Gender differences in paid and unpaid work: findings from a New Zealand birth cohort

This study uses data from a birth cohort of New Zealand-born 30-year-olds to examine gender differences in time use and satisfaction with time use. The specific aims of the study are: to examine gender difference in time spent in paid employment and unpaid work; to examine the extent to which males and females are satisfied with their time use

The Basic Surgical Skills course in sub-Saharan Africa: an observational study of effectiveness

Background: The Basic Surgical Skills (BSS) course is a common component of postgraduate surgical training programmes in sub-Saharan Africa, but was originally designed in a UK context, and its efficacy and relevance have not been formally assessed in Africa. Methods: An observational study was carried out during a BSS course delivered to early-stage surgical trainees from Rwanda and the Democratic Republic of the Congo. Technical skill in a basic wound closure task was assessed in a formal Objective Structured Assessment of Technical Skills (OSAT) before and after course completion. Participants completed a pre-course questionnaire documenting existing surgical experience and self-perceived confidence levels in surgical skills which were to be taught during the course. Participants repeated confidence ratings and completed course evaluation following course delivery. Results: A cohort of 17 participants had completed a pre-course median of 150 Caesarean sections as primary operator. Performance on the OSAT improved from a mean of 10.5/17 pre-course to 14.2/17 post-course (mean of paired differences 3.7, p < 0.001). Improvements were seen in 15/17 components of wound closure. Pre-course, only 47% of candidates were forming hand-tied knots correctly and 38% were appropriately crossing hands with each throw, improving to 88 and 76%, respectively, following the course (p = 0.01 for both components). Confidence levels improved significantly in all technical skills taught, and the course was assessed as highly relevant by trainees. Conclusion: The Basic Surgical Skills course is effective in improving the basic surgical technique of surgical trainees from sub-Saharan Africa and their confidence in key technical skills

Indigenous Suicide in New Zealand

This article describes patterns of suicide and attempted suicide among the indigenous (Ma ̄ori) population of New Zealand using official data from the New Zealand Health Information Service (NZHIS). The majority of Ma ̄ori suicides (75%) occurr in young people aged \u3c35 years. Rates of suicide are higher among Ma ̄ori males and females aged \u3c25 than in their non-Ma ̄ori peers. Rates of hospitalization for attempted suicides are higher amongst Ma ̄ori males aged 15–24, compared to non-Ma ̄ori. In contrast, suicide is virtually unknown amongst older Ma ̄ori (60 years). This article reviews explanations for the observed rates of suicide in Ma ̄ori, and examines approaches to effective intervention to reduce rates of suicide in young Ma ̄ori

The psychological impacts of major disasters

There is a widespread and growing perception that the rate of natural disasters including floods, fires, earthquakes and other disasters is increasing (EM-DAT, 2012; GRID-Arendal, 2012; World Bank, 2013). While these claims are contested, the weight of the evidence suggests that the perceptions of increased rates of natural disaster have arisen for two reasons. First, as a result of climate change there has been an increase in the rate of hydrometeorological events including hurricanes, typhoons and flooding (GRID-Arendal, 2012; The World Bank, 2010). This trend has been augmented by the growth of the human population, which means that more people are living in areas at increased risks of natural disasters (Arnold et al., 2005; The World Bank, 2010)

Does socioeconomic inequality explain ethnic differences in nicotine dependence? Evidence from a New Zealand birth cohort

Objective: The present study examined the role of socioeconomic status and cultural identity in the association between ethnicity and nicotine dependence, in a birth cohort of >1000 methods young people studied to age 30. Methods: Data were gathered on ethnicity, cultural identification, nicotine dependence, and socioeconomic factors, as part of a longitudinal study of a New Zealand birth cohort (the Christchurch Health and Development Study). Results: Those reporting Mori identity had rates of nicotine dependence that were significantly higher (p < 0.05) than rates for non-Mori. Control for socioeconomic factors reduced the associations between ethnic identity and nicotine dependence to statistical non-significance. In addition, there was no evidence of a statistically significant association between Mori cultural identity and nicotine dependence, nor was there evidence of gender differences in the association between ethnic identity and nicotine dependence, after controlling for socioeconomic factors. Conclusions: The higher rates of nicotine dependence observed among Mori appear to be attributable to differences in socioeconomic status. Efforts to improve the socioeconomic standing of Mori should therefore help to reduce rates of nicotine dependence in this population

Alcohol misuse and psychosocial outcomes in young adulthood: Results from a longitudinal birth cohort studied to age 30

PURPOSE: This study examined the associations between measures of alcohol abuse/dependence symptoms and a range of psychosocial outcomes from ages 21 to 30 in a New Zealand birth cohort. METHODS: Outcome measures included measures of: criminal offending, family violence and relationship instability, sexual risk-taking and consequences, mental health, and other adverse health and adjustment outcomes. Bivariate associations between a three-level classification of alcohol misuse (no symptoms, subclinical level of symptoms, met criteria for alcohol dependence) and each outcome during the period 21-30 years were computed using Generalised Estimating Equation models. These associations were then adjusted for non-observed sources of confounding using conditional fixed effects regression modelling, augmented by time-dynamic covariate factors. For both sets of models estimates of the attributable risk (AR) were computed. RESULTS: There were statistically significant (p<.05) bivariate associations between alcohol misuse and each of the fifteen outcome measures, with estimates of the AR ranging from 7.4% to 46.5%. Adjustment for non-observed fixed effects generally reduced the magnitude of these associations; however, after adjustment, 12 of the 15 associations remained statistically significant (p<.05). Estimates of the AR after adjustment for fixed effects ranged from 3.6% to 44.3%. CONCLUSIONS: The results suggest that there are pervasive and persistent linkages between alcohol misuse and a range of adverse psychosocial outcomes. A reduction in levels of alcohol misuse amongst individuals of this age group could reduce substantially the overall level of personal and societal cost of hazardous levels of alcohol consumption

