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Biomedical subjects

G Bowes

Publications and source records attributed to G Bowes.

At least 55 records · Page 3Linked to original sources
PubMed1996

Is smoking associated with depression and anxiety in teenagers?

OBJECTIVES: An association of smoking with depression and anxiety has been documented in adult smokers. This study examines this association in a representative group of teenage smokers. METHODS: A two-stage cluster sample of secondary school students in Victoria, Australia, were surveyed by using a computerized questionnaire, which included a 7-day retrospective diary for tobacco use and a structured psychiatric interview. RESULTS: Subjects reporting high levels of depression and anxiety were twice as likely to be smokers after the potential confounders of year level, sex, alcohol use, and parental smoking were controlled for. Regular smokers were almost twice as likely as occasional smokers to report high levels of depression and anxiety. In a stratified analysis, an association between regular smoking and psychiatric morbidity was found in girls of all ages but for boys only in the youngest group. CONCLUSIONS: The cross-sectional association is consistent with the use of smoking by teenage girls as self-medication for depression and anxiety. Therefore, future health promotional campaigns might consider strategies that attend to perceived psychological benefits of smoking.

Adult↗
PubMed1995

Adolescent health care: perspectives of Victorian general practitioners.

OBJECTIVES: To assess general practitioners' (GPs') views of adolescents as a discrete patient group with specific developmental health care needs; to document GPs' perceived knowledge of and competence in adolescent health care; and to clarify the barriers GPs perceive to effective delivery of such care. DESIGN: Qualitative research. METHODS: Stratified sampling generated a sample of 57 GPs from rural and urban divisions of general practice. Focus group discussions and individual interviews were recorded and transcripts were analysed. RESULTS: Thirty-three GPs (62%) reported that adolescents made up 10% or more of their weekly consultations. Although 10 GPs defined adolescents by developmental criteria, 47 had an incomplete understanding of the developmental aspects of adolescence. Most GPs (43) had some concerns about their knowledge of and competence in delivering adolescent health care and 52 stated that they had had little or no formal training in adolescent health. The participants perceived a range of barriers to effective health care provision, including issues of confidentiality, communication and cost. CONCLUSIONS: Changes are needed in the Medicare card and rebate systems to ensure improved access to affordable, confidential care for adolescents. Our results also support the incorporation of important adolescent health care issues in undergraduate and postgraduate medical training.

Adolescent↗
PubMed1995

Morbidity, medication and trigger factors in a community sample of adults with asthma.

OBJECTIVES: To determine asthma morbidity, use of medications and trigger factors for asthma attacks in an adult community sample. METHODS: Follow-up questionnaires were sent to respondents indicating a history of asthma or any respiratory symptom on a screening questionnaire. A new scale to measure asthma severity was developed. RESULTS: Questionnaires were returned by 74% (589/795). Respondents with diagnosed asthma had more frequent symptoms and more disruption to lifestyle than those with non-specific respiratory symptoms. Inhaled beta-agonist and oral theophylline preparations were used by 61% and 16% of asthmatics, respectively. Preventive medications such as inhaled corticosteroids and cromoglycate were used daily by only 15% and 4%, respectively. The most frequently reported trigger factors were viral upper respiratory tract infections, cigarette smoke, house dust, smog and other non-specific irritants. Twenty per cent of asthmatics reported occupational exacerbation of symptoms. CONCLUSIONS: There is substantial morbidity from asthma in Victorian adults, which could be reduced by greater use of preventive medications, avoidance of trigger factors, peak flow monitoring and action plans. The asthma severity scale proved to be reliable and valid.

Administration, Inhalation↗
PubMed1995

The self-image of adolescents with cystic fibrosis.

