Building research capacity and capabilities in Fiji

Introduction: A barrier to local investigator-led research in low income settings, is the limited availability of personnel with appropriate research skills or qualifications to conduct the type of research required for evidence-informed policy making to improve access and quality of health care. In response to this, Fiji National University’s College of Medicine, Nursing and Health Sciences in Fiji, collaborated with academics based at the University of Auckland, New Zealand to deliver a series of research capacity development workshops in Fiji. This paper aims to explore participants’ perceptions of the outcomes of these research workshops and highlights the implications for capacity building in the Pacific Region. Methods: Participants who attended any of the nine workshops (n=123) were contacted via email to take part in a brief survey regarding their perceptions of the effectiveness of the research capacity building workshops. Of the possible 123 participants, 80% (n=76) completed the questionnaire. Results: Findings demonstrate that the majority of participants reported that they had gained research skills from the workshops (75%) including proposal development skills (68%) and knowledge of appropriate research methods (59%). Furthermore, 70% agreed that the workshops built their research confidence. Since attending a workshop, 18% of respondents had successfully applied and received funding for research grants and/or fellowships. Barriers to conducting research included workload (75%), lack of research knowledge, experience or skills (51%), and lack of institutional support (41%). Suggestions for future workshops included: more focus on data analysis, regular courses rather than ‘one offs’, and preparation of research evidence dissemination. Conclusion: Our findings indicate that the research workshops increased individual research capabilities in designing sustainable, locally led initiatives, backed by institutional and supplementary technical support

Knowledge, Attitudes, and Behaviours of New Zealand Youth in Surf Beach Environments

New Zealand youth are over-represented in drowning statistics yet little is known about their understanding of water safety, especially in surf beach context. This study aimed to ascertain current youth surf safety knowledge, specifically rip current awareness, explore self-reported competencies and confidence when surf swimming, and examine youth behaviour when at the beach. A cross-sectional survey was conducted among senior high school students (n = 599) in Auckland, New Zealand. Over half (58%) reported they were unable to swim \u3e 100 m in a pool. Males and students of European-New Zealand and Maori (New Zealand’s indigenous population) heritage were most likely to report risky behaviors such as swimming alone, outside of the patrol flags, or at a beach without lifeguards. Females reported lower swimming competency and confidence. Students of non-European-New Zealand heritage consistently reported lower surf safety knowledge. The results suggest that, in spite of frequent surf beach use and confidence in their ability to cope with risk, the surf safety knowledge, attitudes, and behaviors of most New Zealand youth leaves them at higher risk of drowning

Effectiveness of the YourCall™ text message intervention to reduce harmful drinking in patients discharged from trauma wards: protocol for a randomised controlled trial

Background Behavioural brief interventions (BI) can support people to reduce harmful drinking but multiple barriers impede the delivery and equitable access to these. To address this challenge, we developed YourCall™, a novel short message service (SMS) text message intervention incorporating BI principles. This protocol describes a trial evaluating the effectiveness of YourCall™ (compared to usual care) in reducing hazardous drinking and alcohol related harm among injured adults who received in-patient care. Methods/design Participants recruited to this single-blind randomised controlled trial comprised patients aged 16-69 years in three trauma-admitting hospitals in Auckland, New Zealand. Those who screened positive for moderately hazardous drinking were randomly assigned by computer to usual care (control group) or the intervention. The latter comprised 16 informational and motivational text messages delivered using an automated system over the four weeks following discharge. The primary outcome is the difference in mean AUDIT-C score between the intervention and control groups at 3 months, with the maintenance of the effect examined at 6 and 12 months follow-up. Secondary outcomes comprised the health and social impacts of heavy drinking ascertained through a web-survey at 12 months, and further injuries identified through probabilistic linkage to national databases on accident insurance, hospital discharges, and mortality. Research staff evaluating outcomes were blinded to allocation. Intention-to-treat analyses will include assessment of interactions based on ethnicity (Māori compared with non-Māori). Discussion If found to be effective, this mobile health strategy has the potential to overcome current barriers to implementing equitably accessible interventions that can reduce harmful drinking. Trial registration Universal Trial Number (UTN) U1111-1134-0028. ACTRN12612001220853. Submitted 8 November 2012 (date of enrolment of first participant); Version 1 registration confirmed 19 November 2012. Retrospectively registered

Alcohol and risk of admission to hospital for unintentional cutting or piercing injuries at home: a population-based case-crossover study

<p>Abstract</p> <p>Background</p> <p>Cutting and piercing injuries are among the leading causes of unintentional injury morbidity in developed countries. In New Zealand, cutting and piercing are second only to falls as the most frequent cause of unintentional home injuries resulting in admissions to hospital among people aged 20 to 64 years. Alcohol intake is known to be associated with many other types of injury. We used a case-crossover study to investigate the role of acute alcohol use (i.e., drinking during the previous 6 h) in unintentional cutting or piercing injuries at home.</p> <p>Methods</p> <p>A population-based case-crossover study was conducted. We identified all people aged 20 to 64 years, resident in one of three regions of the country (Greater Auckland, Waikato and Otago), who were admitted to public hospital within 48 h of an unintentional non-occupational cutting or piercing injury sustained at home (theirs or another's) from August 2008 to December 2009. The main exposure of interest was use of alcohol in the 6-hour period before the injury occurred and the corresponding time intervals 24 h before, and 1 week before, the injury. Other information was collected on known and potential confounders. Information was obtained during face-to-face interviews with cases, and through review of their medical charts.</p> <p>Results</p> <p>Of the 356 participants, 71% were male, and a third sustained injuries from contact with glass. After adjustment for other paired exposures, the odds ratio for injury after consuming 1 to 3 standard drinks of alcohol during the 6-hour period before the injury (compared to the day before), compared to none, was 1.77 (95% confidence interval 0.84 to 3.74), and for four or more drinks was 8.68 (95% confidence interval 3.11 to 24.3). Smokers had higher alcohol-related risks than non-smokers.</p> <p>Conclusions</p> <p>Alcohol consumption increases the odds of unintentional cutting or piercing injury occurring at home and this risk increases with higher levels of drinking.</p

Is driving under the influence of kava associated with motor vehicle crashes? A systematic review of the epidemiological literature

Abstract Objective: Kava is marketed as a herbal anxiolytic in several countries and is consumed recreationally in high doses in many indigenous Pacific and Australian Aboriginal communities. We reviewed the published literature examining the association (if any) between kava use and motor vehicle crashes (MVCs), MVC‐related injuries or driving performance. Methods: Search of MEDLINE, EMBASE, PsycINFO, CINAHL, Scopus, AMED, Australian Medical Index, Australian Transport Index and trials registries and injury journals up to August 2014. Results: No studies quantifying the effects of kava on MVCs or related injury were located. Four experimental studies using computer‐based driving simulation examined the effects of pharmacological doses of kavalactones on cognitive and visuomotor performance. While no statistically significant adverse changes attributable to kava were found, there was weak evidence of slowed reaction time. One study found the visuo‐motor performance on driving simulation to be significantly impaired when kava was consumed with alcohol. Conclusions: With equivocal evidence limited to experimental studies using simulated driving settings, the contribution of kava to MVCs is unknown. Implications: The gap in knowledge regarding the potential risk of injuries associated with therapeutic and recreational use of kava requires priority attention