Extent of regretted sexual intercourse among young teenagers in Scotland: a cross sectional survey

This cross sectional survey determined the extent of regretted sexual intercourse among young teenagers in Scotland. Using a questionnaire, data were obtained from 7395 third-year pupils (3365 boys and 3730 girls) aged 13 years and 6 months to 14 years and 9 months in 24 nondenominational state secondary schools. Regretted sexual intercourse, measured on a three-point scale, was analyzed by ordinal logistic regression. The data revealed that 18% (661) of boys and 15.4% (576) of girls had experienced sexual intercourse, of which 74.8% occurred since their 13th birthday. Boys, compared with girls, reported higher levels of regret. For boys, higher levels of regret were significantly associated with having exerted pressure to have sex. On multivariate analysis, reports of being pressured, exerting pressure, not having planned sexual intercourse with partner, and high levels of parental monitoring were significantly related to girls' regret. For women, regret seemed to be related to lack of control. Sex education should focus on assisting young people to develop relationship and negotiation skills. In addition, making teenagers aware of potential emotional and relationship consequences of early sexual intercourse may delay first intercourse.     

Psychiatric problems in children with hemiplegia: cross sectional epidemiological survey.

OBJECTIVE--To examine the prevalence and predictors of psychiatric problems in children with hemiplegia. DESIGN--Cross sectional questionnaire survey of an epidemiological sample with individual assessments of a representative subgroup. The questionnaire survey was repeated on school age subjects four years later. SUBJECTS--428 hemiplegic children age 2 1/2-16 years, of whom 149 (aged 6-10 years) were individually assessed. MAIN OUTCOME MEASURES--Psychiatric symptom scores and the occurrence of psychiatric disorder. RESULTS--Psychiatric disorders affected 61% (95% confidence interval 53% to 69%) of subjects as judged by individual assessments and 54% (49% to 59%) and 42% (37% to 47%) as judged from parent and teacher questionnaires, respectively. Few affected children had been in contact with child mental health services. The strongest consistent predictor of psychiatric problems was intelligence quotient (IQ), which was highly correlated with an index of neurological severity; age, sex, and laterality of lesion had little or no predictive power. CONCLUSION--Though most hemiplegic children have considerable emotional or behavioural difficulties, these psychological complications commonly go unrecognised or untreated. Comprehensive health provision for children with chronic neurodevelopmental disorders such as hemiplegia should be psychologically as well as physically oriented.     

Prevalence of dysfunctional breathing in patients treated for asthma in primary care: cross sectional survey

ObjectivesTo estimate the prevalence of dysfunctional breathing in adults with asthma treated in the community.DesignPostal questionnaire survey using Nijmegen questionnaire.SettingOne general practice with 7033 patients.ParticipantsAll adult patients aged 17-65 with diagnosed asthma who were receiving treatment.Results227/307 patients returned completed questionnaires; 219 (71.3%) questionnaires were suitable for analysis. 63 participants scored ⩾23. Those scoring ⩾23 were more likely to be female than male (46/132 (35%) v 17/87 (20%), P=0.016) and were younger (mean (SD) age 44.8 (14.7) v 49.0 (13.8, (P=0.05). Patients at different treatment steps of the British Thoracic Society asthma guidelines were affected equally.ConclusionsAbout a third of women and a fifth of men had scores suggestive of dysfunctional breathing. Although further studies are needed to confirm the validity of this screening tool and these findings, these prevalences suggest scope for therapeutic intervention and may explain the anecdotal success of the Buteyko method of treating asthma.

What is already known on this topic

Abnormal breathing patterns may cause characteristic symptoms and impair quality of lifeEffective interventions exist for dysfunctional breathingDysfunctional breathing has been described in patients attending hospital respiratory clinics

What this study adds

29% of adults treated for asthma in primary care had symptoms suggestive of dysfunctional breathingAffected patients were more likely to be female and younger, but no differences were found with severity of asthmaSome patients with asthma may benefit from breathing therapy     

Doctors and patients don't agree: cross sectional study of patients' and doctors' perceptions and assessments of disability in multiple sclerosis.

