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C Bower

Publications and source records attributed to C Bower.

At least 55 records · Page 3Linked to original sources
PubMed1997

Promotion of folate for the prevention of neural tube defects: knowledge and use of periconceptional folic acid supplements in Western Australia, 1992 to 1995.

To assess changes in knowledge and use of folic acid supplements in relation to a statewide health promotion project for the prevention of neural tube defects, we surveyed general practitioners, pharmacists, women of child-bearing age and pregnant women in Western Australia. We also collected data on wholesale sales of folic acid supplements. By the end of the project, 56.5 per cent of general practitioner respondents knew that the recommended dose of folic acid was 0.5 mg and 70 per cent offered folic acid supplements to women planning pregnancy, 82.5 per cent of responding pharmacists knew the recommended dose, and 87.5 per cent reported an increase in sales of 0.5 mg folic acid. Wholesale sales of 0.5 mg folic acid increased markedly in Western Australia compared with other states. From shopping centre surveys of women of child-bearing age we estimated that their knowledge of the association between folate and spina bifida increased from 8.2 per cent before the project to 67.5 per cent 2.5 years later, and doctors were a major source of information for women. In a 1995 survey of a sample of pregnant women, 43.1 per cent with planned pregnancies had taken folic acid supplements periconceptionally, compared with 19.1 per cent in a similar survey in 1993.

Adult↗
PubMed1997

Changes in folate supplementation, and in serum and red cell folate levels in antenatal patients over the course of a health promotion project for the prevention of neural tube defects.

We assessed the use of folic acid supplements and changes in serum and red cell folate levels in pregnancy over the course of a health promotion project in Western Australia by 4 cross-sectional studies of women attending a public antenatal outpatient clinic in 1992 (before the launch of the health promotion project), 1993, 1994, and 1995. A short questionnaire was completed and blood taken for estimation of serum and red cell folate. There was an increase in the proportion of women taking folic acid supplements in the first trimester (51.9% in the final phase) and before pregnancy (15% in the final phase of the study), and no change in the proportion taking other vitamin supplements. Serum and red cell folate levels increased significantly over the study period in both women taking and not taking folic acid supplements. The proportion of women who had seen the pamphlet used in the health promotion project rose to 35.4% in the third phase, and fell to 27.8% in the final phase. Coincident with the health promotion project, there was an increase in folate status in early pregnancy. However, most women were not taking folic acid supplements before they became pregnant and, hence may not have had sufficient folate at the time of normal neural tube closure.

Erythrocytes↗
PubMed1997

Evaluation of a project to enhance knowledge of hereditary diseases and management.

During 1992 and 1993, in a designated suburban area of Perth, Western Australia, information on hereditary disease was provided for health professionals and the general community. This information was in the form of posters, pamphlets, postal flyers and return letter cards, a static display, newspaper articles, advertisements and radio broadcasts, and professional seminars. The aim of this project was to evaluate the effectiveness of combined strategies to convey practical information about hereditary disease to the community and health professionals. Multiple measures of response evaluation were used, which included structured questionnaire surveys of health professionals and members of the community before and after the project. In the community surveys, respondents who were female, married, middle aged, and parents, and had a higher level of education or were born in Australia, New Zealand, or the United Kingdom were generally better informed about hereditary diseases. This intervention resulted in only meagre changes in community knowledge about hereditary disease, even though promotional materials were shown to be appropriate. General Practitioners (GPs) and Child Health Nurses (CHNs) were supportive of clinical genetic services and recognised a need for continuation of education in this field. There is a rapidly increasing need for community and health professional comprehension of the applications of the new genetic technology. This project indicates that routine educational and health promotion strategies will not be enough to achieve desired levels of knowledge and attitude change.

Adult↗
PubMed1997

The prevalence and incidence of Rett syndrome in Australia.

The Australian Paediatric Surveillance Unit and the Rett Syndrome Association of Australia (a parent support group) were the main sources of ascertainment of cases of Rett syndrome (RS) aged 18 years or less in Australia. Further information was obtained from questionnaires to paediatricians and families. Cases were categorised as classical, atypical, potential or non-verifiable, using internationally recognised criteria. Capture recapture methods were used to adjust prevalence measures for missing cases, and Kaplan Meier survival analysis to estimate cumulative incidence. A total of 134 cases of RS was identified, and of those over 5 years of age, 68% were classical and 32% were atypical. The adjusted prevalence was 0.72 per 10,000 females, and the cumulative incidence was 0.96 per 10,000 females to age 12 years. The prevalence was similar to that in Sweden and Scotland, but higher than in Texas. Comparing successive birth cohorts, there was evidence to suggest that RS is being diagnosed earlier and that more cases are being diagnosed as atypical.

