The Height and Weight Changes of Melbourne Children Compared with Other Population Groups*

Bowden, B. D., Johnson, Jill, Ray, L. J. and Towns, Joan (1976). Aust. paediat. J., 12, 281–295. The height and weight changes of Melbourne children compared with other population groups. Serial height and weight records of 120 Melbourne children from 2 to 20 years of age have been compared with figures for 323 Melbourne University students, Meyers' 1956 Australian standards, the 1973 New South Wales survey, a South Australian survey, British standards, United States data and with Aboriginal data. Significant differences are shown at selected ages between the Melbourne groups and the other Australian studies, which seem related to definite varying population groups. The Melbourne group appear to be slightly ahead of the British group in maturation and growth but appear minimally behind the American group. The differences in maturation between population groups could produce clinically significant errors in assessment of growth trends if standards are interpreted too freely.     

PARENT WORKSHOPS: are we giving parents what they need?

This article describes briefly the planning, content and evaluation of a workshop series for a group of parents whose children attend a local authority day ESN(S) school.     

Women in medical school and beyond

The increasing proportion of female students in Australian medical schools warrants an appraisal of the particular factors which may influence their success in their undergraduate and post-graduate careers. Past shortages of medical manpower are giving way to a projected over-abundance of doctors in the near future.
New South Wales has three medical schools, and in 1979 women constituted a significant percentage of the total number of students entering the first year. In the Newcastle school that percentage has exceeded 50. Because the majority of women combine their careers with child-bearing and child-raising, they face special problems in medical school and beyond. The fulfilment of dual roles frequently creates significant conflicts for women, but there are signs that women are gradually overcoming such conflicts. In fact, some male students are now beginning to question their tradition of full-time commitment to a stressful profession with little free time left for their families or other interests.
To make the best use of medical manpower, planning towards more flexible training schemes and more innovative roles in medical practice is essential. Women in particular can help one another by co-operation and imaginative planning.     

INCREASED ANTICARDIOLIPIN ANTIBODIES ASSOCIATED WITH THE DEVELOPMENT OF ANETODERMA IN HIV-1 DISEASE

Background and Objective. Anetoderma has been reported in patients with HIV-1 disease. In patients with autoimmune disease, anetoderma has been associated with increased levels of antiphospholipid antibodies (APL) that include anticardiolipin antibodies (ACA) and lupus anticoagulant (LA). This has led to speculation that the autoimmune phenomena seen in HIV-1 disease and the immune dysregulation induced by HIV-1 disease may play a role in the development of these lesions. We have seen both primary and secondary lesions of anetoderma in patients followed for HIV-1 disease. In this study, we wanted to determine whether there was an association in the development of anetoderma and elevated anticardiolipin antibodies (ACA) in HIV-1 patients. Methods. Quantitative ACA levels were measured in eight HIV-1-infected patients with anetoderma and four HIV-1-infected patients without anetoderma. Results. Anticardiolipin antibodies were moderately elevated in seven of eight patients with lesions and were borderline in the four HIV-1-positive patients without lesions of anetoderma. Conclusions. There appears to be a correlation between increased ACA and the development of cutaneous lesions of anetoderma in HIV-I disease. Patterns of immune dysregulation, including APL, may predispose to the development of lesions of anetoderma in HIV-1-positive patients. Although some of the lesions appear to represent primary anetoderma, the majority of our patients develop lesions in areas secondary to well characterized eruptions.     

Effects of therapeutic suggestion in children undergoing general anesthesia: a randomized controlled trial

Objectives and aim: The goal of this randomized controlled trial was to examine the effect of intraoperative positive therapeutic suggestion on postoperative nausea and vomiting (PONV) in children undergoing general anesthesia and otolaryngological surgery. Background: Because of the high incidence of PONV following otolaryngological surgery and its negative impact on recovery, researchers have examined various nonpharmacological interventions to target this phenomenon. To date, the effectiveness of therapeutic suggestion has not been studied in children. Methods: Participants were 67 children undergoing tonsillectomy and adenoidectomy and their mothers. Children received a standardized anesthetic procedure and were randomly assigned to one of three interventions administered under general anesthesia: therapeutic suggestion, story (prosody control), or standard operating room noise. Children, parents, and healthcare personnel were blinded to group assignment. Nausea and vomiting were recorded in the postanesthesia care unit (PACU) and for the first 3 days at home. Results: Results demonstrated a decrease in nausea severity across the first 3 days, F_2,49 = 10.37, P < 0.001, but no group differences in nausea severity in the PACU (F_2,49 = 0.87, P = 0.43) or at home (F_2,49 = 0.80, P = 0.46). There were also no group differences in vomiting episodes in the PACU (χ² (2) = 1.25, P > 0.05) or at home (F_2,49 = 1.59, P = 0.21). Conclusions: In this blinded controlled trial, therapeutic suggestion delivered intraoperatively did not impact children’s PONV. However, because this is the first study of this kind, replication may be needed.     

