Biomedical subjects

P Baghurst

Publications and source records attributed to P Baghurst.

At least 19 recordsLinked to original sources

PubMed2005

A South Australian population-based study of congenital talipes equinovarus.

The aims of this study were to provide a population-based prevalence for congenital talipes equinovarus (CTEV), to conduct an epidemiological investigation into the risk factors for CTEV and describe associated features. The study used a retrospective case-control design of CTEV notified to the South Australian Birth Defects Register between 1986 and 1996 inclusive, linking characteristics of mother and baby from the perinatal data collection. The prevalence of isolated CTEV was 1.1/1000 total births (n = 231). Four factors were significantly associated with an increased risk of CTEV: maternal Aboriginal race (ORadj = 2.0; 95% CI 1.1, 3.6), male gender (ORadj = 2.4; 95% CI 1.8, 3.2), maternal anaemia (ORadj = 1.8; 95% CI 1.0, 2.9) and maternal hyperemesis (ORadj = 3.6; 95% CI 1.3, 9.8). The prevalence of CTEV associated with another birth defect or syndrome (n = 157) was 0.7/1000 total births. CTEV was associated with specific birth defects and also with oligohydramnios when another birth defect was present.

Anemia↗

PubMed2003

Prevalence of gastroenteritis among 4-year-old children in South Australia.

The aim of this study was to determine the prevalence of gastroenteritis among children aged 4 years in South Australia. A cross-sectional survey of 9543 South Australian children aged 4 years was undertaken. Parents completed a questionnaire on behalf of their child who had attended a pre-school health check in 1998. The questionnaire covered gastrointestinal and respiratory symptoms experienced by the child in the previous 2 weeks and other risk factors for gastroenteritis. The 2-week prevalence of gastroenteritis among 4-year-old children was 14.2%. The major risk factors for gastroenteritis were presence of persons who had gastroenteritis inside the home, contact with persons who had gastroenteritis outside the home, antibiotic use and sore throat. Medical attention was sought for 20% of children who had gastroenteritis. Gastroenteritis is a significant cause of morbidity among young children and presents a considerable burden on the community. A substantial proportion of these occurrences of highly credible gastrointestinal symptoms may be manifestations of respiratory infections.

Child Day Care Centers↗

PubMed2002

Pulmonary volume recruitment manoeuvre restores pulmonary compliance and resistance after apnoea in anaesthetized lambs.

BACKGROUND: We studied the effects of an episode of induced apnoea on the dynamic compliance (Crs) and resistance (Rrs) of the respiratory system in anaesthetized lambs and investigated the mechanisms underlying the effectiveness of a timed reexpansion inspiratory manoeuvre (TRIM). METHODS: Following 2 min of apnoea, three manoeuvres were randomly performed: (i) control: reventilated without TRIM using initial settings and gas composition of 30% oxygen in 70% nitrous oxide; (b) T1: TRIM with 30% oxygen in 70% nitrous oxide, followed by reventilation with the initial settings; and (c) T2: preoxygenate with 100% oxygen, apnoea, then TRIM with 100% oxygen, then reventilation with 100% oxygen at the initial settings. The percentage change in Crs and Rrs was calculated at first breath, second breath, 10, 20, 40, 60, 90, 120 and 180 s postapnoea. RESULTS: Mean control decreased 15% and did not return to baseline during the study period. TRIM increased mean Crs in T1 and T2 by 8% and 9%, respectively, at first breath and returned to baseline and did not deteriorate for the remainder of the study period. Mean Rrs in the control group increased 20% and did not return to baseline during the study period. Mean Rrs in T1 and T2 initially increased 17% and 27%, respectively, at first breath and returned to baseline within 40 s. CONCLUSIONS: These results demonstrate that significant deterioration occurs in Crs and Rrs following 2 min of apnoea in anaesthetized lambs, which is not corrected with normal ventilation but is rapidly and completely reversed with a TRIM. This supports our hypothesis that volume recruitment of alveoli is an effective manoeuvre in restoring lung function. The practice of preoxygenation is also reinforced as the lambs maintained maximal oxygen saturation if they were ventilated with 100% oxygen prior to the 2 min of apnoea.