Abortion and mental health: A response to Romans and Steinberg

In their recent commentaries on our paper (Fergusson et al., 2013), Romans (2013) and Steinberg (2013) produce a series of arguments which they claim impugn the validity of our conclusions that: “at the present time there is no credible evidence to support the research hypothesis that abortion reduces any mental health risks associated with unwanted or unplanned pregnancies that come to term” (p7). Their critiques centre around two general issues: (1) the choice of research design used to test the research hypothesis; and (2) the selection and analysis of data. We address these issues

Childhood self-control and adult outcomes: Results from a 30-year longitudinal study

Objective: A study by Moffitt et al. reported pervasive associations between childhood self-control and adult outcomes. The current study attempts to replicate the findings reported by Moffitt et al., adjusting these results for the confounding influence of childhood conduct problems. Method: Data were gathered from the Christchurch Health and Development Study, a longitudinal birth cohort studied to age 30 years. Self-control during ages 6 to 12 years was measured analogously to that in Moffitt et al., using parent-, teacher-, and self-report methods. Outcome measures to age 30 included criminal offending, substance use, education/employment, sexual behavior, and mental health. Associations between self-control and outcomes were adjusted for possible confounding by gender, socioeconomic status (SES), IQ, and childhood conduct problems (ages 6-10). Results: In confirmation of the findings of Moffitt et al., all outcomes except major depression were significantly (p <.05) associated with childhood self-control. Adjustment for gender, SES, and IQ reduced to some extent the magnitude of the associations. However, adjustment for childhood conduct disorder further reduced the magnitude of many of these associations, with only 4 of the 14 outcomes remaining statistically significantly (p <.05) associated with self-control. After adjustment for gender, SES, IQ, and conduct problems, those individuals who scored higher in self-control had lower odds of violent offending and welfare dependence, were more likely to have obtained a university degree, and had higher income levels. Conclusions: The findings from this study suggest that observed linkages between a measure of childhood self-control and outcomes in adulthood were largely explained by the correlated effects of childhood conduct problems, SES, IQ, and gender

Exposure to childhood sexual and physical abuse and subsequent educational achievement outcomes

Objective: This paper examined the relationship between exposure to sexual and physical abuse (CSA and CPA) in childhood and later educational achievement outcomes in late adolescence and early adulthood in a birth cohort of over 1,000 children studied to age 25. Method: Retrospective data on CSA and CPA were gathered at ages 18 and 21 and used to form a best estimate of exposure to CSA and CPA. The relationship between CSA, CPA, and self-reported educational outcomes to 25 years was examined using logistic regression models that took into account social background, parental factors, and individual factors. Results: Increasing exposure to CSA and CPA was significantly associated with failing to achieve secondary school qualifications (CSA: B = .53, SE = .13, p &lt; .0001; CPA: B = .62, SE = .12, p &lt; .0001), gaining a Higher School Certificate (CSA: B = -.48, SE = .13, p &lt; .001; CPA: B = -.78, SE = .14, p &lt; .001), attending university (CSA: B = -.29, SE = .13, p &lt; .05; CPA: B = -.45, SE = .13, p &lt; .001), and gaining a university degree (CSA: B = -.54, SE = .18, p &lt; .005; CPA: B = -.64, SE = .17, p &lt; .001). Adjustment for confounding social, parental, and individual factors explained most of these associations. After control for confounding factors, omnibus tests of the associations between CSA and outcomes and CPA and outcomes failed to reach statistical significance (CSA: Wald ?2 (4) = 7.72, p = .10; CPA: Wald ?2 (4) = 8.26, p = .08). Conclusions: The effects of exposure to CSA and CPA on later educational achievement outcomes are largely explained by the social, family, and individual context within which exposure to abuse takes place

The short-term consequences of early onset cannabis use

The associations between early onset (prior to 15 years of age) cannabis use and rates of mental health or adjustment problems during the period from 15 to 16 years of age were studied in a New Zealand birth cohort. Early onset cannabis users were at increased risks of later substance use behaviors, conduct/oppositional disorders, juvenile offending, severe truancy, school dropout, anxiety, depression, and suicidal ideation. Early cannabis users had odds of these outcomes ranging from 2.7 to 30.8 times higher than the odds for those who did not use cannabis prior to age 15. Most of the elevated risks of early onset users were explained by the fact that they were a high- risk group of adolescents characterized by family disadvantages, early adjustment problems, and high affiliations with substance-using or delinquent peers. Nonetheless, even after adjustment for a wide range of confounding factors, early onset users had increased risks of later cannabis use. It is concluded that while most of the elevated risks of early onset users were explained by social, family, and individual characteristics of this group, early onset users were at increased risks of later cannabis use