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Slykerman RF, Clasby BE, Chong J, Edward K, Milne BJ, Temperton H, Thabrew H, Bowden N. Case identification of non-traumatic brain injury in youth using linked population data. BMC Neurol 2024; 24:82. [PMID: 38429681 PMCID: PMC10908152 DOI: 10.1186/s12883-024-03575-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 02/19/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Population-level administrative data provides a cost-effective means of monitoring health outcomes and service needs of clinical populations. This study aimed to present a method for case identification of non-traumatic brain injury in population-level data and to examine the association with sociodemographic factors. METHODS An estimated resident population of youth aged 0-24 years was constructed using population-level datasets within the New Zealand Integrated Data Infrastructure. A clinical consensus committee reviewed the International Classification of Diseases Ninth and Tenth Editions codes and Read codes for inclusion in a case definition. Cases were those with at least one non-traumatic brain injury code present in the five years up until 30 June 2018 in one of four databases in the Integrated Data Infrastructure. Rates of non-traumatic brain injury were examined, both including and excluding birth injury codes and across age, sex, ethnicity, and socioeconomic deprivation groups. RESULTS Of the 1 579 089 youth aged 0-24 years on 30 June 2018, 8154 (0.52%) were identified as having one of the brain injury codes in the five-years to 30 June 2018. Rates of non-traumatic brain injury were higher in males, children aged 0-4 years, Māori and Pacific young people, and youth living with high levels of social deprivation. CONCLUSION This study presents a comprehensive method for case identification of non-traumatic brain injury using national population-level administrative data.
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Affiliation(s)
- Rebecca F Slykerman
- Department of Psychological Medicine, Te Ara Hāro, University of Auckland, Building 507, 22-30 Park Avenue, Auckland, Grafton, 1023, New Zealand.
| | - Betony E Clasby
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Jimmy Chong
- Paediatric Rehabilitation Service, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Kathryn Edward
- Paediatric Rehabilitation Service, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Barry J Milne
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
| | - Helen Temperton
- Paediatric Rehabilitation Service, Te Whatu Ora, Te Toka Tumai, Auckland, New Zealand
| | - Hiran Thabrew
- Department of Psychological Medicine, Te Ara Hāro, University of Auckland, Building 507, 22-30 Park Avenue, Auckland, Grafton, 1023, New Zealand
| | - Nicholas Bowden
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
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D'Souza S, Milne BJ, Li C, Anns F, Gardner A, Lumley T, Morton SMB, Murphy IR, Verhagen E, Wright C, Quarrie K. Kumanu Tāngata: the aftermatch study - protocol to examine the health outcomes of high-level male rugby union players using linked administrative data. BMJ Open Sport Exerc Med 2024; 10:e001795. [PMID: 38362564 PMCID: PMC10868174 DOI: 10.1136/bmjsem-2023-001795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2024] [Indexed: 02/17/2024] Open
Abstract
There is increasing interest in the potential long-term outcomes of participation in contact and collision sports, driven by evidence of higher rates of neurodegenerative diseases among former athletes. Recent research has capitalised on large-scale administrative health data to examine health outcomes in contact sport athletes. However, there is limited research on outcomes associated with participation in rugby union, a contact sport with a relatively high incidence of head trauma and musculoskeletal injuries. Additionally, there is scope to investigate a greater range of health outcomes using large, population-based administrative data. The Kumanu Tāngata project is a retrospective cohort study that will use linked information from the New Zealand Rugby Register and health records within a comprehensive deidentified whole-population administrative research database known as the Integrated Data Infrastructure. First-class male rugby union players (N=13 227) will be compared with a general population comparison group (N=2 438 484; weighting will be applied due to demographic differences) on a range of mortality and morbidity outcomes (neurodegenerative diseases, musculoskeletal conditions, chronic physical conditions, mental health outcomes). A range of player-specific variables will also be investigated as risk factors. Analyses will consist primarily of Cox proportional hazards models. Ethics approval for the study has been granted by the Auckland Health Research Ethics Committee (Ref. AH23203). Primary research dissemination will be via peer-reviewed journal articles.
