Background The goal of the current study was to investigate asthma and mental health among youth in the community, and to consider the role of asthma severity and persistence in this link. Method Data were drawn from the Raine Study, a population-based birth cohort study in Western Australia. Logistic regression models and generalized estimating equations were used to examine the relationship between asthma at age 5 years and the range of internalizing and externalizing mental health problems at ages 5–17 years. Analyses were stratified by asthma severity and persistence, and adjusted for a range of potential confounders. Results More severe and persistent asthma at age 5 was associated with significantly increased odds of affective, anxiety, somatic, oppositional defiant and conduct problems at ages 5–17. Mild asthma and remitted asthma were not associated with heightened vulnerability to mental disorders. Conclusions Our results suggest that youth with symptomatic asthma are more likely to suffer from a wide range of mental health problems, and that the likelihood of mental health problems appears to increase as a function of asthma severity. Youth with poorly controlled and/or more severe and persistent asthma may be considered a vulnerable group who might benefit from mental health screening in clinical, school and community settings.

OBJECTIVE:To examine the influence of aggressive behaviour scores on cardiovascular disease (CVD) risk factors throughout childhood. METHODS:This study utilized cross-sectional and longitudinal data from the Western Australian Pregnancy Cohort (Raine) Study (n = 2900). Aggressive behaviour scores were derived from the Child Behavior Checklist/4-18(CBCL), Youth Self-Report/11-18 (YSR) and Teacher Report Form/6-18 (TRF). CVD risk factors included body mass index (BMI), blood pressure, fasting lipids and homeostasis model of insulin resistance (HOMA-IR). RESULTS:Girls with higher aggressive behaviour scores had higher BMI from 10 years of age (P ≤ 0.001), higher BMI trajectories throughout childhood (P = 0.0003) and at 14 years higher HOMA-IR (P = 0.008). At the 14-year survey, this equated to a difference of 1.7 kg/m2 in the predicted BMI between the extreme CBCL scores in girls (top 5% (CBCL ≥ 17) vs. CBCL score = 0). Boys with higher aggressive behaviour scores had higher BMI at 5 years (P = 0.002), lower diastolic pressure at 14 years (P = 0.002) and lower systolic blood pressure trajectories throughout childhood (P = 0.016). CONCLUSION:Aggressive behaviour influences BMI from early childhood in girls but not boys. If this association is causal, childhood offers the opportunity for early behavioural intervention for obesity prevention.

Digit ratio (2D:4D) is widely used as a marker of prenatal androgen exposure. However, there are no published prospective studies where prenatal androgen exposure has been measured and correlated with digit ratio in adult life. We aimed to establish the prospective relationship between prenatal androgen exposure in the second and third trimesters of pregnancy (as measured by maternal circulating androgen concentrations and umbilical cord androgen concentrations) and digit ratio in adolescent girls. Androgen concentrations (testosterone, free androgen index, androstenedione, DHEAS) and sex hormone binding globulin (SHBG) were measured in stored plasma samples from pregnant mothers at 18 (n = 118) and 34/36 (n = 114) weeks of gestation and in cord blood (n = 82) from the Western Australian Pregnancy (Raine) Cohort Study (www.rainestudy.org.au). Digit ratio was measured in 244 female offspring from this cohort at age 14–16 years. Only one borderline statistically significant correlation between maternal circulating androstenedione levels at 18 weeks of gestation and left hand digit ratio was seen. No other statistically significant relationship between maternal androgen concentrations or umbilical cord androgen concentrations and digit ratio in adolescence were observed. These findings suggest that variation in 2D:4D in girls is not established as a result of testosterone concentrations in the second and third trimesters. We conclude that prenatal androgen exposure as measured by maternal circulating androgen concentrations at 18 and 34/36 weeks of gestation or in the umbilical cord at birth may not predict digit ratio in girls.

Background: This article investigates whether reading and writing skills among children of equivalent perinatal characteristics differ by neighbourhood socioeconomic status and maternal factors. Methods: Notifications of births for all non-Aboriginal singletons born in 1990–7 in Western Australia subsequently attending government primary schools were linked to the State literacy tests in grade three and with information on socioeconomic status of the school and the residential area. Using multilevel modelling, the associations between birth characteristics (gestational age, intrauterine growth, birth order and Apgar score at 5 minutes) and literacy attainment in grade three were examined in models that included socioeconomic and demographic factors of the child, mother and community. Results: Higher percentages of optimal head circumference and birth length and term birth were positively and independently associated with literacy scores. A higher percentage of optimal birth weight was associated with higher reading scores especially for children born to mothers residing in educationally advantaged areas. First birth was positively associated with reading and writing attainment: this association was stronger for children born to single mothers and additional advantage in writing was also associated with first birth in children living in disadvantaged areas. Conclusions: These findings suggest that having suboptimal growth in utero or an older sibling at birth increases vulnerability to poor literacy attainment especially among children born to single mothers or those in disadvantaged neighbourhoods. These data provide evidence for advocating lifestyles compatible with optimum fetal growth and socioeconomic conditions conducive to healthy lifestyles, particularly during pregnancy.