Adolescent↗
PubMed1996

Ondansetron decreases postoperative vomiting in pediatric patients undergoing tonsillectomy and adenoidectomy.

One of the most frequently performed pediatric surgical procedures is tonsillectomy and adenoidectomy. Nausea and vomiting and the inability to tolerate oral fluids lead to unplanned hospitalizations. Despite treatment with metoclopramide and droperidol, nausea and vomiting continue to be high after this procedure. We designed this investigation to compare currently utilized antiemetics to ondansetron, a new serotonin antagonist, in hopes of decreasing the occurrence of nausea and vomiting in patients undergoing tonsillectomy and adenoidectomy. This prospective, randomized, double-blinded clinical trial compared ondansetron, droperidol, and placebo administered at the induction of general anesthesia and the incidence of vomiting postoperatively. One-hundred sixty-five children between the ages of 2 and 12 years undergoing ambulatory adenotonsillectomy were enrolled and completed this investigation. The primary outcome measure was the elimination of vomiting during the 24-h investigative period following surgery. Both ondansetron and droperidol significantly lowered the incidence of postoperative emesis after tonsillectomy and adenoidectomy (P < 0.012) compared to placebo. Ondansetron was significantly more effective than droperidol in reducing emesis after discharge (P < 0.025). Both ondansetron and droperidol are effective in decreasing emesis when given before surgical incision in pediatric patients undergoing tonsillectomy and adenoidectomy. Ondansetron's antiemetic effect persists for up to 24 h following surgery with significant reductions in emesis. Ondansetron's effectiveness in eliminating vomiting without sedation or other side effects suggests that it should be considered as part of the standard management in pediatric patients undergoing tonsillectomy and adenoidectomy.

Adenoidectomy↗
PubMed1996

School-aged children with spina bifida in Western Australia--parental perspectives on functional outcome.

A questionnaire mailed to the parent(s) of all 86 school-aged children with spina bifida resident in Western Australia in 1992 who were attending a spinal dysfunction clinic or were members of the Spina Bifida Association was returned by 72 parents. All 72 of these children (55 with myelomeningocele, 17 with meningocele) lived at home with their parent(s). All but two children with meningocele were mobile without aids, whereas only 42% of the children with myelomeningocele were. Twenty one per cent of the children were naturally continent of urine day and night, and 36% were naturally continent of faeces. 76% attended a mainstream school although performance at school was rated below average for 40%. Nine children with meningocele (56%) and 42 with myelomeningocele (76%) were reported to have learning difficulties. This information will be useful in counselling parents of unborn and newborn children with spina bifida, and in allocating resources for children and young adults with spina bifida and their families.

Adolescent↗
PubMed1996

The impact of antenatal screening for Down syndrome in Western Australia: 1980-1994.

Since the early 1970s, women in Western Australia have been screened for fetal Down syndrome risk on the basis of maternal age. Women 35 years of age or more at delivery, were offered fetal karyotyping with genetic diagnostic testing via amniocentesis or chorionic villus sampling. An increase in the prevalence of Down syndrome of 3.9% per year (95% confidence interval: 1.8-6.0%) was observed between 1980 and 1994, almost all of which was accounted for by increased maternal age. In 1991, a maternal serum screening (MSS) programme for Down syndrome was first implemented in Western Australia and has since evolved in 6 separate laboratories providing Down risk assessment in 1994. The gradual introduction of MSS programmes had little discernible impact until 1994, when 38% of Down syndrome fetuses were ascertained as a result of increased-risk MSS tests and the birth prevalence of Down syndrome decreased significantly. In this report, we review antenatal screening programmes and their impact on the birth prevalence of Down syndrome in Western Australia.

Adult↗
PubMed1996

Characterization of surfactant effect on aggregates in model aerosol propellent suspensions.