Anesthesia, General↗

PubMed2001

Reduced total plasma homocyst(e)ine in children and adolescents with type 1 diabetes.

OBJECTIVES: The objective was to investigate total plasma homocyst(e)ine (tHcy), methylenetetrahydrofolate reductase (MTHFR) genotype, and the contribution of diet to homocysteine values in children and adolescents with type 1 diabetes and a control group. STUDY DESIGN: A total of 78 children with type 1 diabetes and 59 members of an age- and sex-matched control group were recruited. Fasting samples were collected for tHcy, MTHFR genotype, serum vitamin B(12), serum folate, red cell folate, and plasma creatinine. Food frequency questionnaires targeted intake of folate, vitamin B(6), and vitamin B(12). RESULTS: Fasting tHcy was reduced in patients compared with the control group (4.7 vs 5.9 micromol/L, P <.001). Serum folate (P =.002), red cell folate(P <.001), and serum vitamin B(12) (P =.005) were higher, and plasma creatinine was lower. A significant difference in tHcy values between patients and the control group persisted after correction was done for these factors (r = 0.1, P =.02). No difference was seen in the frequency of MTHFR polymorphisms. tHcy was not elevated in those patients with the 677TT or 677T/1298C genotypes, although red cell folate was significantly higher in members of the case (P =.01) and control groups (P =.05) with a 677 TT genotype. Dietary intake of folate correlated with serum folate (r = 0.4,P =.005). CONCLUSION: tHcy values are lower in children and adolescents with type 1 diabetes. Higher serum levels of folic acid and vitamin B(12), reflecting differences in dietary intake between children with diabetes and members of a control group, partially account for this difference.

Adolescent↗

PubMed2001

Validity of DSM-IVADHD subtypes in a nationally representative sample of Australian children and adolescents.

OBJECTIVE: To examine the discriminant validity of DSM-IV attention-deficit/hyperactivity disorder (ADHD) subtypes in a nationally representative sample of Australian youths. METHOD: The Diagnostic Interview Schedule for Children, including the symptom-specific impairment questions, was administered to 3,597 parents of children aged 6 to 17 years (response rate = 70%). Parents also completed questionnaires assessing children's emotional and behavioral problems and quality of life. RESULTS: Current DSM-IVADHD prevalence was 7.5% (6.8% with impairment) with inattentive types being more common than hyperactive-impulsive and combined types. ADHD was more prevalent among young males and was linked to social adversity, particularly for combined types. Compared with non-ADHD controls, all three ADHD subtypes were rated as having more emotional and behavioral problems and lower psychosocial quality of life, with combined types consistently rated the most impaired. Combined types received higher ratings than hyperactive-impulsive and inattentive types on externalizing behavior problems, disruption to family activities, and symptom-specific impairments with schoolwork and peer-related activities. Inattentive types were rated as having lower self-esteem, more social and school-related problems, but fewer externalizing problems than hyperactive-impulsive types. CONCLUSION: These findings support the view of DSM-IVADHD subtypes as distinct clinical entities with impairments in multiple domains.

Adolescent↗

PubMed2000

Effects of birthweight and oxygen supplementation on lung function in late childhood in children of very low birth weight.