OBJECTIVES: To compare the judgments of clinicians on which domains of health in the short form questionnaire (SF-36) would be most important to patients with multiple sclerosis with the opinions of patients themselves; to compare assessment of physical disability in multiple sclerosis by a clinician using Kurtzke''s expanded disability status scale and a non-clinically qualified assistant using the Office of Population Census and Surveys'' (OPCS) disability scale with self assessment of disability and other domains of health related quality of life by patients using the SF-36 and the EuroQol questionnaire; and to compare the scores of patients for each domain of the SF-36 with control data matched for age and sex. DESIGN: Cross sectional study. SETTING: Clinical department of neurology, Edinburgh. SUBJECTS: 42 consecutive patients with multiple sclerosis attending a neurology outpatient clinic for review or a neurology ward for rehabilitation. MAIN OUTCOME MEASURES: Scores on the SF-36; EuroQol; Kurtzke''s expanded disability status scale; the OPCS disability scale. RESULTS: Patients and clinicians disagreed on which domains of health status were most important (chi 2 = 21, df = 7, P = 0.003). Patients'' assessment of their physical disability using the physical functioning domain of the SF-36 was highly correlated with the clinicians'' assessment (r = -0.87, P < 0.001) and the non-clinical assessment (r = -0.90, P < 0.001). However, none of the measures of physical disability correlated with overall health related quality of life measured with EuroQol, Quality of life correlated with vitality, general health, and mental health in the SF-36, each of which patients rated as more important than clinicians and for each of which patients scored lower than the controls. CONCLUSIONS: Patients with multiple sclerosis and possibly those with other chronic diseases are less concerned than their clinicians about physical disability in their illness. Clinical trials in multiple sclerosis should assess the effect of treatment on the other elements of health status that patients consider important, which are also affected by the disease process, are more closely related to overall health related quality of life, and may well be adversely affected by side effects of treatment.     

10-year survey of 485 sterilizations. Part II: patients' views on their sterilization.

As part of a study of the complications after sterilisation 485 of the 547 women who had been sterilised by a modified Pomeroy procedure in one unit over 10 years were interviewed. They were asked whether they regretted being sterilised and about the quality of their sex lives, mental health, social relationships, and marriages. Most women were pleased to have been sterilised, only 24 regretting it. Regret was more pronounced among women who had been sterilised in association with a third caesarean section, those sterilised for medical reasons, and those whose marriages had ended in divorce. In each case where a woman regretted a sterilisation that had been performed on the recommendation of a psychiatrist, the psychiatrists were still prepared to defent their opinions. On their sex lives, mental health, social relationships, and marriages, more women reported improvement than deterioration, and in most cases the deterioration could not be attributed to the sterilisation. The overall benefits from sterilisation to the women in this series therefore seemed to outweigh substantially the adverse consequences experienced by a few.     

Child spacing and two child policy in practice in rural Vietnam: cross sectional survey.

OBJECTIVE: To explore the reproductive pattern of women in rural Vietnam in relation to the existing family planning policies and laws. DESIGN: Cross sectional survey with question-naires on reproductive history. SETTING: Tien Hai, a district in Red River Delta area, where the population density is one of the highest in Vietnam. SUBJECTS: 1132 women who had at least one child under 5 years of age in April 1992. MAIN OUTCOME MEASURES: Birth spacing and probability of having a third child. RESULTS: The mean age at first birth was 22.2 years. The average spacing between the first and the second child was 2.6 years. Mothers with a lower educational level, farmers, and women belonging to the Catholic religion had shorter spacing between the first and second child and also a higher probability of having a third child. In addition, women who had no sons or who had lost a previous child were more likely to have a third child. CONCLUSION: Most families do not adhere to the official family planning policy, which was introduced in 1988, stipulating that each couple should have a maximum of two children with 3-5 years'' spacing in between. More consideration should be given to family planning needs and perceptions of the population, supporting the woman to be in control of her fertility. This may imply improved contraceptive services and better consideration of sex issues and cultural differences as well as improved social support for elderly people.     

