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Biomedical subjects

J Spensley

Publications and source records attributed to J Spensley.

At least 19 recordsLinked to original sources
PubMed1996

Growth and physical outcome of children conceived by in vitro fertilization.

OBJECTIVE: To determine the growth and physical outcome at 2 years of age for children born after assisted reproductive techniques in the state of Victoria. DESIGN: Using a case-matched control study between January 1991 and July 1993, 314 children (196 singletons, 47 sets of twins, 8 sets of triplets) conceived after in vitro fertilization (IVF) and related techniques at the Monash IVF and Royal Women's Hospital Reproductive Biology Unit and 150 control children (113 singletons, 17 sets of twins, 1 set of triplets) randomly selected from the general population using the Victorian Perinatal Data Collection Unit records were enrolled to be examined for minor dysmorphic and major organ abnormalities. Singleton and twin cases were matched for plurality and gestation and date of birth. Triplets were not matched. RESULTS: IVF status was not a significant independent factor for physical outcomes, including malformation rates, nor for days of hospitalization postdischarge and operations. There was no significant interaction between IVF status and mean percentiles for weight and head circumference. The IVF group had a greater mean length percentile. Twins in both groups had significantly poorer physical outcomes than singletons on some measures. CONCLUSION: This study did not demonstrate an independent IVF effect on the growth and physical outcome of children at 2 years of age when matched for plurality and gestation. The poor outcomes where noted were related to the effects of multiple births. These findings must be viewed in context of the response rates and therefore representativeness of the data. The need for longitudinal studies is demonstrated.

Adult↗
PubMed1986

Birth centre confinement at the Queen Victoria Medical Centre: four years' experience.

A review of the first four years of the functioning of the birth centre at the Queen Victoria Medical Centre is presented. In that time, 1040 pregnant women were accepted for confinement there. Of these, 52 withdrew for non-obstetric reasons, while 470 were transferred to alternative obstetrical care--274 because of antepartum complications and 196 because of intrapartum problems. Therefore, 518 women were delivered in the birth centre. The care of the women is entrusted almost entirely to a team of midwives and this review demonstrates an enviable safety record.

Australia↗
PubMed1985

Children of IVF.

This chapter has reviewed issues relevant to the consideration of children conceived by in vitro fertilization. The rationale and motivation for studying these children and the factors which might be relevant to their development have been discussed. Such factors involve the child, the parents, the family as a whole and the influences of the community at large. While as yet there is a paucity of research concerning these issues, questions can be generated by reference to possible related areas, such as adoption. The authors then discussed their study of a group comprising the first families (49 children) whose children were conceived by IVF in the Monash Hospital. All children received paediatric follow-up and 33 has psycho-social follow-up. The findings do not indicate any increased risk of pathology in IVF children or in their families. However, there was a significant increase in very low birth weight children and in twins. Those children with problems tended to fall into these two groups. It is recognized that this was an unmatched group seen at an early stage in development. The significance of these findings have been discussed and issues for management raised. There was also discussion of future directions for research in this area, particularly the need for a careful, long-term follow-up study of families in which children are conceived by in vitro fertilization.

Cesarean Section↗
PubMed1981

Birth centre confinement at the Queen Victoria Medical Centre. I. Obstetric and neonatal outcome.

A review of hte first 175 confinements at the Queen Victoria Medical Centre Birth Centre is presented. The design, structure and function of hte Birth Centre is described and the safety of the programme demonstrated. Seventy-four pregnancies (42%) accepted for Birth Centre confinement required transfer because of antepartum or intrapartum complications. There were satisfactory obstetric and neonatal outcomes in all pregnancies. The first year's experience has allowed a reassessment of the risk factors, which will permit greater use of the Birth Centre without any increases risk to mothers or babies.

Australia↗
PubMed1979

Conservatorship: an involuntary legal status for 'gravely disabled' mentally disordered persons.

Since 1969 in California, conservatorship has been the only form of civil, longterm involuntary psychiatric legal process. It does not require hospital-based treatment. This paper reports a preliminary study of this process through a retrospective analysis of conservatorship records in Sacramento County, California, from 1969 through 1976. There is a steady overall increase in the incidence of conservatorships each year. A dramatic decrease in state hospital admissions preceded this increase. Referrals were predominantly (69 percent) from the private sector. Once the first legal step was taken 87 percent of the patients completed the process and were placed on full conservatorship. Median age was 50; 52 percent were male and 90 percent were white. The relative proportion of single persons was high (45 percent). Diagnoses of schizophrenia and organic brain syndrome accounted for 86 percent of conservatees. About half (52 percent) terminate conservatorship after one year. No data were found which could be related to the character of treatment of conservatees. Future research in this area is urgently needed.

California↗
PubMed1976

Doxepin: a useful adjunct in the treatment of heroin addicts in a methadone program.

An uncontrolled trial of doxepin as an adjunct to treatment of heroin addicts in a methadone program was performed over a 14-month period. Approximately 10% (27) of the program's population utilized a mean of 73 mg of doxepin, usually briefly, and beneficial results were noted in 93% (25). One adverse reaction occurred. No instance of habituation or addiction was noted. A controlled study is warranted to confirm the impression that doxepin represents a useful adjunct in the treatment of heroin addicts in a methadone program.

Adult↗