For clinicians such as GPs, critical thinking includes critical appraisal of scientific evidence and the context of their clinical practice, and critical introspection.Largely due to a lack of rigorous research, there is no evidence that teaching critical thinking or appraisal, at undergraduate or postgraduate levels, improves GPs' clinical performance or their patients' health.Before conducting such research, a systematic review of the available literature (largely in education and psychology) is warranted to assess the efficacy of teaching critical thinking in non-medical environments.Critical thinking is being taught in Australian medical schools and will be introduced in the RACGP Training Program. However, it will be a while before this will have an impact in GPs' surgeries. The challenge will be to design an attractive CME program relevant to GPs while simultaneously evaluating its efficacy.

OBJECTIVE:To assess the prevalence of abdominal aortic aneurysm (AAA) in men with diabetes aged 60 years and over. DESIGN:Prospective screening study. PATIENTS:303 eligible participants among the first 1000 recruited to a large, community-based study of diabetes. MAIN OUTCOME MEASURES:Aortic diameter > or = 30 mm on screening ultrasonography, or previous surgery for AAA. RESULTS:AAA was diagnosed in three of the 303 men screened, and four others had previously had surgery for AAA. The aorta was not visualised in three obese men. Only one AAA required surgery (> or = 50 mm diameter). The overall prevalence of AAA was 2.3% (7/300), lower than that reported previously in the general population. Multivariate logistic regression analysis showed statistically significant associations with fasting triglyceride levels, and a history of intermittent claudication. CONCLUSIONS:Although a small number of men with diabetes aged 60 or more have undiagnosed AAA, the prevalence does not appear to be high enough to warrant targeted ultrasound screening.

Objectives: To assess temporal trends in the incidence of surgical procedures for peripheral occlusive arterial disease (POAD) and associated changes in outcome as measured by the rate of major lower limb amputations for POAD.Design: a retrospective descriptive population-based study was conducted of the geographically isolated population of Western Austrialia between 1980 and 1992.Methods: Vascular procedures with an accompanying diagnosis of POAD were identified in a computerised system of name-identified records of all discharges from hospital for the population. These procedures were detected using relevant codes from the International Classification of Disease and Procedures. Records of angioplasty and thrombolysis procedures were augmented by searches of hospital-based registers of invasive radiological procedures. The data for the remaining procedures were validated by a review of a random sample of medical records.Results: over the 13 years of the study, rates of major amputations fell significantly for in non-amputation vascular surgery for individuals under the age of 60. In addition, rather than an overall rise in surgery there was shift away from sympathectomy and thromboendarterectomy to angioplasty and bypass surgery. Furthermore, an increasing proportion of all major amputations had a prior attempt at arterial reconstruction.Conclusion: These observations suggest the decrease in major amputations for POAD may reflect a fall in the incidence of POAD, possibly aided by move effective surgery, rather than increased rates of vascular surgery.

We present a compact camera for holographic interferometry equipped with a semiconductor laser as the source of coherent radiation. The setup is extremely simple, alignment and operation are very easy. Due to its rigidness a sophisticated vibration insulation is not necessary, in contrary to the practice elsewhere in industrial holography.

The physical effects involved during the fragmentation of a urinary or gall stone by laser lithotripsy are not yet completely understood. We present the first in vitro experiments which display the deformations and vibrations produced by a shock wave in such a stone by means of holographic double-exposure interferometry. In the shell of an egg used as test object a slowly decreasing eigen vibration resulting from the shock wave can be observed. A gall stone shows a strongly inhomogeneous short-time deformation equalizing after some microseconds.

A compact camera for holography and holographic interferometry is presented. Owing to its simple and rigid construction, vibration insulation is not necessary. The use of a semiconductor laser with a wavelength of 670 nm permits the use of common holographic recording materials. The only optical components of this camera are a beam splitter and a deflection mirror. As an example of the application of this camera, holographic surface contouring is demonstrated.