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Charlotte Paul

Publications and source records attributed to Charlotte Paul.

At least 19 recordsLinked to original sources
PubMed2006

Body piercing, personality, and sexual behavior.

The associations of body piercing with other social characteristics, personality, and sexual behavior were investigated in a population-based sample of young adults, in light of the theory that body piercing has meaning in terms of a corporeal expression of the self. At age 26 years, 966 (95%) of 1019 members of the birth-cohort of the Dunedin Multidisciplinary Health and Development Study were asked about body piercing (at interview) and sexual behavior (questions presented by computer). Assessment of personality traits was conducted at ages 18 or 21 years. In total, 183 participants (9% of the men and 29% of the women) had piercings at a site other than the earlobes. People who lived outside New Zealand or who were of Maori descent were more likely to be pierced, but unemployment and low occupational status were not significantly related to piercing. Women who were pierced, compared with those without piercings, were more likely to have personality traits of low constraint or high negative emotionality. Women with piercings were also more likely to report having had, during the previous year, five or more heterosexual partners (odds ratio, 5.8, 95% CI: 2.3-14.6) or any same-sex partner involving genital contact (odds ratio, 10.3, CI: 2.9-37.2). The associations with sexual behavior in men were weaker and not statistically significant. In this population, body piercing in women was associated with sexual behavior. Having multiple heterosexual partners or any same-sex partner was very rare among women without piercings. The theory of meaning for body piercing was generally supported, offering the possibility of a richer understanding of this phenomenon in the general population.

Adult↗
PubMed2006

Risk factors for prostate cancer: A national case-control study.

Statutory notification of cancer in New Zealand provided an opportunity to investigate risk factors for prostate cancer in a large national population-based case-control study. We analyzed data obtained from telephone interviews with 923 cases and 1,224 controls. For inclusion in the study, all subjects had to have been married at some time. We found an increased risk of prostate cancer among those with a history of prostate cancer in first degree relatives (RR 2.6; 95% CI, 1.9-3.7) and an increased risk of prostate cancer with length of marriage among men married only once and still married at interview. For a consecutive subgroup of 550 cases and 819 controls, data on height and weight at age 20 and at 5 years before interview were collected. Men less than or equal to 1.7 m in height at age 20 years had a lower risk of prostate cancer than men taller at that age. There was no association between weight or body mass index and risk of prostate cancer.

Adult↗
PubMed2006

Air travel and fatal pulmonary embolism.

Although long-distance air travel is commonly regarded as a risk factor for venous thromboembolism, the risk of clinically important events has not been well defined. We estimated the absolute risk of dying from pulmonary embolism following long-distance air travel in a national population-based descriptive study of 121 men and women who were aged 15-59 years (the age range in which the majority of international arrivals are found) and whose underlying cause of death was certified as codes 415.1, 451, or 453 of the International Classification of Diseases (ninth revision). Eleven cases had undertaken long-distance air travel in the four weeks before the onset of the fatal episode. The estimated risks of fatal pulmonary embolism following a flight of at least three hours' duration were 0.5 (95% CI 0.2-1.2) and 0.6 (95% CI 0.2-1.4) per million arrivals for overseas visitors and New Zealand residents, respectively. For air travel of more than eight hours' duration, the risk in New Zealand residents was 1.3 (95% CI 0.4-3.0) per million arrivals. We also conducted a case-control study based on those cases who were normally resident in New Zealand and registered on the electoral roll (n = 99). For each case, four controls matched for sex, age, and electorate, were randomly selected from the electoral roll. In the key analysis (based on 88 cases and 334 controls), the adjusted odds ratio for travellers who had flown for more than eight hours was 7.9 (95% CI 1.1-55.1) compared with those who did not undertake a long-distance flight. Long-distance air travellers have a higher risk of dying from pulmonary embolism than non-travellers, but the absolute risk in people aged 15-59 years appears to be very small.

Adolescent↗
PubMed2005

Herpes simplex virus type 2 status at age 26 is not related to early circumcision in a birth cohort.

OBJECTIVE: The objective of this study was to determine if circumcision in early childhood affects the risk of acquiring herpes simplex virus type 2 (HSV-2) infection. STUDY: Study members were born in 1972-1973 in Dunedin, New Zealand. Circumcision status was sought at age 3, when the cohort was established. Information about sexual behavior was obtained at ages 21 and 26. Serum was tested for HSV-2 antibodies at age 26 for 435 men (82.9% of the surviving cohort). RESULTS: Of eligible men, 40.2% had been circumcised. The prevalence of HSV-2 antibodies was 7.3% in uncircumcised men and 7.4% in circumcised men. Social and sexual factors were very similar between the 2 groups and adjustment had no effect on the association (odds ratio, 1.1; 95% confidence interval, 0.46-2.5). Seroconversion rates according to years since first sexual intercourse were 0.85 and 0.86 per 100 person-years for uncircumcised and circumcised men. CONCLUSION: The results support a lack of association between circumcision status and HSV-2 acquisition, although a small effect cannot be ruled out.

Adult↗
PubMed2003

Psychotropic drugs and fatal pulmonary embolism.

