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Biomedical subjects

J Lumley

Publications and source records attributed to J Lumley.

At least 37 records · Page 2Linked to original sources
PubMed2000

NCCGs.

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Career Mobility↗
PubMed2000

Calman training.

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Clinical Competence↗
PubMed1999

Long-term effects on women of assisted reproduction.

The long-term health sequelae for women from assisted reproductive technology (ART) have not been studied extensively. There are a number of reasons that women's health may be compromised after ART procedures, including the consequences of the increased incidence of multiple births, operative deliveries, and preterm infants, the possible adverse effects of the drug regimens used for ovarian stimulation, and the instrumentation involved in ART procedures. In this paper we review the existing literature in these areas. It emphasizes the effects of the drugs used for ovarian stimulation, and in particular the incidence of cancer among women who have undergone ART. The review indicates that there is cause for concern about the long-term effects on women from ART treatments. It highlights the lack of research undertaken in almost all areas related to women's long-term health after ART. In the area of ART and cancer, it draws attention to the lack of conclusive evidence in relation to the posited association between fertility treatments and cancer, resulting from the limited number of very large studies and the need for longer follow-up periods. We make a number of recommendations regarding further research that is needed to address the current shortcomings in the published literature.

Breast Neoplasms↗
PubMed1999

Cross-cultural research: trying to do it better. 1. Issues in study design.

OBJECTIVE: To discuss a range of strategies to address the methodological and practical challenges in designing cross-cultural public health studies. METHOD: The Mothers in a New Country (MINC) Study was an interview study of 318 Vietnamese, Turkish and Filipino recent mothers exploring their views of maternity care and the early months of motherhood. It was carried out in Melbourne between 1994 and 1997. Sampling, recruitment, retention and representativeness all pose problems for studies involving non-English-speaking background immigrant populations, as do selection, training and support processes for bicultural interviewers. These issues are discussed with reference to the strategies undertaken to tackle them in the MINC Study. RESULTS: In the MINC Study, a systematic approach to sampling and recruitment, combined with a flexible and sensitive study protocol were largely successful both in achieving in adequate sample size and a largely representative study sample. Similarly, paying significant attention to the selection, training and ongoing support of the biocultural interviewers employed on the study contributed greatly to its successful completion and enhanced confidence in the study findings. IMPLICATIONS: Both researchers and funders need to take seriously the implications of the many methodological and practical issues involved in designing sound cross-cultural public health studies. In particular, there are major implications for study costs and timelines. However, the benefits to be gained are significant.

Attitude to Health↗
PubMed1999

Cross-cultural research: trying to do it better. 2. Enhancing data quality.

OBJECTIVE: To describe the dilemmas for cross-cultural research in translating study instruments and implementing quality assurance methods, drawing on strategies utilised in the Mothers in a New Country (MINC) Study. METHOD: To translation of study instruments in the MINC Study included: forward and back translations, a bilingual group review process, consultation with bilingual content experts, piloting of different versions of translations, a process for exploring unresolved difficulties and caution in interpreting unusual study findings. Interview quality was assessed by: 1. An ongoing review of interviewer-prepared English coding schedules to ensure completeness of data and identify problems with interview administration. 2. Analysis of fully translated transcripts of six randomly selected early interviews to assess the accuracy and consistency with which questions were asked. 3. A comparison of data sources for 45 randomly selected interviews (original language interview schedules, English coding schedules and translated interview transcripts) to determine the rate and nature of discrepancies. RESULTS: Translation strategies that went beyond simple forward and back translations achieved more reliable and appropriate translations. The complexity of language and cultural differences sometimes still meant less than satisfactory results. Interview tapes played an important quality assurance role, enabling feedback to the interviewers and providing a basis of comparison for identification of data discrepancies. IMPLICATIONS: Ensuring good data quality in cross-cultural research is both critically important and difficult. Open discussion of the problems and concerted efforts to deal with them would benefit future research.

Attitude to Health↗
PubMed1999

Mothers in a new country: the role of culture and communication in Vietnamese, Turkish and Filipino women's experiences of giving birth in Australia.

There are few population based studies which explore the views immigrant women have of the maternity care they receive in their new homelands. Three hundred and eighteen Vietnamese, Turkish and Filipino women who gave birth in three major city hospitals in Melbourne, Australia were interviewed about their experiences of maternity care. Outcomes and experiences for women with different levels of English fluency were studied, as were women's needs and preferences for assistance with interpreting. Observance of traditional cultural practices surrounding birth and the impact of not being able to observe such practices on women's experiences of care were also explored. Women in the study not fluent in English experienced problems in communicating with their caregivers and these were reflected in less positive experiences of care. Women were less concerned that caregivers knew little about their cultural practices than they were about care they experienced as unkind, rushed, and unsupportive. Maternity care for immigrant women is only likely to improve when barriers to effective communication are addressed and attention is paid to raising standards of care.

Adolescent↗
PubMed1998

Is baby too warm? The use of infant clothing, bedding and home heating in Victoria, Australia.

