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Biomedical subjects

M J McDowell

Publications and source records attributed to M J McDowell.

6 recordsLinked to original sources

Developmental-behavioural problems in general paediatrics.

OBJECTIVE: To determine the current role of private general paediatrics in the care of children with problems of development and behaviour. METHODS: We surveyed all general paediatricians registered with the Australian College of Paediatrics to assess their current role in developmental-behavioural (DB) problems--their rate of referrals, their role in the continuing management, and opinions regarding duration of training in this area. RESULTS: Of 394 questionnaires sent, 284 replies were received (72%). From these 284 we analysed results for all 172 who spent more than 25% of their time in private general paediatric practice. On average, 32% of new referrals were for DB problems. With 10 DB clinical vignettes presented, paediatricians chose to continue to manage in conjunction with allied health services in 65% of cases. Other management choices included referral to a multidisciplinary team (16%), referral elsewhere (10%) and manage alone (7%). For training to be a general paediatrician, they indicated 3 months should be spent during basic training in each of the three areas of; DB paediatrics, developmental disabilities and child psychiatry (separately or concurrently); and 6 months of each during advanced training. Free comments highlighted lack of public allied health and psychosocial services. CONCLUSION: Private community-based general paediatricians are deeply involved in this area of work. The results raise questions about services for training and for clinical collaboration between public and private child health providers.

Australia

Management of children prescribed psychostimulant medication for attention deficit hyperactivity disorder in the Hunter region of NSW.

OBJECTIVE: To examine local procedures for assessment of attention deficit hyperactivity disorder (ADHD) and its management with psychostimulant medication and to compare these with published practice guidelines. DESIGN: Retrospective postal survey. PARTICIPANTS: Parents of children living in the Hunter region of New South Wales first prescribed psychostimulants between 1992 and 1994. MAIN OUTCOME MEASURES: Procedures for diagnostic assessment, treatment monitoring and continuing management. RESULTS: 788 parents (60%) responded. Diagnostic assessment procedures complied with published guidelines for about 70%, and detection of comorbid conditions was consistent with community prevalence estimates. There was systematic assessment of treatment response with questionnaires in only a third. Some children with academic or behavioural problems (19%-24% and 32%, respectively), almost 50% with emotional problems and 63% with motor problems were not receiving treatment for these difficulties. Modal interval for review was six months. Trials off medication were most commonly during school holidays, contrary to recommendations of the New South Wales Health Department. Most parents reported considerable improvement in their children's quality of life with medication. CONCLUSIONS: Problems comorbid with ADHD are detected often. Areas of deficiency in management of ADHD include the low rate of contact with schools for diagnostic assessment and determining treatment efficacy, poor support for comorbid problems, infrequent review, and inadequate methods for determining need to continue treatment.

Adolescent

Translation of reovirus messenger RNAs synthetesized in vitro into reovirus polypeptides by several mammalian cell-free extracts.

Single-stranded reovirus RNA, synthesized in vitro by reovirus cores, functioned as messenger RNA in cell-free extracts prepared from several mammalian cells: Krebs II mouse ascites cells, mouse L cells, Chinese hamster ovary cells, HeLa cells, and rabbit reticulocytes. As shown by acrylamide gel electrophoresis, all eight polypeptides known to be specified by reovirus were synthesized in the reticulocyte system. In the other extracts, from 5 to 7 complete virus proteins were made.

Animals