Impaired respiratory function has been found frequently in ex-premature children, but it is unclear which specific factors influence this impairment the most. The aim of this study was to determine the importance of the contributions of birth weight, gestational age, neonatal respiratory disease, and its treatment on subsequent childhood lung function at age 11 years in a cohort of children of very low birth weight (VLBW; </=1,500 g). Detailed clinical histories were recorded, and lung function was measured in 60% (102 children) of surviving VLBW infants born 1981/1982, and compared with 82 matched control children (birth weight >2,000 g) of similar age. VLBW children were shorter and lighter than controls (P < 0.0001) at 11 years of age, and had reduced expiratory flows (P < 0.00001) and forced vital capacities (P < 0.001). The residual volume to total lung capacity ratio (RV/TLC ratio) was increased (P < 0.00001), while total lung capacity (TLC) remained unchanged. Those with bronchopulmonary dysplasia (BPD) had the lowest mean expiratory flows. Males had lower expiratory flows than females. On univariate analysis, gestational age by itself accounted for 8.8% of the explained variance in FEV(1) at 11 years of age, but birth weight accounted for 16% on its own; both together accounted for a further 0.2% (16.2%), suggesting that the latter was the dominant factor. On multivariate analysis, the contribution of birth weight and gestational age was small, and the best predictors at 11 years of age, which together explained 43.4% of the total variance in FEV(1), were log days of supplemental oxygen (9.6%) and a reported history of asthma (10.8%). For FEF(25-75), these predictors explained 7.2% and 13.4%, respectively, of the total explained variance of 40.6%. The relation between neonatal oxygen supplementation and childhood FEV(1) was such that up to 20 days of supplemental oxygen had little effect on subsequent FEV(1) at 11 years of age, but each additional week of supplemental oxygen after that time was associated with a progressive reduction in FEV(1) of 3%. These data confirm the significant role of supplemental oxygen in the neonatal period and a history of asthma on the subsequent reduction of expiratory flows in VLBW children. Birth weight was a more important prenatal factor than gestational age, but both were of lesser predictive significance than either supplemental oxygen or a reported history of asthma.

Asthma↗

PubMed2000

The relationship between asthma severity, family functioning and the health-related quality of life of children with asthma.

This study compared the health-related quality of life (HRQL) of 236 children with mild or moderate/severe asthma with that of a large representative sample of children in the general community. The study also examined the relationship between the HRQL of children with asthma and their demographic characteristics, asthma severity and family functioning. Children with asthma had a significantly poorer HRQL than other children in the community. Amongst the children with asthma, parents reported that children living in single-parent families had poorer physical health, mental health and social functioning than children in two-parent families. There was a significant relationship between the mental health of children with asthma and family functioning but no significant relationship between their physical health and family functioning. These findings suggest that the domains comprising the HRQL of children with asthma are related to both disease and non-disease factors. A better understanding of these relationships will facilitate the development of new interventions to help children with asthma.

Asthma↗

PubMed2000

Quality of life of mothers and families caring for preterm infants requiring home oxygen therapy: a brief report.

OBJECTIVE: To investigate the impact on mothers and families of caring for a premature infant receiving home oxygen therapy (HOT). METHODS: Standard questionnaires were used to compare the functioning of mothers and families of 10 premature infants receiving HOT, 10 premature infants who were discharged from hospital on HOT but who no longer required it and 20 premature infants who had never required treatment with HOT. RESULTS: After adjustment for gestational age, chronological age, birthweight and place of residence (urban/rural), the care required by premature infants receiving HOT had a significantly greater impact on their families than the care of infants not receiving HOT. Mothers of premature infants receiving HOT reported significantly less vitality and more mental health problems than mothers of infants not receiving HOT. CONCLUSIONS: The use of HOT for premature infants may have a significant adverse impact on their mothers and families.

Adult↗

PubMed2000

Sudden infant death syndrome (SIDS) in South Australia 1968-97. Part 2: the epidemiology of non-prone and non-covered SIDS infants.

OBJECTIVE: To identify the risk factors for infants who die suddenly and unexpectedly, but whose deaths are not related to prone position, or having the head covered. METHODOLOGY: A case-control study was designed in which the cases were infants who had died of sudden infant death syndrome (SIDS) in South Australia between January 1974 and December 1997, who were found not prone, not bed sharing and with the head not covered. The controls were two infants for each case, born in the same year and found in the prone position (again not bed sharing and with the head not covered). RESULTS: Sudden unexpected death infancy is rare in non-prone infants with the head not covered. occurring on average twice a year in South Australia, where there are 18,000-21,000 births per year. In this group there was a higher percentage of infants with features associated with low socio-economic groups (teenage pregnancies and maternal smoking), sibling SIDS, suspicion of non-accidental injury and the presence of minor congenital anomalies, especially cardiac anomalies. CONCLUSIONS: The majority of unexpected deaths in infancy can be prevented by not allowing infants to be unobserved in prone position, and by preventing them from getting their faces covered. For the few infants not found in these positions, a careful investigation should be made for malformations or non-accidental injury.