PURPOSE: The changing expectations, therapies and outcomes for young people with cystic fibrosis (CF) necessitate a re-evaluation of the impact of this chronic illness on adolescent development. The aim of this study was to assess the psychological well-being and adjustment of contemporary adolescents with CF. METHODS: Forty-nine adolescents with CF (24 males, 25 females) aged 14-18 years were enrolled from the Royal Children's Hospital CF Clinic, Melbourne, Australia. The Offer Self-Image Questionnaire was administered to participating subjects whose growth and pubertal developmental and pulmonary function was assessed. RESULTS: The mean (SD) FEV1% was 82 (21), and mean (SD) National Institute of Health clinical score was 81 (12). There were no significant differences between males and females in pulmonary function or clinical scores, but growth and pubertal development were delayed in both sexes. Females, but not males, with CF were less well-adjusted than their healthy peers. Two-way analysis of variance was performed and showed significant sex differences in sub-scales of the Offer questionnaire numbers I, II, III, VI, VIII, IX, as well as in the total score. Age was significant only for scales II and VIII, and only scale II displayed an interaction between sex and age. CONCLUSIONS: This study suggests that adjustment and self-esteem are less than ideal in young people with CF, especially females.

Adaptation, Psychological↗
PubMed1995

Reproductive health in young women with cystic fibrosis: knowledge, behavior and attitudes.

PURPOSE: The improved life-expectancy in cystic fibrosis (CF) results in the fact that the majority of affected young women now survive to face the same reproductive health decisions as other women, in addition to those that specifically relate to CF. The aim of this study was to assess the reproductive health knowledge of women with CF, to investigate the range of their reproductive health problems, and to review their reproductive health attitudes and behaviors. METHODS: Women aged 18 years and over attending CF services in the state of Victoria, Australia were invited to complete a reproductive health questionnaire. Comparison subjects (n = 76) were enrolled from 2 primary care practices. RESULTS: Fifty-five women participated (89%), with a median age of 22 years (range 18-50). There was no significant difference in marital status between the two groups and a similar proportion were sexually active, yet women with CF were less likely to use contraception. A majority of women with CF believed that fertility was reduced, and there was poor knowledge of the potentially deleterious effect of pregnancy. A relatively high proportion were planning to become pregnant in the near future. Twenty-two percent had tried to conceive, with a success rate of 67%. CONCLUSIONS: Women with CF are currently lacking important information about reproductive health that potentially has a major impact on their health and their lives.

Adolescent↗
PubMed1995

The prevalence of prodromal features of schizophrenia in adolescence: a preliminary survey.

In most cases of schizophrenia the onset of frank psychosis is preceded by a period of prodromal features. This period has been relatively neglected by researchers and is potentially important in promoting early intervention. The prevalence of DSM-III-R schizophrenia prodrome symptoms was assessed as part (n = 657) of a large (n = 2525) questionnaire-based survey of high school students. Individual symptoms were highly prevalent and the prevalence of DSM-III-R prodromes ranged from 10 - 15% to 50%. Despite methodological weaknesses, the data suggest that DSM-III-R prodromal features are extremely prevalent among older adolescents and unlikely to be specific for subsequent schizophrenia. Clinically these features cannot be regarded as sufficient evidence of early schizophrenia and more accurate predictors of incipient schizophrenia need to be defined.

Adolescent↗
PubMed1995

Patterns of common drug use in teenagers.

To ascertain current levels of drug use among teenagers and to examine interrelationships in use, a two-stage cluster sample of Victorian secondary school students in years 7 (aged 12 to 13 years), 9 (14 to 15 years) and 11 (16 to 17 years) were surveyed using a questionnaire on computer. Tobacco use and alcohol consumption were evaluated by self-reported frequency of use and seven-day retrospective diaries. Marijuana and coffee consumption were assessed by self-reported frequency of recent use. The questionnaire was completed by 2525, a participation rate of 83 per cent. Tobacco use rose with year, with 24 per cent of young women and 16 per cent of young men in year 11 being regular smokers. Trends across year level for heavier alcohol consumption were also observed, with just under 10 per cent of year 11 students reporting a weekly consumption higher than the current recommended guidelines for adults. Strong interrelationships in drug use were found, with a pattern of association between smoking and drinking consistent with a mutual elevation of risk. Frequent use of tobacco and alcohol had a high risk for associated marijuana use. Coffee consumption carried a significant independent association with regular smoking. Teenage substance use is common and most occurs at low level and frequency. However, for a substantial and increasing minority across the teenage years, high levels of tobacco and alcohol consumption potentially compromise health. Frequent alcohol or tobacco use rather than heavy intermittent consumption is most likely to be associated with concurrent substance use potentially damaging to health.

