Caroline Bower

Last updated

Caroline Bower
AC
NationalityAustralian
Education
  • MBBS, University of Western Australia
  • MSc, DLSHTM in epidemiology, University of London
  • PhD, University of Western Australia
Known for
  • Register of birth defects
  • FASD in juvenile detention
Medical career
ProfessionEmeritus Professor of Medicine
FieldEpidemiology
Institutions

Caroline Isabel Bower AC is an Australian medical researcher, professor of medicine, and public health advocate. Now retired, she is an emeritus professor at the University of Western Australia.

Contents

Bower's area of research is epidemiology, especially as it relates to the health of babies. She founded Australia's first registry of birth defects, and led the campaign to reduce neural tube defects in babies by adding folic acid to flour. Subsequently, she conducted research on Fetal Alcohol Spectrum Disorder and how it should be handled in the juvenile justice system.

In 2023 she was awarded Australia's highest civilian honour, Companion of the Order of Australia, for her service to medical research and education.

Education

Bower initially intended to practice obstetrics, but the desire to spend more time with her young family prompted her to opt for a research-oriented field instead. She graduated with a medical degree (MBBS) from the University of Western Australia (UWA). She later qualified with a Master of Science (MSc) from the London School of Hygiene and Tropical Medicine, and a PhD from UWA. [1]

Medical career

Birth defects register

Bower started work in 1980 as a Research Epidemiologist at the University of Western Australia (UWA). [2] Her initial project was to set up Australia's first birth defects registry (the Western Australia Register of Developmental Anomalies) for the Department of Health, Western Australia. Bower served as its head from 1980 to 2016. [2] The creation of the register was motivated largely by concerns about after-effects from the Vietnam War: she told Cosmos magazine: "In Australia there wasn't a collection of information on birth defects, but there was concern about Australian – and other – veterans from Vietnam that had been or might have been exposed to Agent Orange, and whether that exposure caused birth defects in their offspring." [3] All other Australian states have since replicated that register, providing crucial data for innumerable research projects. [4]

Instead of confirming the concerns about Agent Orange, Bower and her colleague Professor Fiona Stanley uncovered another, more significant, issue - the need for adequate folate in circumventing neural tube defects. This discovery ultimately led to the incorporation of folate into wheat flour from 2009, which significantly reduced the occurrence of these problems. [3]

Fetal Alcohol Spectrum Disorder

Bower has since investigated numerous other aspects of children's health, with the most challenging being preventing, diagnosing, and managing Fetal Alcohol Spectrum Disorder (FASD). "FASD is far more complex than folate and neural tube defects... We became aware of FASD back in 1973, so progress has been slow," she told Cosmos. [3] Having identified this as a major problem, she led the lobbying that resulted in adding warning messages targeted at pregnant women on packaged alcohol. [5]

She held numerous significant roles throughout her career at the Centre of Research Excellence at FASD Research Australia and the Telethon Kids Institute, which is an Australian medical research institute associated with the University of Western Australia and the Perth Children's Hospital, focused on the prevention of paediatric disease. She jointly ran the world's first nation-wide study of FASD rates, finding significantly elevated rates among Aboriginal children and prompting the development of community initiatives and collaboratively formulating protocols for diagnosis. [5]

Her FASD research reached a substantial milestone in 2018, with the publication in the British Medical Journal of her report which examined inmates at the Banksia Hill Juvenile Detention Centre, supported by the WA Department of Justice and the Department of Communities. That centre had been the subject of allegations of abuse, scrutiny by the media, and criticism by Amnesty International. [6] [7] Multi-disciplinary assessments were conducted on 113 10-17 year olds during 2015 and 2016. The analysis found that 89% had at least one type of severe neurological impairment and 36% had FASD, which is a higher prevalence than has been identified in any similar institution world-wide. In addition, many of the inmates had multiple problems: 65% of them had at least three distinct issues, and 23% had at least five. These problems caused difficulties in many executive functions including memory, attention, social interactions, the ability to relate cause to effect, planning, and motor skills. "Almost half the young people had severe problems with language, how to listen and understand and how to reply and explain what they think", Bower told the ABC News. [8] [9] [5]