Bedding and Linens↗

PubMed2000

The National Survey of Mental Health and Wellbeing: the child and adolescent component.

OBJECTIVE: This paper describes the Child and Adolescent Component of the National Survey of Mental Health and Wellbeing. METHOD: The aims of the study, critical decisions in planning for the study, progress to date and key issues which influenced the course of the study are described. RESULTS: The Child and Adolescent Component of the National Survey of Mental Health and Wellbeing is the largest study of child and adolescent mental health conducted in Australia and one of the few national studies to be conducted in the world. Results from the study will provide the first national picture of child and adolescent mental health in Australia. CONCLUSIONS: Large-scale epidemiological studies have the potential to provide considerable information about the mental health of children and adolescents. However, having a clear set of aims, ensuring that the scope of the study remains within manageable proportions and paying careful attention to the details of fieldwork are essential to ensure that high-quality data is obtained in such studies.

Adolescent↗

PubMed1999

Epidemiological characteristics of women with high grade CIN who do and do not have human papillomavirus.

OBJECTIVE: Human papillomavirus infection is an important aetiological agent associated with the development of cervical neoplasia. However, even with the most sensitive methods of detection, human papillomavirus DNA has been detected in only 90% of cases of cervical cancer and between 80%-90% of cases of dysplasia. This study aimed to determine if there are epidemiological differences between women who are positive or negative for human papillomavirus, with high grade cervical intraepithelial neoplasia (CIN). DESIGN: Four hundred and sixty women with CIN II and III lesions were studied. To ensure optimal detection of human papillomavirus DNA, two specimens (i.e. tampon and cervical biopsy) were collected from each woman and tested by three techniques: L1-polymerase chain reaction, E6-PCR and low stringency Southern blotting. A detailed questionnaire was completed and blood sample collected for determination of serum levels of beta-carotene, vitamin A and E from each patient. Human leucocyte antigen (HLA)-DQB 1 alleles were also compared between the groups of women who were positive or negative for human papillomavirus. RESULTS: Overall, human papillomavirus DNA analysis was positive in 411 women (89%). Age, number of sexual partners in the last 12 months, past pregnancy and marital status were associated with human papillomavirus detection in the crude analysis. However, in the adjusted analysis no epidemiological features remained significantly different between the human papillomavirus positive and negative patients. Moreover, examination of vitamin A, E and beta-carotene levels did not show a significant difference between the two groups of patients. However, in the HLA-DQB1 allele profile a significantly higher proportion of women who were negative for human papillomavirus had DQB1 *0201, *0603 and *0604 (P = 0.05, 0.001, 0.03, respectively). CONCLUSION: We did not find a significant difference in epidemiological factors between women with human papillomavirus positive and negative high grade CIN. However differences between the frequency of three HLA DQB1 alleles suggest that women with these allele profiles have a higher chance of clearing human papillomavirus, without affecting their chance of developing dysplasia.

Adult↗

PubMed1998

The influence of distress on mothers' and fathers' reports of childhood emotional and behavioral problems.

This study examined the effect of parental distress on mothers' and fathers' reports of children's emotional and behavioral problems. The subjects were the parents of 696 children aged 10 to 11 or 14 to 15 years living in two-parent families in the community. The study utilized an extended version of the model previously employed by Fergusson, Lynskey, and Horwood (1993) to examine the impact of maternal depression on mothers' reports of children's behavior. In the present study, the extended model was used to assess the impact of distress on reports of childhood externalizing and internalizing problems obtained from both mothers and fathers. The results suggested that distress had little influence on mothers' or fathers' reports of childhood behavior problems. It is concluded that in community studies the size of any bias in mothers' and fathers' reports of childhood behavior problems due to parental distress is likely to be very small and of little clinical significance.