Adolescent↗
PubMed1995

Compliance issues in adolescence: practical strategies.

Understanding the process of adolescent development is crucial to engendering good compliance. Successful outcomes can be achieved by approaching adolescents with respect and negotiating with them shared treatment goals. A few simple interventions can help make the issue of compliance in adolescents less problematic.

Adolescent↗
PubMed1994

Factors in childhood as predictors of asthma in adult life.

OBJECTIVE: To determine which factors measured in childhood predict asthma in adult life. DESIGN: Prospective study over 25 years of a birth cohort initially studied at the age of 7. SETTING: Tasmania, Australia. SUBJECTS: 1494 men and women surveyed in 1991-3 when aged 29 to 32 (75% of a random stratified sample from the 1968 Tasmanian asthma survey of children born in 1961 and at school in Tasmania). MAIN OUTCOME MEASURES: Self reported asthma or wheezy breathing in the previous 12 months (current asthma). RESULTS: Of the subjects with asthma or wheezy breathing by the age of 7, as reported by their parents 25.6% (190/741) reported current asthma as an adult compared with 10.8% (81/753) of subjects without parent reported childhood asthma (P < 0.001). Factors measured at the age of 7 that independently predicted current asthma as an adult were being female (odds ratio 1.57; 95% confidence interval 1.19 to 2.08); having a history of eczema (1.45; 1.04 to 2.03); having a low mild forced expiratory flow rate (interquartile odds ratio 1.40; 1.15 to 1.71); having a mother or father with a history of asthma (1.74 (1.23 to 2.47) and 1.68 (1.18 to 2.38) respectively); and having childhood asthma (1.59; 1.10 to 2.29) and, if so, having the first attack after the age of 2 (1.66; 1.17 to 2.36) or having had more than 10 attacks (1.70; 1.17 to 2.48). CONCLUSION: Children with asthma reported by their parents in 1968 were more likely than not to be free of symptoms as adults. The subjects who had more severe asthma (especially if it developed after the age of 2 and was associated with reduced expiratory flow), were female, or had parents who had asthma were at an increased risk of having asthma as an adult. These findings have implications for the treatment and prognosis of childhood asthma, targeting preventive and educational strategies and understanding the onset of asthma in adult life.

Adolescent↗
PubMed1994

A national policy on asthma management for schools. The Asthma Special Interest Group, Thoracic Society of Australia and New Zealand.

Since asthma is the most common chronic illness in childhood, many of the problems associated with this condition will impact on the child's education. Because of widespread concerns regarding the management of asthma in schools, a subcommittee of the Thoracic Society of Australia and New Zealand, Asthma Special Interest Group, was convened to draw up national guidelines for school staff in order to provide optimal management of asthma in the school setting. We used current medial literature and the clinical experience of the authors who have dealt with children and adolescents suffering from asthma in the hospital, community and school environment. A number of issues had been identified, including: the availability of an asthma first aid kit; correct use of bronchodilator aerosols by puffer and spacer devices; and clear instructions as to when to notify parents and when to call an ambulance to the school.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Critical evaluation of three chest radiograph scores in cystic fibrosis.