This study represented the first extensive examination of FASD within the Australian justice system. FASD is regarded as the "invisible disability" due to its wide range of symptoms, and it is often disregarded or falsely attributed to poor parenting. The study resulted in updated guidelines for engaging with children by the Western Australia Department of Justice. [10]

The Banksia Hill study went on to play a key role in the 2023 Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, which devoted a chapter of their final report to this centre. [11] The report stated that "Impairment in domains such as language, executive function, memory and cognition, may contribute to offending behaviours and/or difficulties in negotiating all aspects of the justice system." [9] However, acceptance of these findings among non-medical people is not universal, and the W.A. premier Mark McGowan claimed "That's more excuse making," [12] a comment that drew condemnation from medical and legal experts. [13] [14]

Other research

On other topics, Bower has also conducted studies that looked into the results of assisted reproductive technologies, the use of medications during pregnancy, the correlation between birth defects and intellectual disability and cerebral palsy, and identifying risks and consequences related to birth defects such as trachea-esophageal fistula, orofacial clefts, and congenital heart defects. [15]

Along the way, she became Senior Principal Research Fellow at the UWA Medical School Centre for Child Health Research, and Principal Research Fellow at the National Health and Medical Research Council (NHMRC). [2] At the Telethon Kids Institute, she held the position of Senior Principal Research Fellow in Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder Research (2004–2021). As of March 2024, her key research activities include studying the effects of FASD within the juvenile justice system, and establishing a Centre of Research Excellence for Reducing the Effects of Antenatal Alcohol on Child Health - REAACH. [16]

She retired in 2021, [4] and moved to Sydney, although she is still actively linked to both TKI and UWS. [5] To recognize her extensive service, the UWA appointed her an Emeritus Professor. [2]

Professional service

She also served numerous roles on professional and industry bodies, including: [2]

Awards and recognition

In the 2023 King's Birthday Honours, Bower was awarded Companion of the Order of Australia, "for eminent service to medical research as a paediatric epidemiologist, particularly in birth defects and early childhood development, to health and welfare through public health initiatives, and to medical education". [17]

She is an honorary Emeritus Fellow of the Telethon Kids Institute. She was awarded the Distinguished Service Award by the International Clearinghouse for Birth Defects Surveillance Research in 2015, inducted into the Western Australian Science Hall of Fame in 2019, and won the Sue Miers Lifetime Achievement Award from the National Organisation for Fetal Alcohol Spectrum Disorders Australia (NOFASD Australia) in 2020. [18] [2]

The Public Health Association of Australia in 2018 declared that adding folate to flour was "one of the top 10 public health achievements of the past 20 years". [4] In 2023, Research Australia awarded her the Peter Wills Medal. [19]

She is a Fellow of the Australian Academy of Health and Medical Sciences (2017) [15] and the Public Health Association of Australia (2008), and a Life Member of the Royal Australasian College of Physicians (2017) and the Australasian Epidemiological Association (2011). [2]

Publications

ResearchGate lists 386 of her scientific publications. [20] As of 17 March 2024, Google Scholar lists 26,867 citations to her works, and an h-index of 81. [21]

Related Research Articles

<span class="mw-page-title-main">Folate</span> Vitamin B9; nutrient essential for DNA synthesis

Folate, also known as vitamin B9 and folacin, is one of the B vitamins. Manufactured folic acid, which is converted into folate by the body, is used as a dietary supplement and in food fortification as it is more stable during processing and storage. Folate is required for the body to make DNA and RNA and metabolise amino acids necessary for cell division and maturation of blood cells. As the human body cannot make folate, it is required in the diet, making it an essential nutrient. It occurs naturally in many foods. The recommended adult daily intake of folate in the U.S. is 400 micrograms from foods or dietary supplements.

