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Biomedical subjects

R E Marks

Publications and source records attributed to R E Marks.

9 recordsLinked to original sources
PubMed1995

The prevalence of fetal alcohol syndrome in New Zealand.

AIMS: To obtain an estimate of the prevalence of fetal alcohol syndrome in New Zealand and to report information on paediatrician surveillance for alcohol related birth defects. METHODS: New Zealand paediatricians were asked to complete a postal survey. Questions recorded the number of children with alcohol related birth defects under their care, and examined the respondents' surveillance for alcohol related birth defects. RESULTS: There were 63 children under 10 years of age with fetal alcohol syndrome under paediatric care in 1993. The majority of paediatricians considered the diagnosis only when risk features were identified: the most frequent being children of high risk mothers and children with dysmorphic features. CONCLUSIONS: Fetal alcohol syndrome exists in New Zealand. The prevalence of fetal alcohol syndrome as estimated in this study is lower than would be expected from international prevalence reports and is likely to be an underestimate. Current surveillance for alcohol related birth defects depends on an individual paediatrician considering the diagnosis only when faced with a perceived at risk infant or child, and there is likely under recognition. An increased awareness of the risks of alcohol consumption in pregnancy and the full spectrum of alcohol related birth defects is required.

Abnormalities, Drug-Induced↗
PubMed1995

Alcohol and pregnancy: doctors' attitudes, knowledge and clinical practice.

AIMS: This study was undertaken to gain an understanding about doctors' perspectives on alcohol consumption in pregnancy. The specific aim was to examine attitudes, knowledge and clinical practice of a sample of New Zealand doctors. METHODS: A questionnaire was sent to all paediatricians, all obstetricians and a random sample of general practitioners throughout New Zealand. RESULTS: All respondents felt there should be a limit on alcohol consumption in pregnancy and 46% recommended abstinence. Doctors perceived public awareness of the risks of alcohol consumption in pregnancy to be poor and over 90% believed awareness needed to improve. Eighty-nine per cent of obstetricians and 84% of general practitioners reported they felt sufficiently knowledgeable to inform people of the risks of alcohol consumption in pregnancy. Fifty-nine per cent of obstetricians and 40% of general practitioners routinely enquire about alcohol consumption at the first antenatal contact (p < 0.003). Fifty three per cent of obstetricians and 48% of general practitioners routinely advise women about alcohol consumption at the first antenatal contact. CONCLUSIONS: Doctors in New Zealand believe alcohol in pregnancy is an important health issue. Awareness of the risks of alcohol consumption in pregnancy is perceived as poor. Doctors' attitudes to alcohol consumption in pregnancy do not reflect their reported clinical practice.

Alcohol Drinking↗
PubMed1994

Cannabis laws: an analysis of costs.

There is evidence that the use of cannabis is increasing in Australia, with stable black-market prices, despite the 9-year National Campaign Against Drug Abuse, increasing expenditure to enforce the laws against cannabis use, and the seizure of large plantations of cannabis plants. Recent government data are used to estimate the conservative cost of drug-law enforcement against cannabis use as being $329m in 1991-92. Alternatives to the existing regime are examined, including expiation, decriminalization, and legalization.

Journal Article↗
PubMed1991

Clinical effects of methylphenidate and thioridazine in intellectually subaverage children.

Thirty children with subaverage IQs and psychiatric diagnoses of attention deficit disorder and/or or conduct disorder took part in a double-blind study of placebo, methylphenidate, and thioridazine, which were given for 3 weeks each. The results showed a consistent and highly significant effect of methylphenidate in reducing teacher ratings of problem behavior. Parent ratings showed no behavioral effects for the group as a whole. An attentional model of stimulant drug response was used to divide subjects according to a cognitive maturity domain presumed to reflect selective attention. When divided according to breadth of attention, mental age, and IQ level, higher functioning subjects were found to show a generally favorable response to methylphenidate on both teacher and parent rating scales, whereas children of low functional level typically showed an adverse or indifferent response. The present data suggest that mental age and IQ may be important determinants of drug response; below a given level, there was a greatly reduced likelihood of responding positively. Clinical response to thioridazine was substantially less than the response to methylphenidate, with significant improvements confined to conduct and hyperactivity problems on teacher ratings.

Adolescent↗
PubMed1991

Methylphenidate and thioridazine in the treatment of intellectually subaverage children: effects on cognitive-motor performance.

Twenty-seven children (or smaller subgroups depending upon task difficulty and subject ability) with subaverage IQs took part in a double-blind, placebo-controlled, cross-over study of methylphenidate (0.4 mg/kg/day) and thioridazine (1.75 mg/kg/day). The children were tested for IQ performance, breadth of attention, and performance on a series of electronically controlled cognitive-motor tests. Methylphenidate improved accuracy on a memory task, reduced omission errors on an attentional task, and reduced seat movements on two tasks. Thioridazine failed to have any deleterious effects on IQ performance when subjects received reinforcers for correct answers. Thioridazine at the given dose did not adversely affect performance on any of the cognitive-motor performance tests. Methylphenidate appears likely to enhance sustained attention and motivation in appropriately selected children with mild developmental delays, whereas thioridazine at this modest dose does not appear to impair performance on most psychomotor tests.

Adolescent↗