BACKGROUND: A number of chest radiographic scores have been developed to assess the severity of respiratory disease in cystic fibrosis but critical statistical evaluation has been limited. In particular, the chest radiograph component of the National Institutes of Health (NIH) clinical score has not previously been validated. Three different chest radiograph scores have been compared and the association between them and lung function tests investigated. METHODS: The interobserver and intraobserver variation of the Brasfield, NIH chest radiograph, and the Royal Children's Hospital (RCH) chest radiograph score was assessed by three observers--a paediatric radiologist, a junior and a senior respiratory physician--who independently scored, on separate occasions, 62 chest radiographs randomly selected from three age strata of patients ranging from 7 to 18 years. Lung function tests were available for 61 patients obtained within three months of the chest radiograph. Two way analysis of variance was used to estimate components of variation in scores. RESULTS: Results were similar for the Brasfield and NIH scores, both of which demonstrated greater precision than the RCH score, but the estimated repeatability of the Brasfield and NIH scores can be expected to differ by up to 20% of the maximum score. The reliabilities (intraclass correlation) are all reasonably high at 0.74, 0.73, and 0.61 for the Brasfield, NIH, and RCH scores, respectively. The estimated correlation between radiographic scores and lung function tests, adjusted for attenuation caused by measurement error, showed a similar correlation for all three scoring methods ranging from 0.55 to 0.78. Correlations were slightly greater with FEV1% than FVC%. These correlations are substantial but not high, indicating that a large proportion of the variability in radiographic scores cannot be explained by lung function measurements. CONCLUSIONS: The Brasfield and NIH chest radiograph scores have very similar statistical profiles and can be equally recommended if a chest radiograph score is to be used. The RCH radiographic score appears to be less reliable. The limitations of these scores need to be understood.

Adolescent↗
PubMed1994

Changes in airway resistance during sleep onset.

Ventilation is lower during sleep than wakefulness. An increase in airway resistance has been proposed as the critical factor. As the change in ventilation has been shown to occur abruptly at transitions between alpha and theta electroencephalogram activity, it was of interest to determine whether the increase in airway resistance between wakefulness and sleep also occurs at these transitions. Three young healthy male subjects were run for an average of 15 sleep onsets in each of three conditions. The three conditions were 1) an esophageal balloon was put in place to allow the measurement of airway resistance, 2) in addition to an esophageal balloon the nose was occluded, and 3) there was no esophageal balloon and the nose was not occluded. Ventilation and airway resistance were measured during sleep onset and analyzed as a function of arousal state. In those conditions of the experiment in which airway resistance was affected by state, the changes, like those in ventilation, occurred at transitions between alpha and theta electroencephalogram activity. However, in the three subjects studied, the magnitude of ventilatory changes at alpha-theta transitions and the extent to which changes in ventilation were associated with changes in airway resistance differed between subjects. It was concluded that although inspiratory airway resistance is a major component affecting the state-related changes in ventilation at sleep onset, the degree of its contribution may vary over individuals.

Adult↗
PubMed1994

Allergies, upper respiratory tract infections, and asthma.

The aims of this study were (1) to quantify the prevalence of aeroallergen hypersensitivity in presentations for emergency treatment of asthma and (2) to determine the strength of association between viral upper respiratory tract infections (URTIs) and admission for treatment of asthma. A series of 209 asthmatic patients presenting to the Emergency Department (ED) of the Alfred Hospital over 6 months underwent skin prick testing and venipuncture for serum IgE and rye grass pollen (RGP) RAST. A case-control study of 38 asthmatic inpatients and 90 controls admitted for road trauma or endoscopy underwent nasopharyngeal aspiration for viral culture and immunofluorescence (IF). Eighty-four percent of ED asthmatic patients had one or more positive skin tests to common aeroallergens, 57% had a positive skin test, and 45% had a positive RAST to RGP. Viral cultures or IF studies were positive in 8 asthmatic patients and 2 controls. Asthmatic inpatients were 6 times more likely to have a viral URTI than were controls. It is concluded that aeroallergen hypersensitivity is present in most asthmatic patients presenting to the ED, and that there is a strong association between viral URTIs and admission for asthma.

Adolescent↗