Adolescent↗

PubMed1997

Epidemiologic aspects of gallbladder cancer: a case-control study of the SEARCH Program of the International Agency for Research on Cancer.

BACKGROUND: There are few previous epidemiologic studies of gallbladder cancer, a rare but nearly always lethal gastrointestinal cancer with a demonstrated greater frequency in adult women and older subjects of both sexes, and also in the members of populations throughout central and eastern Europe and certain racial groups such as native American Indians. Unfortunately, the prospects for the prevention of this form of cancer are poor. PURPOSE: Our purpose in conducting this study was to investigate possible new risk factors for gallbladder cancer and to strengthen our understanding of established causal agents that may be involved in this disease. METHODS: A large, collaborative, multicenter, case-control study of cancer of the gallbladder was conducted in five centers located in Australia (Adelaide), Canada (Montreal and Toronto), The Netherlands (Utrecht), and Poland (Opole) from January 1983 through July 1988. Case subjects with gallbladder cancer were accrued by the centers from hospital pathology records and from reports to regional cancer registries. Cancer diagnosis was confirmed by either biopsy, cholecystectomy, or at the time of autopsy. Control subjects were randomly assigned at each center from the population. The pooled analysis included 196 case subjects and 1515 control subjects (who did not report previous cholecystectomy). Ninety-eight percent of the subjects were white. Personal interviews of case subjects, control subjects, and surrogates (spouse or next of kin) were conducted by trained personnel. RESULTS: After adjusting for potential confounding factors (age, sex, center, type of interview, years of schooling, alcohol intake, and lifetime cigarette smoking), a history of gallbladder symptoms requiring medical attention (e.g., reduced bile secretion from the gallbladder into the small intestine due to obstructions of the common bile or cystic ducts) was the major risk factor associated with this form of cancer (odds ratio [OR] = 4.4; 95% confidence interval [CI] = 2.6-7.5). This association was present even in subjects who had their first gallbladder examination because of symptoms present more than 20 years earlier (OR = 6.2; 95% CI = 2.8-13.4). Other variables associated with gallbladder cancer risk included an elevated body mass index, high total energy intake, high carbohydrate intake (after adjustment for total energy intake), and chronic diarrhea. All of these risk factors have been previously associated with gallstone disease. CONCLUSIONS: These findings are consistent with a major role of gallstones, or risk factors for gallstones, in the cause of gallbladder cancer. Additional information on whether or not screening high-risk subjects for gallstones or gallbladder cancer is needed.

Adult↗

PubMed1997

Social skills training for primary school children: a 1-year follow-up study.

OBJECTIVE: To evaluate the effectiveness of the Rochester Social Problem Solving Program to reduce emotional and behavioural problems amongst primary school children. METHODOLOGY: Children in years 3 and 4 at primary school were assessed prior to receiving the program, immediately after the program and 1 year after the program. At each assessment, the functioning of the children who received the program was compared to the functioning of children enrolled in years 3 and 4 at a comparable school who did not receive the program. RESULTS: The program improved the ability of children to cope with potentially difficult social situations. However, the program did not reduce the prevalence of teacher-reported or mother-reported childhood emotional and behavioural problems. CONCLUSIONS: School-based social skills programs may be more effective in reducing childhood emotional and behavioural problems if they include components which focus specifically on childhood behaviour problems as well as components focusing on social skills and peer relationships.

Affective Symptoms↗

PubMed1996

Cigarette smoking and pancreas cancer: a case control study of the search programme of the IARC.

A multi-centre case-control study of pancreas cancer, designed to be population-based, to use a random sample of local populations as controls and to use a common protocol and core questionnaire, was conducted as the first study of the SEARCH programme of the International Agency for Research on Cancer. "Ever-smokers" were found to be at increased risk for pancreas cancer compared with "never-smokers" consistently in all strata of gender, response status and centre. Risk of pancreas cancer was found to increase with increasing lifetime consumption of cigarettes, the relative risk rising to 2.70 (95% C.I. 1.95 to 3.74) in the highest intake category. The overall trend in risk was highly significant and the association was found consistently in each stratum of gender, response status and centre. Fifteen years had to pass from quitting cigarette smoking until the risk fell to a level compatible with that in never-smokers among the heaviest group of smokers; among the 2 lowest tertiles this happened within 5 years. Further, reported smoking habits more than 15 years before diagnosis appeared to have no influence on pancreas-cancer risk, irrespective of amount smoked. The results are consistent with a causal role for cigarette smoking in the aetiology of pancreas cancer and illustrate that ceasing to smoke cigarettes can lead to reductions in the elevated risk of pancreas cancer produced by this habit.

