Aimee L. Ward

Persistent cannabis users show neuropsychological decline from childhood to midlife

Recent reports show that fewer adolescents believe that regular cannabis use is harmful to health. Concomitantly, adolescents are initiating cannabis use at younger ages, and more adolescents are using cannabis on a daily basis. The purpose of the present study was to test the association between persistent cannabis use and neuropsychological decline and determine whether decline is concentrated among adolescent-onset cannabis users. Participants were members of the Dunedin Study, a prospective study of a birth cohort of 1,037 individuals followed from birth (1972/1973) to age 38 y. Cannabis use was ascertained in interviews at ages 18, 21, 26, 32, and 38 y. Neuropsychological testing was conducted at age 13 y, before initiation of cannabis use, and again at age 38 y, after a pattern of persistent cannabis use had developed. Persistent cannabis use was associated with neuropsychological decline broadly across domains of functioning, even after controlling for years of education. Informants also reported noticing more cognitive problems for persistent cannabis users. Impairment was concentrated among adolescent-onset cannabis users, with more persistent use associated with greater decline. Further, cessation of cannabis use did not fully restore neuropsychological functioning among adolescent-onset cannabis users. Findings are suggestive of a neurotoxic effect of cannabis on the adolescent brain and highlight the importance of prevention and policy efforts targeting adolescents.

Weight loss in obese adults 65 years and older: A review of the controversy

Obesity in older adults is ubiquitous in many developed countries and is related to various negative health outcomes, making it an important public health target for intervention. However, treatment approaches for obesity in older adults remain controversial due to concerns surrounding the difficulty of behavior change with advancing age, exacerbating the age-related loss of skeletal muscle and bone, and the feasibility of long-term weight maintenance and related health consequences. This review serves to systematically examine the evidence regarding weight loss interventions with a focus on obese (body mass index 30kg/m(2) and above) older adults (aged 65years and older) and some proposed mechanisms associated with exercise and caloric restriction (lifestyle intervention). Our findings indicate that healthy weight loss in this age group can be achieved through lifestyle interventions of up to a one-year period. Most interventions reviewed reported a loss of lean body mass and bone mineral density with weight loss. Paradoxically muscle quality and physical function improved. Inflammatory molecules and metabolic markers also improved, although the independent and additive effects of exercise and weight loss on these pathways are poorly understood. Using our review inclusion criteria, only one small pilot study investigating long-term weight maintenance and associated health implications was found in the literature. Future research on lifestyle interventions for obese older adults should address the loss of bone and lean body mass, inflammatory mechanisms, and include sufficient follow-up to assess long-term weight maintenance and health outcomes.

Found in (survey) translation: lessons learned while engaging with a wharekura in Southland, New Zealand

ABSTRACT We liaised with a wharekura (Māori language immersion school) to translate and disseminate an online survey for a group of Māori youth in Southland, New Zealand (NZ). The focus of this article is not results, but the processes of respondent orientation and engagement to more genuinely include Māori in a youth survey. An online survey about transport and well-being was conducted with older teenagers from 12 schools, including the wharekura. After working with wharekura staff and students, the survey was translated from English into te reo Māori using best-practice methods. Steps were taken to safeguard authentic engagement, including how the survey translation was conducted, and how the survey data were shared. This NZ-specific experience adds to the literature about the practice of applying the principle of respondent orientation to the process of translating an existing survey into te reo Māori, demonstrating commitment to some Treaty of Waitangi principles. While this is not a kaupapa Māori research project, it is informed by some kaupapa Māori principles. This may be seen as a limitation of this work; however, we believe there are many positive experiences and lessons to be learned from our approach.

Transport behaviours among older teenagers from semi-rural New Zealand

Objective: Transport impacts teenagers by affecting their autonomy and independent access to activities. This manuscript reports descriptive findings of transport behaviours among teenagers in Southland, New Zealand, and discusses the implications of these for public health and policy.

0078 Assessing the feasibility of an online survey of transport behaviour and well-being among teenagers in rural new zealand

Statement of purpose Motor vehicle accidents (MVAs) are a significant cause of injury among youth aged 15–19. The crude rates of hospitalisation due to MVA were 101 and 153/100,000 persons (U.S. and NZ, respectively, 2000–2012). During the same period, Southland, NZ reported a rate of 167/100,000. Differences in licencing age and overall fleet/road quality may contribute to some variances between countries. But knowledge gaps remain. Youth licensure and vehicle miles travelled (VMT) have declined worldwide, and, although injuries affect well-being, mental health with regard to transport isn’t researched. This presentation will discuss these gaps via preliminary findings from, and the testing of, a pilot study of youth in Southland. Methods/Approach Preliminary qualitative research informed the writing of an on-line pilot survey to assess transport behaviour and well-being among a sample of NZ teenagers, allowing for assessment of feasibility with regard to content and process prior to dissemination to a larger study population. In-class and home-based delivery methods were evaluated through a pilot study. Results The pilot study indicates that a larger survey is feasible. Overall response rate was 82%. Response rate was higher in those completing the survey in-class compared to those completing it at home (97% and 55%, respectively). Thirty-one percent had no level of licensure. During the previous month, 55% of those with some level of licensure drove, 84% were car passengers and 78% used active transport (AT). Reasons for low licensure and VMT included economic and geographical barriers, safety concerns, and ambivalence. Happiness levels corresponded with AT, access and proximity to town. These results seem reasonable, demonstrating the pilot survey questions are valid and satisfactory for the main study. Conclusions In-class survey dissemination is preferable due to increased response. Results of the pilot corresponded with the literature, indicating a larger study will provide a stronger evidence base for current hypotheses. Geography and access appeared to relate to well-being; this is an interesting association not previously observed, and will be further examined in the main study. Significance and contribution to the field This pilot study assessed questions and methods that addressed all modes of transport through the lens of public health, and uniquely considered measures of associations between transport behaviour and well-being among those with the highest injury risk. The main study in 2015, among youth in both NZ and the U.S., will provide new knowledge in these areas.