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Affiliation(s)
- Stephanie D'Souza
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Barry J Milne
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Social Sciences, University of Auckland, Auckland, New Zealand
| | - Chao Li
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
| | - Francesca Anns
- COMPASS Research Centre, University of Auckland, Auckland, New Zealand
- School of Psychology, University of Auckland, Auckland, New Zealand
| | - Andrew Gardner
- Sydney School of Health Sciences, The University of Sydney Faculty of Medicine and Health, Sydney, New South Wales, Australia
| | - Thomas Lumley
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Research Institute for Innovative Solutions for Well-being and Health (INSIGHT), University of Technology Sydney, Sydney, New South Wales, Australia
| | - Ian R Murphy
- Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
| | - Evert Verhagen
- Department of Public and Occupational Health, EMGO, Amsterdam UMC Locatie VUmc, Amsterdam, Netherlands
| | - Craig Wright
- Social Wellbeing Agency, Wellington, New Zealand
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Vu H, Bowden N, Gibb S, Audas R, Dacombe J, McLay L, Sporle A, Stace H, Taylor B, Thabrew H, Theodore R, Tupou J, Schluter PJ. Mortality risk among Autistic children and young people: A nationwide birth cohort study. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2024:13623613231224015. [PMID: 38311609 DOI: 10.1177/13623613231224015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
LAY ABSTRACT Existing literature indicates that Autistic people have shorter life expectancy, but little is known about the mortality risk among Autistic children and young people (0-24 years). We used a 15-year nationwide birth cohort study to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. The study included 895,707 children and 11,919 (1.4%) were Autistic. We found that autism was associated with a significantly higher mortality risk compared to the non-Autistic population. In addition, we found that this risk was significantly higher among females compared to males and for those with a co-occurring intellectual disability. Increased efforts are required to better meet the health needs of this population.
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Affiliation(s)
- Hien Vu
- University of Otago, Dunedin, New Zealand
| | - Nicholas Bowden
- University of Otago, Dunedin, New Zealand
- National Science Challenge, New Zealand
| | - Sheree Gibb
- National Science Challenge, New Zealand
- University of Otago, Wellington, New Zealand
| | - Richard Audas
- Memorial University of Newfoundland and Labrador, Canada
| | | | | | - Andrew Sporle
- INZight Analytics Ltd., New Zealand
- University of Auckland, New Zealand
| | | | - Barry Taylor
- University of Otago, Dunedin, New Zealand
- National Science Challenge, New Zealand
| | - Hiran Thabrew
- National Science Challenge, New Zealand
- University of Auckland, New Zealand
| | | | | | - Philip J Schluter
- National Science Challenge, New Zealand
- University of Canterbury, New Zealand
- University of Queensland, Australia
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Cleary M, West S, Johnston-Devin C, Kornhaber R, McLean L, Hungerford C. Collateral Damage: The Impacts of School Exclusion on the Mental Health of Parents Caring for Autistic Children. Issues Ment Health Nurs 2024; 45:3-8. [PMID: 38190434 DOI: 10.1080/01612840.2023.2280718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Despite legislative and policy mechanisms that promote inclusion in education for children with disabilities, many students still experience exclusion from the education setting. For example, autistic children are more likely than their neurotypical counterparts to be expelled or suspended from school or to refuse to attend school on an ongoing basis. This situation gives rise to various challenges for their parents. This discursive paper synthesizes current knowledge on school exclusion involving autistic children, including the causes and consequences of exclusionary practices. The paper also considers the negative impacts of these exclusionary practices on the emotional and psychological well-being of parents and caregivers. Mental health nurses who understand the issues related to school exclusion can better support the educational, social, and developmental needs of autistic children and the mental health needs of parents or caregivers.
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Affiliation(s)
- Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, NSW, Australia
| | - Sancia West
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, NSW, Australia
| | | | - Rachel Kornhaber
- School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, NSW, Australia
| | - Loyola McLean
- Brain and Mind Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
- Westmead Psychotherapy Program for Complex Traumatic Disorders, Western Sydney Local Health District, Parramatta, NSW, Australia
- Western Clinical School, The University of Sydney, Sydney, NSW, Australia
- Consultation-Liaison Psychiatry, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia
| | - Catherine Hungerford
- School of Nursing, Midwifery & Social Sciences, CQUniversity, Sydney, NSW, Australia
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Mujoo H, Bowden N, Thabrew H, Kokaua J, Audas R, Taylor B. Identifying neurodevelopmental disabilities from nationalised preschool health check. Aust N Z J Psychiatry 2023; 57:1140-1149. [PMID: 36748102 PMCID: PMC10363952 DOI: 10.1177/00048674231151606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Models of psychometric screening to identify individuals with neurodevelopmental disabilities (NDDs) have had limited success. In Aotearoa/New Zealand, routine developmental surveillance of preschool children is undertaken using the Before School Check (B4SC), which includes psychometric and physical health screening instruments. This study aimed to determine whether combining multiple screening measures could improve the prediction of NDDs. METHODS Linked administrative health data were used to identify NDDs, including attention deficit hyperactivity disorder, autism spectrum disorder and intellectual disability, within a multi-year national cohort of children who undertook the B4SC. Cox proportional hazards models, with different combinations of potential predictors, were used to predict onset of a NDD. Harrell's c-statistic for composite models were compared with a model representing recommended cutoff psychometric scores for referral in New Zealand. RESULTS Data were examined for 287,754 children, and NDDs were identified in 10,953 (3.8%). The best-performing composite model combining the Strengths and Difficulties Questionnaire, the Parental Evaluation of Developmental Status, vision screening and biological sex had 'excellent' predictive power (C-statistic: 0.83) compared with existing referral pathways which had 'poor' predictive power (C-statistic: 0.68). In addition, the composite model was able to improve the sensitivity of NDD diagnosis detection by 13% without any reduction in specificity. CONCLUSIONS Combination of B4SC screening measures using composite modelling could lead to significantly improved identification of preschool children with NDDs when compared with surveillance that rely on individual psychometric test results alone. This may optimise access to academic, personal and family support for children with NDDs.