The Intellectually Handicapped Mother and Her Child

Hockey, Athel, and Bain, Jill (1979). Aust. Paediatr. J. , 15, 173–176. The intellectually handicapped mother and her child. This paper presents information on the intellectually handicapped mother with regard to numbers, mode of ascertainment, diagnosis, intelligence, number of children born, intelligence and outcome for the child. It assesses the role of genetic counselling and its limitations in this field. It defines the most appropriate form early intervention for the offspring to offset or prevent handicaps. Cases are used to illustrate and discuss the effect of assortive mating: the difficulty of defining risk to a person, herself affected, and of expecting a reasoned decision; joint plans to follow up and assist in the care of the children by Child Health Services and the Division for the Intellectually Handicapped.
Reasons are given for the conclusion that an eugenic approach is inappropriate here. Instead, genetic counselling and family planning, with practical training in child rearing are the main resources.     

SOME DYNAMIC ASPECTS OF BRAIN METABOLISM IN RATS GIVEN A PORTOCAVAL ANASTOMOSIS

Some dynamic aspects of brain metabolism in rats given a portocaval anastomosis
Three weeks after portocaval shunt, when the only ultrastructural change in the CNS is watery swelling of astrocytes, the chronic hyperammonaemia so induced is associated with an increase of brain glutamine (330%), and a decrease of glutamate (90%) and glucose (63%). The metabolic fate of [2–¹⁴C] glucose was followed over a time course of 40 min after an intravenous injection. Details are given of a compartmental analysis of metabolic kinetic relationships, particularly of brain glutamate and glutamine. When applied to [2–¹⁴C]glucose data there was no evidence of an increased rate of glutamine synthesis in the operated rats. The increased labelling of glutamine could be accounted for by a larger pool size with a slower fractional turnover coefficient. In control rats [l-¹⁴C]butyrate conferred label very rapidly on a small fraction of brain glutamine. Analysis showed there was little or no overlap between pools of amino acids labelled by [1–¹⁴C]butyrate and those labelled by [2–¹⁴C]glu-cose. In operated animals there was a marked decrease in the total amount of labelled [l-¹⁴C]butyrate entering the brain. Analysis showed some overlap between labelling of amino acids by [¹⁴C]butyrate and [¹⁴C]glucose, as well as several other changes. The biochemical differences found are likely to be causally related to the ultrastructural changes in astrocytes and lend support to previous concepts of morphological assignments to metabolic compartments.     

Gender Differences and Perceptions About Childbearing Among Infertile couples

Objective: To explore gender dierences and responses of in fertile couples to childbearing issues.
Design: Data analysis from the first wave of a larger three wave prospective panel study. Face-to-face tnterviews with both husbands and wives were conducted.
Setting: Husbands and wives were interviewed separately in their homes. One was generally interviewed immediately after the other.
Participants: One hundred sixty-one infert ile couples in southeastern Michigan were interviewed in 1988.
Measures: Variables of interest included the self recognized source of the fertility problem, the tmportance of children to individuals, stress associated with infertility treatment, the number of tests and treatments received, the acceptabiltty of indicated treatments, the length of time couples expected it would take to have a child, and the ideal and expected number of children.
Results: Women experienced signijcantly more stress from tests and treatment, placed greater importance on havtng children, were more accepting of indicated treatments, and wanted more children than men did.
Conclusions: Implications for nurses working with in fertile couples are discussed, including provision of emotional support, evaluation of perceptions of success, assessment of couples' expectations, and inclusion of husbands in decision making.     

BONE MASS IN HIRSUTE WOMEN WITH ANDROGEN EXCESS

The spinal and femoral bone mass of 32 hirsute women with oligomenorrhoea and androgen excess was measured using dual photon absorptiometry and compared with the bone mass of 32 control women with regular menstrual cycles. Despite significantly lower oestradiol levels in the hirsute population there was no significant difference in the bone mass. Furthermore there was no significant difference in bone mass in five hirsute women with undetectable levels of oestradiol. It is concluded that androgen excess can maintain normal bone mass in the face of low or undetectable oestradiol levels.