<span class="mw-page-title-main">Fiona Stanley</span> Australian epidemiologist

Fiona Juliet Stanley is an Australian epidemiologist noted for her public health work, her research into child and maternal health as well as birth disorders such as cerebral palsy. Stanley is the patron of the Telethon Kids Institute and a distinguished professorial fellow in the School of Paediatrics and Child Health at the University of Western Australia. From 1990 to December 2011 she was the founding director of Telethon Kids.

Teratology is the study of abnormalities of physiological development in organisms during their life span. It is a sub-discipline in medical genetics which focuses on the classification of congenital abnormalities in dysmorphology caused by teratogens. Teratogens are substances that may cause non-heritable birth defects via a toxic effect on an embryo or fetus. Defects include malformations, disruptions, deformations, and dysplasia that may cause stunted growth, delayed mental development, or other congenital disorders that lack structural malformations. The related term developmental toxicity includes all manifestations of abnormal development that are caused by environmental insult. The extent to which teratogens will impact an embryo is dependent on several factors, such as how long the embryo has been exposed, the stage of development the embryo was in when exposed, the genetic makeup of the embryo, and the transfer rate of the teratogen.

A physical disability is a limitation on a person's physical functioning, mobility, dexterity or stamina. Other physical disabilities include impairments which limit other facets of daily living, such as respiratory disorders, blindness, epilepsy and sleep disorders.

<span class="mw-page-title-main">Fetal alcohol spectrum disorder</span> Group of conditions resulting from maternal alcohol consumption during pregnancy

Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person who is exposed to alcohol during gestation. FASD affects 1 in 20 Americans, but is highly mis- and under-diagnosed.

The Kids Research Institute Australia is an Australian medical research institute focused on the prevention of paediatric disease and the development of improved treatments to improve the health and wellbeing of children. The Kids has developed a particular focus on Aboriginal health and has more than 500 staff, post-graduate students and visiting scholars. The Kids is located in the Perth suburb of Nedlands, in the Perth Children's Hospital building. The Kids Research Institute Australia is an independent not-for-profit, non-government organisation with close affiliations with the University of Western Australia and the Perth Children's Hospital.

<span class="mw-page-title-main">Neural tube defect</span> Group of birth defects of the brain or spinal cord

Neural tube defects (NTDs) are a group of birth defects in which an opening in the spine or cranium remains from early in human development. In the third week of pregnancy called gastrulation, specialized cells on the dorsal side of the embryo begin to change shape and form the neural tube. When the neural tube does not close completely, an NTD develops.

James Paul Fitzpatrick is an Australian paediatrician notable for his advocacy of rural and indigenous health issues, particularly his work with fetal alcohol spectrum disorder.

<span class="mw-page-title-main">Folate deficiency</span> Abnormally low level of folate (vitamin B9) in the body

Folate deficiency, also known as vitamin B9 deficiency, is a low level of folate and derivatives in the body. This may result in megaloblastic anemia in which red blood cells become abnormally large, and folate deficiency anemia is the term given for this medical condition. Signs of folate deficiency are often subtle. Symptoms may include fatigue, heart palpitations, shortness of breath, feeling faint, open sores on the tongue, loss of appetite, changes in the color of the skin or hair, irritability, and behavioral changes. Temporary reversible infertility may occur. Folate deficiency anemia during pregnancy may give rise to the birth of low weight birth premature infants and infants with neural tube defects.

<span class="mw-page-title-main">Martin Whitely</span> Australian politician

Martin Paul Whitely is a mental health researcher, author and was a Labor member of the Western Australian Legislative Assembly from February 2001 until he retired from state politics in March 2013. During his parliamentary and academic research career Whitely has been a prominent critic of increasing child mental health medication prescribing rates.

Women should speak to their doctor or healthcare professional before starting or stopping any medications while pregnant. Non-essential drugs and medications should be avoided while pregnant. Tobacco, alcohol, marijuana, and illicit drug use while pregnant may be dangerous for the unborn baby and may lead to severe health problems and/or birth defects. Even small amounts of alcohol, tobacco, and marijuana have not been proven to be safe when taken while pregnant. In some cases, for example, if the mother has epilepsy or diabetes, the risk of stopping a medication may be worse than risks associated with taking the medication while pregnant. The mother's healthcare professional will help make these decisions about the safest way to protect the health of both the mother and unborn child. In addition to medications and substances, some dietary supplements are important for a healthy pregnancy, however, others may cause harm to the unborn child.