Overheating of infants has been associated with a raised risk for sudden infant death syndrome (SIDS). Data on the use of heating, bedding and clothing and other measures affecting the thermal environment of 4 week old infants were collected at a home interview for infants of women born in Australia (Anglo-Celtic background), in Southern Europe, in Asia and of women who had a planned out-of-hospital birth. These groups have different risks of SIDS not explained by the classic social and perinatal risk factors nor associated with the currently promoted 'new' risk factors. Thermal insulation of the infant's bedding and clothing and excess thermal insulation (for any observed room temperature) were calculated. Bed sharing differed significantly between the groups as did the use of a sheepskin, tucking in firmly, the closing of doors and windows and the use of heating in the infant's room. After stratifying by bed sharing practice and season of interview, it was found that bed sharing infants had more thermal insulation than those sleeping alone irrespective of season of interview. Infants sleeping alone in the Asian-born and Southern European-born groups were kept warmer than infants in the other two groups. Cultural factors appear to affect the thermal environment in which infants are raised. Some bed sharing infants in all four groups were inappropriately warm, particularly in colder weather, but this was more likely in the Asian-born (low risk) group than in the home birth (high risk) group. These results do not explain the differences in SIDS incidence between the groups.

Adult↗
PubMed1998

Shared antenatal care fails to rate well with women of non-English-speaking backgrounds.

OBJECTIVES: To compare the views of women from non-English-speaking backgrounds who received antenatal care at a public hospital clinic with those whose care was shared between a public hospital clinic and a general practitioner. DESIGN: Structured interviews in the language of the woman's choice. SETTING: Women were recruited from the postnatal wards of three maternity teaching hospitals in Melbourne between July 1994 and November 1995, and interviewed six to nine months later. PARTICIPANTS: Women born in Vietnam, Turkey and the Philippines who gave birth to a live healthy baby (over 1500 g) were eligible. Of 435 women recruited, 318 (Vietnamese [32.7%], Filipino [33.6%] and Turkish [33.6%]) completed the study. MAIN OUTCOME MEASURES: Women's ratings of their antenatal care overall and views on specific aspects of their antenatal care. RESULTS: Women in shared care (n = 151) were not more likely than women in public clinic care (n = 143) to rate their care as "very good" (odds ratio [OR], 1.38; 95% confidence interval [95% CI], 0.72-2.63). Satisfaction with particular aspects of care (waiting times, opportunity to ask questions, whether caregivers were rushed, whether concerns were taken seriously) did not differ significantly between those in shared care and those in public clinic care. Women in shared care were not happier with their medical care than women in public clinic care (OR, 0.83; 95% CI, 0.35-1.96), but were more likely to see a caregiver who spoke their language (OR, 17.69; 95% CI, 6.15-69.06), although two-thirds still saw a GP who spoke only English. CONCLUSION: Shared antenatal care is not more satisfying than public clinic care for women from non-English-speaking backgrounds. Further evaluation of shared care is clearly needed.

Emigration and Immigration↗
PubMed1998

Support, sensitivity, satisfaction: Filipino, Turkish and Vietnamese women's experiences of postnatal hospital stay.

OBJECTIVE: To assess Filipino, Turkish and Vietnamese women's views about their care during the postnatal hospital stay. DESIGN: Interviews were conducted with recent mothers in the language of the women's choice, 6-9 months after birth, by three bilingual interviewers. PARTICIPANTS: Three hundred and eighteen women born in the Philippines (107), Turkey (107) and Vietnam (104) who had migrated to Australia. SETTING: Women were recruited from the postnatal wards of three maternity teaching hospitals in Melbourne, Australia, and interviewed at home. FINDINGS: Overall satisfaction with care was low, and one in three women left hospital feeling that they required more support and assistance with both baby care and their own personal needs. The method of baby feeding varied between the groups, with women giving some insight into the reason for their choice. A significant minority wanted more help with feeding, irrespective of the method. The need for rest was a recurrent theme, with women stating that staff's attitudes to individual preferences, coupled with lack of assistance, made this difficult. The majority of comments women made regarding their postnatal stay focused on the attitude and behaviour of staff and about routine aspects of care. Issues related to culture and cultural practices were not of primary concern to women. CONCLUSION: Maternity services need to consider ways in which care can focus on the individual needs and preferences of women.

Adult↗
PubMed1998

Laparoscopic stoma formation for faecal diversion.

BACKGROUND: Laparoscopic creation of an intestinal stoma may be preferable to open operation when intervention is required solely for faecal diversion. METHODS: Experience with laparoscopic intestinal stoma formation for faecal diversion from a single institution is presented. RESULTS: A total of 55 stomas were studied, 40 laparoscopic and 15 open. The conversion rate from laparoscopic to open operation was 5 per cent. Mean(s.e.m.) operating time was significantly reduced for laparoscopic stomas (54(4.7) versus 72(8.7) min). Time to return of bowel function was significantly reduced (1.6(0.3) versus 2.2(0.2) days). Mean(s.e.m.) hospital stay was significantly reduced in the laparoscopic group (7.4(0.5) versus 12.6(2.5) days). CONCLUSION: Morbidity and mortality appeared to be reduced in patients undergoing laparoscopic stoma formation. The technique was found to be safe, suitable for the majority of patients and to give results superior to those of open surgery.

Aged↗