A novel technique of rheometry combined with image analysis to study model aerosol suspensions used in inhalation technology has been used. The role of surfactants in the stability and aggregation of such suspensions was also investigated. Addition of increasing concentrations of sorbitan monooleate (Span 80) to suspensions of micronized polar solids in model CFC suspensions caused marked changes in aggregate morphology and suspension stability. The aggregate behaviour was characterized in a modified constant stress rheometer by use of image analysis techniques, allowing the measurement of particle size, elongation and fractal dimension as a function of shear stress. This method was used to study the effect of Span 80 on suspensions of lactose and salbutamol sulphate in P113. Lactose suspensions showed a gradual reduction in aggregate size, and more spherical structure, with increasing surfactant concentration. Salbutamol sulphate suspensions displayed a more prominent transition from an aggregated state to a weakly aggregated state at 0.02% w/w surfactant. Both suspensions were disaggregated by shear, the resulting fractal properties of the aggregates in shear demonstrating the increased particle mobility caused by the surfactant.

Adrenergic beta-Agonists↗
PubMed1996

The effect of surfactant and solid phase concentration on drug aggregates in model aerosol propellent suspensions.

The effect of increasing solid phase concentration on the morphology and flocculation rate of model aerosol suspensions has been investigated. Suspensions of micronized salbutamol sulphate and lactose in trichlorotrifluoroethane (P113) were studied under conditions of increasing shear stress. By use of image analysis techniques, measurement of aggregate size, fractal dimension and rate of aggregation was performed. The effect of the surfactant sorbitan monooleate on morphology and flocculation rate was also studied. Increased solid phase concentration caused an increase in the rate of aggregation and average aggregate size at a given value of shear stress. Surfactant addition retarded the aggregation rate, and caused a shift from a diffusion-limited cluster aggregation to a reaction-limited cluster aggregation mechanism. The aggregate profiles showed a corresponding change from rugged and crenellated without surfactant, to increasingly smooth and Euclidian with increasing surfactant concentration. The morphological changes were characterized by a decrease in the average boundary fractal dimension which also correlated well with the corresponding reduction in aggregation rate.

Adrenergic beta-Agonists↗
PubMed1995

Skeletal abnormalities in Rett syndrome: increasing evidence for dysmorphogenetic defects.

The presence of metatarsal and metacarpal abnormalities in some individuals has raised the possibility that Rett syndrome is, in fact, a multiple congenital abnormalities/mental retardation (MCA/MR) syndrome. We have conducted radiological examination of 17 cases of Rett syndrome in Western Australia. Short fourth and/or fifth metatarsals were identified in 65% of cases and short fourth and/or fifth metacarpals in 57%. Metatarsal (P = 0.045) and metacarpal (P = 0.006) shortness were significantly more common in girls 14 years or older. Negative ulnar variance (found in 79% of cases) appeared to be independent of age. Reduced bone density in the hands was found in 86% of cases. A nationwide study using the Australian Rett Syndrome Database is planned to follow up these findings and compare them with findings from a control group. The confirmation of these abnormalities in a high proportion of cases may provide morphologic markers to assist in the diagnosis of Rett syndrome and perhaps provide a further avenue of research into the pathogenesis of this disorder.

Abnormalities, Multiple↗
PubMed1995

Pre-pregnancy counselling for the primary prevention of birth defects: rubella vaccination and folate intake.

OBJECTIVE: To describe women's experiences of pre-pregnancy counselling and their knowledge of rubella immunity and folate intake. DESIGN: A cross-sectional sample of 121 public and 32 private patients at or less than 20 weeks' gestation attending their first antenatal appointment completed a self-administered questionnaire. MAIN OUTCOME MEASURES: Awareness of the importance of rubella immunity and folate intake; and the proportion of women who discussed these with their general practitioner (GP) before pregnancy. RESULTS: Rubella: 59% correctly identified the effect of rubella infection in pregnancy and 86% had been vaccinated. Women born in Australia, New Zealand or the United Kingdom were nearly 16 times more likely to have been vaccinated against rubella than those born elsewhere. Folate: 54% knew of the protective effect of folate, 30% correctly identified the timing of this effect, 72% correctly identified some of the sources of dietary folate, and 13% had increased their folate intake before pregnancy. In 49% of women their GP was aware of their intention to conceive, but rubella had not been discussed with the GP before 50% of these planned pregnancies, and in 80% the issue of folate had not been discussed. Private patients were more likely to have had their rubella immune status checked and to have increased their folate intake compared with public patients. CONCLUSIONS: Pre-pregnancy counselling about rubella immunity and folate intake is underused in the primary prevention of birth defects. Given the high proportion of unplanned pregnancies, primary prevention strategies for birth defects must involve all women of child-bearing age and not simply those planning a pregnancy.

Adolescent↗