraint/seatbelt usage in motor vehicles by Maori in Northland, New Zealand Type Journal Article
  Year 2003 Publication Injury Prevention Abbreviated Journal  
  Volume 9 Issue 1 Pages 85-86  
  Keywords Indigenous Research; Medical Health  
  Abstract Objective: To investigate child restraint/seatbelt use by the indigenous (Maori) population in Northland New Zealand.Method: Observational surveys were conducted at the two main car parks (McDonald’s and the largest supermarket) to determine the number of passengers restrained, the type of restraints, and correct use. Observations were restricted to those who were obviously Maori, based upon the local knowledge of the observer. In addition, face to face questionnaires were administered to Maori whanau/caregivers involved in the care of two or more children for more than three days a week.Results: A total of 788 participants were observed. Babies were those most likely to have all occupants restrained correctly (97%), followed by toddlers (66%), adults (56%), and school age children (48%); 138 interviews were conducted. Females (86%) were significantly more likely to ensure that all passengers were restrained on short journeys compared to males (67%; p  
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  Notes Approved yes  
  Call Number TRM @ admin @ Brewin2003 Serial 82  
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Author (up) Conner, K.R.; Langley, J.; Tomaszewski, K.J.; Conwell, Y. url 
  Title Injury hospitalization and risks for subsequent self-injury and suicide: A national study from New Zealand Type Journal Article
  Year 2003 Publication American Journal of Public Health Abbreviated Journal  
  Volume 93 Issue 7 Pages 1128-1131  
  Keywords Demographic Factors; Suicide; non-fatal self injury; injury hospitalization  
  Abstract Objectives. Risks for suicide and nonfatal self-injury hospitalizations associated with previous injury hospitalizations were investigated in a nationwide retrospective cohort study conducted in New Zealand. Methods. Linked data from all New Zealand public hospitals were used to identify individuals with injury hospitalizations. Participants were followed for 12 months. Results. Significantly increased age- and sex-adjusted relative risks for suicide were associated with previous hospitalization for self-injury, injuries of undetermined causes, and assault. Also, elevated risks were associated with these causes of hospitalization in the case of subsequent self-injury hospitalizations. Conclusions. Results indicate that identifiable subgroups of individuals hospitalized for injuries are at marked risk for serious suicidal behavior and suggest the potential of targeted suicide prevention for these individuals.  
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  Publisher Place of Publication Kenneth R. Conner, PsyD, Department of Psychiatry, University of Rochester Medical Center, 300 Critt Editor  
  Notes Approved no  
  Call Number TRM @ admin @ Conner,K.R.,Langley,J.,Tomaszewski,K.J.,&Conwell,Y.(2003).Injuryhospitalizationandrisksforsubsequentself-injuryandsuicide Serial 115  
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