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Biomedical subjects

F Bowman

Publications and source records attributed to F Bowman.

10 recordsLinked to original sources
PubMed1995

Psychiatric intervention in primary care for mothers whose schoolchildren have psychiatric disorder.

BACKGROUND: Psychiatric disorder in schoolchildren has been linked to increased general practice attendance rates. This increase may, in part, be a result of maternal stress focused on the disturbed child, and of a decrease in confidence in parenting. AIM: A study was undertaken to pilot the feasibility of a single session, psychiatric intervention in primary care for mothers of disturbed children and to examine uptake rates and reported immediate and long-term effects. METHOD: Single psychiatric sessions by a child psychiatrist in general practice were offered to mothers of 26 schoolchildren. The schoolchildren (age range 7-12 years, mean nine years) were frequent attenders in general practice with physical symptoms, and were identified from research interviews carried out with a parent (usually their mother) as psychiatrically disordered. The main outcome measures were the mothers' ratings of helpfulness of the intervention; degree of behavioural, emotional or health problems in their children and confidence in managing them; the Rutter A parental behaviour questionnaire; and children's yearly general practice attendance rates. RESULTS: Sixteen mothers (62%) who were offered appointments attended for the intervention. Nine of the 14 who responded at three-month follow up (64%) reported that the intervention had been markedly or extremely helpful. The main areas of perceived improvement at both three months and at 18-24 months were in the child's behaviour, emotional and health problems, and in the mother's confidence in dealing with these. Mothers also found the specific advice discussed and the ability to talk to somebody about the problems helpful. Mothers were less likely to find the intervention extremely or markedly useful where the child had had previous psychiatric intervention. The mean yearly attendance rate for the whole group of 23 children (data missing for three) decreased from 6.5 consultations before the intervention to 2.8 afterwards; there was a non-significant trend for the drop in attendance to be more marked in the group whose mothers attended the intervention and who felt helped by it, than among the group of children whose mothers only reported finding the intervention slightly useful. CONCLUSION: Standardized child psychiatric interventions which may be used in the primary care setting appear acceptable and may be helpful to mothers in addressing psychiatric disorders associated with somatic presentation in their schoolchildren.

Attitude to Health↗
PubMed1982

Surgical repair of congenitally corrected transposition of the great arteries: results and follow-up.

Eighteen patients with congenitally corrected transposition of the great arteries had open heart repair for intracardiac associated defects. Fourteen patients (78%) are alive during the follow-up period (mean 4.5 years). Seventeen (94%) of the 18 patients had ventricular septal defect closure, and 12 (66%) insertion of a pulmonary artery conduit. Surgical repair of the tricuspid valve was required in 6 patients (33%) during the first operation and in 3 additional patients during a second operation (total 50%). When hemodynamic overload or cardiac compromise was detected after surgery it was directly related to identifiable residual defects such as atrioventricular valvular insufficiency, residual ventricular septal defect, or pulmonary conduit stenosis. Repeat open heart operation for residual defects was common during the follow-up period (8 of 18 patients, 44%). No patient showed primary systemic or pulmonary ventricular dysfunction during the follow-up period. None of the last 11 patients developed complete heart block. Postoperative intraventricular conduction defects were common and are presumably caused by surgical injury of the bundle branches. Our observations suggest that surgical repair of congenitally corrected transposition of the great arteries can be currently achieved with acceptable risk. Improved knowledge of the precise location of the specialized conduction system resulted in a marked decrease in the incidence of atrioventricular (A-V) block in patients with congenitally corrected transposition of the great arteries undergoing intracardiac repair. In the absence of postoperative residual defects it can be expected that longevity and quality of life will improve considerably, but many of these patients may require a repeat operation.

Adolescent↗
PubMed1974

The specificity of some agonists and antagonists for nicotine-sensitive receptors in ganglia.

1 The guinea-pig isolated ileum has been used to estimate the ability of substituted phenylalkylonium salts (related to nicotine) to stimulate or block receptors in ganglia. The effects of hexamethonium were used to indicate which were the most specific ganglion stimulants; these were tested on the blood-pressure of pithed rats and for neuromuscular blocking activity on the rat diaphragm preparation.2m-Hydroxyphenylpropyltrimethylammonium and 3,4-dihydroxyphenethyltrimethylammonium (coryneine, ;quaternary dopamine') were the most active and specific ganglion stimulants but their usefulness in vivo may be limited by their neuromuscular blocking activity. The analogous tertiary compounds are being investigated.3 The affinities of substances which were blocking agents at ganglionic receptors were measured on the isolated ileum with m-hydroxyphenylpropyltrimethylammonium as agonist. The affinities of selected compounds for postganglionic receptors were measured in experiments on the ileum in the presence of hexamethonium and with carbachol as agonist. Some of the compounds were tested for neuromuscular blocking activity on the rat diaphragm.4 Phenylbutyldiethylamine had ganglion-blocking activity greater than pempidine and little postganglionic blocking or neuromuscular blocking activity. Its triethylammonium analogue had higher ganglion-blocking activity but had appreciable neuromuscular blocking activity.5 The aromatic ring system is not essential either for activity or affinity and the effects of substituents are not related to their effects on electron distribution. Stimulant activity is enhanced only by hydroxyl or amino groups in suitable positions; it is not improved by the presence of rigid features (double or triple bonds or a cyclopropane ring) in the side chain. Affinity is slightly increased by chloro or bromo groups in suitable positions but the unsubstituted compounds are among those with the highest affinity. Substituents have similar effects on affinity for postganglionic receptors, though for these receptors the compounds mostly have only about one-tenth of their affinity for ganglionic receptors.

Animals↗