Doctors' use of electronic medical records systems in hospitals: cross sectional survey

ObjectivesTo compare the use of three electronic medical records systems by doctors in Norwegian hospitals for general clinical tasks.DesignCross sectional questionnaire survey. Semistructured telephone interviews with key staff in information technology in each hospital for details of local implementation of the systems.Setting32 hospital units in 19 Norwegian hospitals with electronic medical records systems.Participants227 (72%) of 314 hospital doctors responded, equally distributed between the three electronic medical records systems.ResultsMost tasks listed in the questionnaire (15/23) were generally covered with implemented functions in the electronic medical records systems. However, the systems were used for only 2-7 of the tasks, mainly associated with reading patient data. Respondents showed significant differences in frequency of use of the different systems for four tasks for which the systems offered equivalent functionality. The respondents scored highly in computer literacy (72.2/100), and computer use showed no correlation with respondents'' age, sex, or work position. User satisfaction scores were generally positive (67.2/100), with some difference between the systems.ConclusionsDoctors used electronic medical records systems for far fewer tasks than the systems supported.

What is already known on this topic

Electronic information systems in health care have not undergone systematic evaluation, and few comparisons between electronic medical records systems have been madeGiven the information intensive nature of clinical work, electronic medical records systems should be of help to doctors for most clinical tasks

What this study adds

Doctors in Norwegian hospitals reported a low level of use of all electronic medical records systemsThe systems were mainly used for reading patient data, and doctors used the systems for less than half of the tasks for which the systems were functionalAnalyses of actual use of electronic medical records provide more information than user satisfaction or functionality of such records systems     

Asbestos and lung cancer in Glasgow and the west of Scotland.

OBJECTIVE--To quantify the relation between lung cancer and exposure to asbestos in men in west Scotland and to estimate the proportion of lung cancer which may be attributed to exposure to asbestos. DESIGN--An ecological correlation study of the incidence of lung cancer in men and past asbestos exposure. The unit of analysis was the postcode sector. Correction was made for past cigarette smoking, air pollution, and deprivation. SETTING--The region covered by the west of Scotland cancer registry, containing 2.72 million people and including Glasgow and the lower reaches of the River Clyde, where shipbuilding was once a major industry. SUBJECTS--All men diagnosed with lung cancer between 1975 and 1984 whose residence at the time of registration was within the west of Scotland. MAIN OUTCOME MEASURE--The population attributable risk for asbestos related lung cancer. RESULTS--An estimated 5.7% (95% confidence interval 2.3 to 9.1%) of all lung cancers in men registered in the west of Scotland during the period 1975-84 were asbestos related, amounting to 1081 cases. CONCLUSIONS--A considerable proportion of cases of lung cancer in men in Glasgow and the west of Scotland from 1975 to 1984 were asbestos related. Most of these may not have been considered for compensation by the Department of Social Security. Given the very small annual number of recorded cases of asbestosis this condition is probably not a prerequisite for the development of asbestos related lung cancer. A heightened awareness of the increasing incidence of asbestos related neoplasms and their more thorough investigation are recommended.     

Public information needs after the poisoning of Alexander Litvinenko with polonium-210 in London: cross sectional telephone survey and qualitative analysis

Objectives To identify public perceptions of the risk to health after the poisoning of Alexander Litvinenko with polonium-210 (²¹⁰Po) in London and to assess the impact of public health communications.Design Cross sectional telephone survey and qualitative interviews.Setting London, United Kingdom.Participants 1000 people completed the cross sectional survey and 86 potentially exposed people completed the qualitative interviews.Main outcome measures Perception of risk to personal health after the ²¹⁰Po incident. Qualitative interviews were analysed with an emphasis on information needs.Results 11.7% of the survey sample (n=117) perceived their health to be at risk. Aside from personal variables the main predictors of perceived risk to health were believing that the incident was related to terrorism (odds ratio 2.7, 95% confidence interval 1.5 to 4.6) rather than to espionage, that it was targeted at the wider public rather than one person (5.9, 3.2 to 10.9), and that it could affect people who had not been in the contaminated area (3.2, 2.1 to 5.1). Participants in the qualitative interviews were generally satisfied with the information they had received, although they would have preferred more information about their individual risk of exposure, the results of their urine tests, and the health implications of the incident.Conclusions Perceptions of the public that the ²¹⁰Po incident in London in 2006 was related to espionage helped to reassure them that the risks to personal health were low. In the event of future incidents it is important to ensure that detailed, comprehensible information about the risks of any exposure is available.     