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Affiliation(s)
- Himang Mujoo
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Nicholas Bowden
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
| | - Hiran Thabrew
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Jesse Kokaua
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Va’a O Tautai – Centre for Pacific Health, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Richard Audas
- Faculty of Medicine, Memorial University of Newfoundland and Labrador, St. John’s, NL, Canada
| | - Barry Taylor
- A Better Start National Science Challenge, Liggins Institute, University of Auckland, Auckland, New Zealand
- Department of Women’s and Children’s Health, University of Otago, Dunedin, New Zealand
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Gorman E, Bowden N, Kokaua J, McNeill B, Schluter PJ. A national multiple baseline cohort study of mental health conditions in early adolescence and subsequent educational outcomes in New Zealand. Sci Rep 2023; 13:11025. [PMID: 37419984 PMCID: PMC10329034 DOI: 10.1038/s41598-023-38131-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 07/03/2023] [Indexed: 07/09/2023] Open
Abstract
Young people experiencing mental health conditions are vulnerable to poorer educational outcomes for many reasons, including: social exclusion, stigma, and limited in-school support. Using a near-complete New Zealand population administrative database, this prospective cohort study aimed to quantify differences in educational attainment (at ages 15-16 years) and school suspensions (over ages 13-16 years), between those with and without a prior mental health condition. The data included five student cohorts, each starting secondary school from 2013 to 2017 respectively (N = 272,901). Both internalising and externalising mental health conditions were examined. Overall, 6.8% had a mental health condition. Using adjusted modified Poisson regression analyses, those with prior mental health conditions exhibited lower rates of attainment (IRR 0.87, 95% CI 0.86-0.88) and higher rates of school suspensions (IRR 1.63, 95% CI 1.57-1.70) by age 15-16 years. Associations were stronger among those exhibiting behavioural conditions, compared to emotional conditions, in line with previous literature. These findings highlight the importance of support for young people experiencing mental health conditions at this crucial juncture in their educational pathway. While mental health conditions increase the likelihood of poorer educational outcomes, deleterious outcomes were not a necessary sequalae. In this study, most participants with mental health conditions had successful educational outcomes.
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Affiliation(s)
- Emma Gorman
- School of Organisations, Economy and Society, University of Westminster, 35 Marylebone Rd, Marylebone, London, NW1 5LS, UK.
| | - Nicholas Bowden
- Department of Women's and Children's Health, University of Otago, 201 Great King St, Dunedin, 9016, New Zealand
- A Better Start National Science Challenge, Auckland, New Zealand
| | - Jesse Kokaua
- Department of Women's and Children's Health, University of Otago, 201 Great King St, Dunedin, 9016, New Zealand
- A Better Start National Science Challenge, Auckland, New Zealand
- Va'a O Tautai-Centre for Pacific Health, Division of Health Sciences, University of Otago, 78 Frederick St, Dunedin, 9017, New Zealand
| | - Brigid McNeill
- Te Kāhui Pā Harakeke, Child Well‑being Research Institute, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, 8041, New Zealand
- Te Kura Whakangungu Kaiako, The School of Teacher Education, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, 8041, New Zealand
| | - Philip J Schluter
- Te Kāhui Pā Harakeke, Child Well‑being Research Institute, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, 8041, New Zealand
- Te Kaupeka Oranga, Faculty of Health, Te Whare Wānanga o Waitaha, University of Canterbury, Christchurch, 8041, New Zealand
- Primary Care Clinical Unit, School of Clinical Medicine, The University of Queensland, Brisbane, Australia
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