Frank Lloyd-Griffiths.

One of the youngest people to ever qualify as a vet, he was a life-long practitioner whose philosophy was one of caring - whether it be for animals, student vets, farmers, local people or friends.

Applying One Health to behaviour.

The British Veterinary Behaviour Association and the Association of Pet Behaviour Counsellors held a meeting last month to highlight the One Health principle with regard to the behaviour of people and animals, particularly pets. Caroline Bower reports.

Baseline investigations of folate status in Aboriginal and non-Aboriginal West Australians prior to the introduction of mandatory fortification.

OBJECTIVE: In September 2009, Australia implemented mandatory folic acid fortification of wheat flour for bread-making to reduce the incidence of neural tube defects. Our study aimed to establish baseline folate status data in Aboriginal and non-Aboriginal Western Australians. METHODS: Patients who presented at a health service or collection centre for blood tests were invited to participate. One hundred and ninety-one Aboriginals and 159 non-Aboriginals were recruited between April 2008 and September 2009. Participants completed a five-minute questionnaire and had blood taken for red blood cell (RBC) folate and serum vitamin B12. Data were analysed using SPSS (version 17.0.2, SPSS Inc., Chicago, IL, USA). RESULTS: Ten per cent (95% confidence intervals (CI): 5, 19) of the Aboriginal women participants and 26% (95% CI: 16, 40) of men had RBC folate concentrations below 250 ng/mL, the cut-off associated with folate deficiency. None of the non-Aboriginal women (95% CI: 0, 4) and 4% of the non-Aboriginal men (95% CI: 2, 12) had RBC folate concentrations below 250 ng/mL. All participants were vitamin B12 replete. None of the 96 Aboriginal and 8% of non-Aboriginal women aged 16-44 reported consumption of supplements with a daily intake of >400 µg folic acid during the previous week. CONCLUSIONS AND IMPLICATIONS: This study established a baseline of RBC folate, folate consumption and supplement use in Aboriginal and non-Aboriginal groups. We identified 10% of Aboriginal women and none of non-Aboriginal women participants with low folate concentrations. The higher prevalence of folate deficiency in Aboriginal participants suggests they are more likely to benefit from a universal program of folate fortification.

International trends of Down syndrome 1993-2004: Births in relation to maternal age and terminations of pregnancies.

BACKGROUND: The aim of this study was to examine trends of Down syndrome (DS) in relation to maternal age and termination of pregnancies (ToP) in 20 registries of the International Clearinghouse for Birth Defects Surveillance and Research (ICBDSR). METHODS: Trends of births with DS (live-born and stillborn), ToP with DS, and maternal age (percentage of mothers older than 35 years) were examined by year over a 12-year period (1993-2004). The total mean number of births covered was 1550,000 annually. RESULTS: The mean percentage of mothers older than 35 years of age increased from 10.9% in 1993 to 18.8% in 2004. However, a variation among the different registers from 4-8% to 20-25% of mothers >35 years of age was found. The total mean prevalence of DS (still births, live births, and ToP) increased from 13.1 to 18.2/10,000 births between 1993 and 2004. The total mean prevalence of DS births remained stable at 8.3/10,000 births, balanced by a great increase of ToP. In the registers from France, Italy, and the Czech Republic, a decrease of DS births and a great increase of ToP was observed. The number of DS births remained high or even increased in Canada Alberta, and Norway during the study period. CONCLUSIONS: Although an increase in older mothers was observed in most registers, the prevalence of DS births remained stable in most registers as a result of increasing use of prenatal diagnostic procedures and ToP with DS.

The outcomes of pregnancies following a prenatal diagnosis of fetal exomphalos in Western Australia.

AIMS: To review the perinatal outcomes for prenatally diagnosed exomphalos from a single geographical region. METHODS: Retrospective review of cases of prenatally identified exomphalos in the state of Western Australia in the ten-year period 1998-2007 using the medical databases of the sole tertiary obstetric and paediatric hospitals. RESULTS: Ninety-four cases of prenatally identified exomphalos comprise this consecutive case series. Culture-proven karyotypic abnormalities occurred in 40 (42.6%) fetuses. No karyotypically abnormal fetus survived the neonatal period, with 33 of 40 (82.5%) pregnancies interrupted, five of 40 (12.5%) resulting in fetal demise and two (5%) neonatal deaths. For the 49 (52.1%) fetuses with a normal karyotype, 26 (53.1%) had associated abnormalities with termination occurring in 22 (84.6%). Prenatally isolated exomphalos was present in 23 cases (24.5%), with live birth in 15 cases (30.6% of euploid fetuses). Fourteen (93.3%) of the liveborn prenatally isolated exomphalos cases survived with no postoperative deaths, although four (28.5%) had significant abnormalities detected postdelivery and most have experienced childhood morbidity. CONCLUSIONS: In the the majority of cases of prenatally detected exomphalos the pregnancy was interrupted secondary to chromosomal or structural abnormalities. In only 10.6% of prenatally recognised fetuses with exomphalos was the disorder truly isolated with neonatal survival occurring.

Talipes equinovarus in Western Australia.

In Western Australia (WA), talipes equinovarus is a notifiable birth defect and, since 1980, has been ascertained by the population-based Birth Defects Registry (BDR). Talipes equinovarus deformities were classified as two distinct and distinguishable types, viz. isolated talipes equinovarus (no other birth defects present) and associated talipes equinovarus (other birth defects present). The birth prevalence of associated talipes in WA between 1980 and 1994 was 0.90 per 1000 births, and of isolated talipes was 1.25 per 1000 births. The rate of the isolated deformity was higher in Aboriginal infants (3.49 per 1000 births) than in Caucasian infants (1.11 per 1000 births) and non-Aboriginal non-Caucasian infants (0.73 per 1000 births). The sex differential in the rate of the isolated deformity was greatest among Aboriginal infants, with the rate in males being almost four times that in females. The birth prevalence of both types of the deformity remained stable over the 15-year study period. The rate of caesarean and breech deliveries and the proportion of bilaterally affected feet was greater among infants with associated talipes equinovarus deformity. An accurate and complete identification of cases of isolated talipes equinovarus in the 1980-94 WA birth cohort provides a basis for furthering the understanding of the epidemiology and hence the aetiology of the deformity.