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Biomedical subjects

John Tripp

Publications and source records attributed to John Tripp.

6 recordsLinked to original sources
PubMed2003

Sudden infant death syndrome and social deprivation: assessing epidemiological factors after post-matching for deprivation.

As part of the confidential enquiry into stillbirths and deaths in infancy (CESDI), a 3-year population-based case-control study was specifically designed to look at risk factors associated with sudden infant death syndrome (SIDS) after the dramatic fall in incidence. The study was conducted between 1993 and 1996 in five English Health Regions (population 17 million) with parental interviews for each death and four age-matched controls. The aim of this analysis was to investigate the extent to which epidemiological characteristics associated with SIDS were particular to the syndrome or more general markers for socio-economic deprivation. One control was reassigned to each case post-matched for infant age, time of sleep and socio-economic status using components of the Townsend Deprivation Score. The post-matched analysis involved 323 SIDS infants and 323 controls with a similar socio-economic profile. Notable factors significant in the original univariable analysis that became non-significant after post-matching included young maternal age (median: 23 years 4 months SIDS vs. 23 years 11 months post-matched controls), being an unsupported mother (13.6% SIDS vs. 11.1% post-matched controls) and being bottle-fed (56.7% SIDS vs. 55.4% post-matched controls). Other factors, although clearly related to deprivation, such as parental smoking, remained significant in both the univariable and multivariable post-matched analyses.

Adult↗
PubMed2002

Clinical performance of the Nova T380 intrauterine device in routine use by the UK Family Planning and Reproductive Health Research Network: 5-year report.

OBJECTIVES: The purpose of the study was to evaluate the pregnancy and complication rates of this new device, with its increased area of copper, in comparison with other published results, in the clinical setting of British general practice and family planning clinics. DESIGN: Doctors working in general practice and at family planning clinics throughout the UK who collaborate in the UK Family Planning and Reproductive Health Research Network were responsible for the fitting of 574 Nova T380 intrauterine contraceptive devices (IUDs). The Nova T (and formerly the identical Novagard IUDs have copper with a surface area of 200 mm(2). The Nova T380 has copper with a surface area of 380 mm(2). RESULTS: This is the first 5-year report on this device. The 5-year cumulative life-table event rates per 100 women were pregnancy 2.0, expulsion 13.0, and removal for bleeding problems and bleeding with pain 29.6. CONCLUSIONS: The increased surface area of copper was associated with a reduced pregnancy rate as compared to the Nova T though no statistical comparison is possible. Although the present study was not a direct comparative study with the Nova T, the result lends weight to the notion that increasing the copper reduces the pregnancy rate. The discontinuation rate for bleeding problems and bleeding with pain and the expulsion rates were higher than in published Nova T studies.

Adult↗
PubMed2002

Clinical performance of the levonorgestrel intrauterine system in routine use by the UK Family Planning and Reproductive Health Research Network: 5-year report.

OBJECTIVES: This study was undertaken to determine the performance of the levonorgestrel intrauterine system (LNG IUS) in British women in routine clinical use. DESIGN: Doctors working in general practice and at family planning clinics throughout the UK who collaborate in the UK Family Planning and Reproductive Health Research Network were responsible for the fitting of 678 LNG IUSs. RESULTS: Gross cumulative event rates at 5 years per 100 women were pregnancy 1.0, expulsion 5.9, removal for bleeding problems 16.7, removal for pain 4.3, and removal for pelvic inflammatory disease (PID) 1.2. Removals were also required for side effects that may be due to absorbed levonorgestrel. Positive effects include effective contraception and considerably reduced quantity of bleeding for most participants. CONCLUSIONS: A need was identified to counsel women about the early bleeding problems including the possibility of oligomenorrhoea or amenorrhoea. This is considered to be very important as it will help women to persevere so that they can enjoy the longer-term benefits.

Adult↗
PubMed2002

Oves contraceptive cap: short-term acceptability, aspects of use and user satisfaction.

OBJECTIVE: To assess the short-term acceptability, aspects of use and user satisfaction with the Oves cap. DESIGN, SETTING AND SUBJECTS: A multicentre observational study, commissioned by Veos Ltd, manufacturers of the Oves cap, was carried out by the UK Family Planning and Reproductive Health Research Network in collaboration with the Institute of Population Studies, University of Exeter, Exeter, UK. Women from ten Network centres and one collaborating centre were invited to participate. Following an assessment by vaginal examination women were fitted with the cap and taught self-fitting by a doctor. The women were asked to use the cap six times in 8 weeks. Participants were asked to complete four questionnaires on various aspects of cap use including Likert-type measures and open-ended questions on experiences with the cap. Doctors were asked to complete a first visit and follow-up questionnaires. Women were self-selected clients in the participating centres. Women aged 18 years and over, gynaecologically healthy, using hormonal contraception or sterilised were eligible for the study. Thirty-five women were enrolled and fitted with the cap; 20 chose to participate in the study. MAIN OUTCOME MEASURES: Ease of fitting and removal of the cap expressed in structured and open-ended questions by both cap users and doctors; satisfaction of women and partners with the cap, measured by desire to use the cap in the future and by premature withdrawal from the trial. RESULTS: Twenty women used the cap on a total of 84 occasions. Four women completed the trial of six uses. While most doctors did not have difficulty with fittings or removals, 10/20 Oves cap users reported some difficulty in fitting it over the cervix and 12 reported some difficulty removing it in the first three uses. Fewer women had difficulty in fitting in uses 4-6 but nearly half continued to have some difficulty with removals. CONCLUSIONS: Few women indicated that they would use the cap in the future. However, most women were satisfied with their current method of contraception. The study raises the question whether women using non-barrier methods of contraception and satisfied with their current method of contraception are the appropriate target recruits for a trial such as this, even in the absence of robust efficacy data.

Adult↗