<span class="mw-page-title-main">Alcohol (drug)</span> Active ingredient in fermented drinks

Alcohol, sometimes referred to by the chemical name ethanol, is one of the most widely used and abused psychoactive drugs in the world. It is a central nervous system (CNS) depressant, decreasing electrical activity of neurons in the brain. The World Health Organization (WHO) classifies alcohol as a toxic, psychoactive, dependence-producing, and carcinogenic substance.

Aleksandra Filipovska is an Australian scientist who is a professor, Deputy Director of the ARC Centre of Excellence in Synthetic Biology and NHMRC Investigator at the University of Western Australia, heading a research group at the Telethon Kids Institute. Specializing in biochemistry and molecular biology, she has made contributions to the understanding of human mitochondrial genetics in health and disease.

<span class="mw-page-title-main">June Oscar</span>

June Oscar is an Australian Aboriginal woman of Bunuba descent, Indigenous rights activist, community health and welfare worker, film and theatre, and since 2017 and as of February 2022 Aboriginal and Torres Strait Islander Social Justice Commissioner.

<span class="mw-page-title-main">University of Western Australia School of Medicine</span> Medical school in Western Australia

The University of Western Australia Medical School is the medical school of The University of Western Australia, located in Perth, Western Australia. Established in 1957, it is the oldest medical school in Western Australia, with over 6000 alumni. Well known for its research and clinical teaching, the medical school is ranked 8th in the world and 1st in Australia by the 2019 Academic Ranking of World Universities in clinical medicine. The medical school is affiliated with various teaching hospitals in Perth such as Royal Perth Hospital and Sir Charles Gairdner Hospital. The medical school is also heavily affiliated with the Queen Elizabeth II Medical Centre and its various research institutes. The school has prominent researchers and clinicians amongst its faculty and alumni, including Nobel Prize laureates Barry Marshall and Robin Warren ; recipients of the Australian of the Year award Fiona Stanley and Fiona Wood; and cancer researcher Richard Pestell. The school has produced 11 Rhodes Scholars.

<span class="mw-page-title-main">Alcohol packaging warning messages</span> Warning messages about health issues appearing on alcohol packaging

Alcohol packaging warning messages are warning messages that appear on the packaging of alcoholic drinks concerning their health effects. They have been implemented in an effort to enhance the public's awareness of the harmful effects of consuming alcoholic beverages, especially with respect to foetal alcohol syndrome and alcohol's carcinogenic properties. In general, warnings used in different countries try to emphasize the same messages. Such warnings have been required in alcohol advertising for many years, although the content of the warnings differ by nation.

Elizabeth Jane Elliott is an Australian clinician scientist. She is a Member of the Order of Australia (AM), for services to paediatrics and child health, as well as an Elected Fellow of the Australian Academy of Health and Medical Science (AAHMS), Fellow of the Royal Society of NSW, and Fellow of the Academy of Child and Adolescent Health. She was the first female to win the James Cook Medal, awarded by the Royal Society of NSW for contributions to human welfare. She is a Distinguished Professor of paediatrics at the University of Sydney and a Consultant Paediatrician at the Sydney Children’s Hospitals Network, Westmead, and regarded as a "pioneer in fetal alcohol spectrum disorder, advocacy and patient care".

Jennifer J. Kurinczuk is a British physician who is a Professor of Perinatal Epidemiology and Director of the National Perinatal Epidemiology Unit at the University of Oxford. In 2019 she was named an Honorary Fellow of the Royal College of Obstetricians and Gynaecologists. During the COVID-19 pandemic, Kurinczuk investigated the neonatal complications of coronavirus disease.

Anita Gibbs is a New Zealand academic, and is Professor of Criminology and Social Work at the University of Otago, specialising in sociology, the impact on people of complex social systems such as mental health and criminal justice systems, and Fetal Alcohol Spectrum Disorder.