Case-Control Studies↗

PubMed1996

Lifetime exposure to environmental lead and children's intelligence at 11-13 years: the Port Pirie cohort study.

OBJECTIVE: To examine the association between environmental exposure to lead and children's intelligence at age 11-13 years, and to assess the implications of exposure in the first seven years of life for later childhood development. DESIGN: Prospective cohort study. SUBJECTS: 375 children born in or around the lead smelting town of Port Pirie, Australia, between 1979 and 1982. MAIN OUTCOME MEASURE: Children's intelligence quotient (IQ) measured at 11-13 years of age. RESULTS: IQ was inversely associated with both antenatal and postnatal blood lead concentrations. Verbal, performance, and full scale IQ were inversely related to blood lead concentration with no apparent threshold. Multivariate analyses indicated that after adjustment for a wide range of confounders, the postnatal blood lead concentrations (particularly within the age range 15 months to 7 years) exhibited inverse associations with IQ. Strong associations with IQ were observed for lifetime average blood lead concentrations at various ages. The expected mean full scale IQ declined by 3.0 points (95% confidence interval 0.07 to 5.93) for an increase in lifetime average blood lead concentration from 0.48 to 0.96 mumol/l (10 to 20 micrograms/dl). CONCLUSION: Exposure to environmental lead during the first seven years of life is associated with cognitive deficits that seem to persist into later childhood.

Adolescent↗

PubMed1996

A prospective study of childhood emotional and behavioural problems in Port Pirie, South Australia.

OBJECTIVE: To describe the extent to which emotional and behavioural problems experienced by 5-year-old children living in or around Port Pirie, South Australia, persisted when the children were aged 11-12 years. METHOD: Childhood emotional and behavioural problems were identified at the age of 5 years using Child Behaviour Checklists completed by mothers. When the children were aged 11-12 years, problems were identified using checklists completed by mothers, children and teachers. RESULTS: Attention problems, aggressive behaviour and anxious/depressed problems were the most persistent problems over this period of the children's lives. In general, the strongest relationship over time occurred when reports were obtained from mothers on each occasion. A weaker relationship existed between earlier mother-reported problems and later teacher-reported problems, while the relationship between mother-reported problems and later self-reported problems occupied an intermediate position. CONCLUSION: The course of problems among children in Port Pirie appeared similar to that previously reported for children in Holland and North America. To better understand the aetiology of psychiatric disorders and to plan for effective interventions, more information is needed about the natural course of childhood emotional and behavioural disorders in Australia.

Age Factors↗

PubMed1995

A prospective study of the psychological adjustment of children with cancer.

PURPOSE: This paper describes the prevalence of emotional and behavioral problems and the social competencies of forty children with cancer immediately after their diagnosis and one year post-diagnosis. PATIENTS AND METHODS: At both points of time the problems and competencies of the children with cancer were compared with the problems and competencies of a matched group of children living in the community. RESULTS: The results suggest that early in their illnesses, younger children with cancer experience more internalising problems than children in the community. However, the younger children with cancer improved significantly in these areas during the year after their diagnosis. As a result, one year after their diagnosis there was little difference in the prevalence of problems amongst the younger children with cancer and the children in the community. The older children with cancer did not appear to have more problems than children in the community at either the first or the second assessment. CONCLUSIONS: The results of the study draw attention to possible differences in the prevalence of emotional and behavioral problems experienced by younger and older children with cancer. The results also suggest that amongst younger children with cancer the prevalence of problems declines during the year after their initial diagnoses.

Adolescent↗