Retirement on grounds of ill health: cross sectional survey in six organisations in United Kingdom.

OBJECTIVE: To assess the process and outcome of retirement due to ill health in six large organisations. DESIGN: Cross sectional study of the rate of retirement due to ill health by age, sex, and length of service. Principal diagnoses by age and length of service were also compared. SETTING: Four public and two private large employers in the United Kingdom. MAIN OUTCOME MEASURES: Rates of retirement on the grounds of ill health by age, sex, and length of service of employees contributing to pension schemes. RESULTS: Rates of ill health retirement varied from 20 to 250 per 10,000 contributing members, and in two organisations the rate varied geographically within the same organisation. In the two organisations that provided data by sex, women retired at a greater rate than men under age 40 and over age 50. In four organisations the modal age or length of service coincided with enhancements in benefits. In the four that provided information on diagnoses, musculoskeletal and minor psychiatric illnesses were the most common reasons for retirement. CONCLUSION: The granting of ill health retirement benefits may not be determined by illness. There is a need for some employers and pension schemes to improve their processes for granting benefits. Doctors should be wary of conflicts of interest and work to guidelines when they advise pension schemes about the merits of an application for benefits.     

Telephone monitoring of patients with pacemakers in the west of Scotland.

A regional telephone pacemaker follow-up service has been established in the west of Scotland. Medical care is provided by clinics at district general hospitals in Ayrshire, and the pacemaker signals are transmitted by telephone from these clinics to a pacemaker centre in Glasgow. The success of the pilot project in Ayrshire will allow expansion of the service to include hospitals in other areas of the west of Scotland. The scheme is carefully monitored to ensure that patients with pacemakers receive adequate attention with a minimum of inconvenience.     

Sexual behaviour of adolescents in Nigeria: cross sectional survey of secondary school students

ObjectivesTo determine whether family structure (polygamous or monogamous) is associated with sexual activity among school students in Nigeria.DesignCross sectional school survey with a two stage, clustered sampling design.Participants4218 students aged 12-21 years attending 39 schools in Plateau state, Nigeria. Responses from 2705 students were included in the analysis.ResultsOverall 909 students (34%) reported ever having had sexual intercourse, and 1119 (41%) reported a polygamous family structure. Sexual activity was more common among students from polygamous families (42% of students) than monogamous families (28%) (χ²=64.23; P<0.0001). Variables independently associated with sexual activity were male sex (adjusted odds ratio 2.52 (95% confidence interval 2.05 to 3.12)), older age (1.62 (1.24 to 2.14)), lower sense of connectedness with parents (1.87 (1.48 to 2.38)), having a dead parent (1.59 (1.27 to 2.00)), family polygamy (1.58 (1.29 to 1.92)), lower sense of connectedness with school (1.25 (1.09 to 1.44)), and lower educational level of parents (1.14 (1.05 to 1.24)). Multistep logistic regression analysis showed that the effect of polygamy on sexual activity was reduced by 27% by whether students were married and 22% by a history of forced sex.ConclusionsSecondary school students in Nigeria from a polygamous family structure are more likely to have engaged in sexual activity than students from a monogamous family structure. This effect is partly explained by a higher likelihood of marriage during adolescence and forced sex. Students'' sense of connectedness to their parents and school, regardless of family structure, decreases the likelihood of sexual activity, and fostering this sense may help reduce risky sexual behaviour among Nigerian youth.

What is already known on this topic

In 2000 Nigeria developed a national health policy aimed at preventing behaviour among adolescents leading to sexually transmitted infections (including HIV), pregnancy, and dropout from schoolEffective interventions in Nigeria have been hampered by inadequate information on contextual factors associated with sexual behaviour of adolescentsIn Western countries adolescents'' sense of connectedness to their parents and to school is inversely associated with risky sexual behaviour, but these effects may differ in countries where polygamy is prevalent and where school attendance is low

What this paper adds

A polygamous family structure is associated with early sexual activity among adolescents, an effect partly explained by a higher likelihood of marriage and history of forced sexual intercourseA greater sense of connectedness to parents and school decreases the likelihood of sexual activity, regardless of family structure