Donna Cross is an Australian academic, professor, a child health advocate at the School of Global and Population Health within the University of Western Australia and leader of the Telethon Kids Institute. She was awarded an Order of Australia for her work in children's mental health.

References

  1. ↑ "Emeritus Professor Carol Bower". alumni.uwa.edu.au. University of Western Australia. Retrieved 18 March 2024.
  2. 1 2 3 4 5 6 7 "Media Notes - AC - The King's Birthday 2023 Honours List" (PDF). The Office of the Official Secretary to the Governor-General. 9 June 2023. pp. 2–3. Retrieved 18 March 2024.
  3. 1 2 3 Bowler, Jacinta (12 June 2023). "Epidemiologist and folate expert given Order of Australia". Cosmos magazine. Retrieved 18 March 2024.
  4. 1 2 3 "Top honour for folate hero Carol Bower". www.telethonkids.org.au. 12 June 2023. Retrieved 18 March 2024.
  5. 1 2 3 4 Rintoul, Caitlyn (12 June 2023). "No drinking in pregnancy pioneer given highest honour". The West Australian. Archived from the original on 24 March 2024. Retrieved 18 March 2024.
  6. ↑ "Amnesty International condemns violence against youth detained in Banksia Hill youth detention centre". Amnesty International Australia. 11 May 2023. Retrieved 18 March 2024.
  7. ↑ "Nine out of ten young people in detention have mental disability, study finds". NITV. SBS. 14 February 2018. Retrieved 18 March 2024.
  8. ↑ Mills, Vanessa; Bamford, Matt (29 May 2021). "WA Police learn better ways to engage people with neurological impairments". ABC News. Retrieved 18 March 2024.
  9. 1 2 Perpitch, Nicolas (14 February 2018). "Groundbreaking research finds severe brain impairments in almost all juvenile detainees". ABC News. Retrieved 18 March 2024.
  10. ↑ Brown, Kyle (14 February 2018). "Study finds 89 per cent of WA youth in detention have neurological impairments". SBS News. Retrieved 18 March 2024.
  11. ↑ Zadvirna, Daryna (30 September 2023). "Royal commission report delivers scathing assessment of WA's Justice Department". ABC News. Retrieved 18 March 2024.
  12. ↑ Bourke, Keane (16 May 2023). "Is foetal alcohol spectrum disorder an excuse for the Banksia Hill riot, or is the truth more complicated?". ABC News. Retrieved 18 March 2024.
  13. ↑ McNeill, Heather (10 May 2023). "Premier labels FASD 'an excuse' as 50 juveniles spark 12-hour riot at Banksia Hill". WA Today. Retrieved 18 March 2024.
  14. ↑ Torre, Giovanni (10 May 2023). "Aboriginal Legal Service WA slams McGowan for claim medical disorders "just an excuse" for young offenders". National Indigenous Times. Retrieved 18 March 2024.
  15. 1 2 "Professor Carol Bower - AAHMS". aahms.org. Australian Academy of Health and Medical Sciences. 19 October 2017. Archived from the original on 28 May 2023. Retrieved 18 March 2024.
  16. ↑ "Professor Carol Bower". www.telethonkids.org.au. Telethon Kids Institute. Retrieved 18 March 2024.
  17. ↑ "Emeritus Professor Caroline Isabel BOWER". honours.pmc.gov.au. Australian Government: Department of the Prime Minister and Cabinet. Retrieved 18 March 2024.
  18. ↑ "FASD Hub Australia Awards 2020". www.fasdhub.org.au. FASD Research Australia. Retrieved 18 March 2024.
  19. ↑ "2023 winners of Research Australia Health and Medical Research Awards". RESEARCH AUSTRALIA. Archived from the original on 15 March 2024. Retrieved 18 March 2024.
  20. ↑ "Carol Bower's research while affiliated with Telethon Kids Institute and other places" . Retrieved 18 March 2024.
  21. ↑ "Carol Bower". scholar.google.com. Retrieved 18 March 2024.
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