Objective To determine whether insulating existing houses increases indoor temperatures and improves occupants' health and wellbeing.Design Community based, cluster, single blinded randomised study.Setting Seven low income communities in New Zealand.Participants 1350 households containing 4407 participants.Intervention Installation of a standard retrofit insulation package.Main outcome measures Indoor temperature and relative humidity, energy consumption, self reported health, wheezing, days off school and work, visits to general practitioners, and admissions to hospital.Results Insulation was associated with a small increase in bedroom temperatures during the winter (0.5°C) and decreased relative humidity (−2.3%), despite energy consumption in insulated houses being 81% of that in uninsulated houses. Bedroom temperatures were below 10°C for 1.7 fewer hours each day in insulated homes than in uninsulated ones. These changes were associated with reduced odds in the insulated homes of fair or poor self rated health (adjusted odds ratio 0.50, 95% confidence interval 0.38 to 0.68), self reports of wheezing in the past three months (0.57, 0.47 to 0.70), self reports of children taking a day off school (0.49, 0.31 to 0.80), and self reports of adults taking a day off work (0.62, 0
IntroductionTo reduce the burden on injury survivors and their supporters, factors associated with poor outcomes need to be identified so that timely post-injury interventions can be implemented. To date, few studies have investigated outcomes for both those who were hospitalised and those who were not.AimTo describe the prevalence and to identify pre-injury and injury-related predictors of disability among hospitalised and non-hospitalised people, three months after injury.MethodsParticipants in the Prospective Outcomes of Injury Study were aged 18–64 years and on an injury entitlement claims register with New Zealand's no-fault injury compensation insurer, following referral by healthcare professionals. A wide range of pre-injury demographic, health and injury-related characteristics were collected at interview. Participants were categorised as ‘hospitalised’ if they were placed on New Zealand's National Minimum Data Set within seven days of the injury event. Injury severity scores (NISS) and 12 injury categories were derived from ICD-10 codes. WHODAS assessed disability. Multivariable analyses examined relationships between explanatory variables and disability.ResultsOf 2856 participants, 2752 (96%) had WHODAS scores available for multivariable analysis; 673 were hospitalised; 2079 were not. Disability was highly prevalent among hospitalised (53.6%) and non-hospitalised (39.4%) participants, three-months after injury. In both groups, pre-injury disability, obesity and higher injury severity were associated with increased odds of post-injury disability. A range of other factors were associated with disability in only one group: e.g. female, ≥2 chronic conditions and leg fracture among hospitalised; aged 35–54 years, trouble accessing healthcare, spine or lower extremity sprains/dislocations and assault among non-hospitalised.SignificanceDisability was highly prevalent among both groups yet, with a few exceptions, factors associated with disability were not common to both groups. Where possible, including a range of injured people in studies, hospitalised and not, will increase understanding of the burden of disability in the sub-acute phase.
Background: Although many countries experience an increase in mortality during winter, the magnitude of this increase varies considerably, suggesting that some winter excess may be avoidable. Conflicting evidence has been presented on the role of gender, region and deprivation. Little has been published on the magnitude of excess winter mortality (EWM) in New Zealand (NZ) and other Southern Hemisphere countries.
OBJECTIVE: To identify the age of adiposity rebound and the value of its associated BMI and examine their association with BMI at ages 18 and 21 y for males and females. DESIGN: A longitudinal study of a large cohort of people born in Dunedin, New Zealand between 1972 ± 1973. SUBJECTS: Four hundred and seventy-four males and 448 females aged between birth and 21 y. MEASUREMENTS: BMI was derived from measurements of weight and height made when the participants were born and at intervals from age 3 ± 21 y. RESULTS: When a random coef®cients model was ®tted to the data for those who had ®ve or more measures of BMI between age 3 and age 18 y, adiposity rebound occurred at 6.0 y of age for boys and 5.6 y for girls. The values of BMI associated with these were 15.7 kgam 2 for boys and 15.5 kgam 2 for girls. The correlations between age at adiposity rebound and BMI at ages 18 and 21 y were between 70.72 and 70.65 for boys and 70.59 and 70.47 for girls. These were higher than those derived from ®tting individual curves or from deriving the adiposity rebound from data collected up to age 11 y. The correlation between BMI at age 7 y and BMI at ages 18 and 21 y were 0.70 and 0.61 for boys and 0.56 and 0.52 for girls. The correlations between measures of skeletal maturity at age 7 y and adiposity rebound were statistically signi®cant for boys but not for girls. CONCLUSIONS: BMI in early adulthood was associated with both age of adiposity rebound and BMI at that age. As the correlations between BMI at age 7 y and BMI at ages 18 and 21 y were similar in magnitude, BMI at age 7 y may be a more practical way of predicting BMI in early adulthood.
Asymptomatic VDD is common in East African immigrant children residing at a temperate latitude. Risk factors for VDD limit endogenous vitamin D production. Screening of immigrant children with increased skin pigmentation for VDD, anaemia, iron and vitamin A deficiency is appropriate. VDD in adolescent females identifies an increased risk of future infants with VDD.
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