PURPOSE: To examine the association between the use of psychotropic drugs and fatal pulmonary embolism. METHODS: We conducted a national case-control study of fatal pulmonary embolism. Cases were 75 New Zealand men and women aged 15-59 years who died between 1 January 1990 and 31 December 1998, where the underlying cause of death was certified as codes 415.1, 451 or 453 of the International Classification of Diseases (9th Revision). Four controls, matched for sex and age, were selected from the general practice to which each case had belonged. Information was abstracted from the records of general practitioners, family planning clinics and psychiatric services. Odds ratios and 95% confidence intervals (95% CI) were estimated using conditional logistic regression. The key analyses were restricted to cases (n = 62) and controls (n = 243) without major risk factors for venous thromboembolism. RESULTS: Compared to non-use, the adjusted odds ratio for current use of antipsychotic drugs was 13.3 (95% CI: 2.3-76.3). Low potency antipsychotics appeared to carry the highest risk (odds ratio: 20.8 [95% CI: 1.7-259.0]). The main drug involved was thioridazine. The odds ratio for current use of antidepressants was also increased, at 4.9 (95% CI: 1.1-22.5). CONCLUSIONS: Our results for conventional antipsychotics are consistent with previous studies of non-fatal venous thromboembolism. The finding for antidepressants needs to be replicated in other studies.

Adolescent↗
PubMed2003

Same-sex attraction in a birth cohort: prevalence and persistence in early adulthood.

There is a continuing debate about the importance of social versus biological factors in the expression of same-sex attraction. Investigation of prevalence, continuities, and changes over time among young adults growing up in a country with a relatively accepting climate to homosexuality is likely to illuminate this debate. Analyses were therefore undertaken of self-reported same-sex attraction at age 21 and 26, in a cohort of about 1000 people born in 1972/3 in one New Zealand city. Participants were also asked about same-sex behaviour and attitudes to same-sex relationships. By age 26, 10.7% of men and 24.5% of women reported being attracted to their own sex at some time. This dropped to 5.6% of men and 16.4% of women who reported some current same-sex attraction. Current attraction predominantly to their own sex or equally to both sexes (major attraction) was reported by 1.6% of men and 2.1% of women. Occasional same-sex attraction, but not major attraction, was more common among the most educated. Between age 21 and 26, slightly more men moved away from an exclusive heterosexual attraction (1.9% of all men) than moved towards it (1.0%), while for women, many more moved away (9.5%) than towards (1.3%) exclusive heterosexual attraction. These findings show that much same-sex attraction is not exclusive and is unstable in early adulthood, especially among women. The proportion of women reporting some same-sex attraction in New Zealand is high compared both to men, and to women in the UK and US. These observations, along with the variation with education, are consistent with a large role for the social environment in the acknowledgement of same-sex attraction. The smaller group with major same-sex attraction, which changed less over time, and did not differ by education, is consistent with a basic biological dimension to sexual attraction. Overall these findings argue against any single explanation for homosexual attraction.

Adult↗
PubMed2003

National audit of women with abnormal cervical smears in New Zealand.

OBJECTIVE: To evaluate the follow-up of women with abnormal cervical smears identified by the National Cervical Screening Programme (NCSP) in New Zealand. DESIGN: Survey and clinical audit. SETTING: The study took place in New Zealand. POPULATION: The population included women aged 20-69 years enrolled on the NCSP with first abnormal smear recorded in 1999. METHODS: Participants were interviewed, and clinical data collected from the NCSP-register, and from clinicians. MAIN OUTCOME MEASURES AND RESULTS: The overall response rate was 57%. The proportions of women whose initial assessment, treatment or follow-up fell outside recommended times were between 17 and 35%. Of women with high-grade smears, 72% underwent a treatment procedure. Of these, 91% were excision biopsies, 6% hysterectomies and 4% ablation procedures. Approximately 10% of women had persistent or recurrent abnormalities at 6 and 12 months after treatment. CONCLUSIONS: Overall, results were largely reassuring, but limited by the low response rate. Most women were managed within current clinical guidelines. Areas requiring improvement were identified, in particular in relation to longer than recommended waiting times for assessment and treatment.

Adult↗
PubMed2003

Core group evolution over time: high-risk sexual behavior in a birth cohort between sexual debut and age 26.

BACKGROUND AND OBJECTIVE: Among the limitations of the concept of a sexually transmitted disease core is uncertainty about the stability of sexual behavior over time. The objective was to shed light on characteristics and stability of the core group by assessing sexual behavior longitudinally in a birth cohort. GOALS: The goals were to describe group size and characteristics of people who report 5 or more heterosexual partners per year (a surrogate for the core group) at ages 18, 21, and 26 years. STUDY DESIGN: We used a prospective cohort study with a computer-presented questionnaire on sexual behavior. RESULTS: Of the original cohort members, 991 (97.3% of those believed to be alive) responded at at least one age. A total of 14.7% of women and 26.0% of men were in the core group at either age 18 or 21 or 26, but only 0.5% and 0.9% of women and men, respectively, were in the core group at all ages. Those in the core group were significantly more likely to report concurrent partnerships and higher sexually transmitted disease (STD) rates. Early age at first sex was consistently associated with being in the core group, whereas those with less education were more likely to be in the core group at age 18 but not at later ages. CONCLUSION: The high degree of variability in sexual behavior over time of individuals adds another degree of complexity to the identification of a core group for STD transmission.

Adolescent↗
PubMed2003

PSA testing and digital rectal examination in New Zealand.

OBJECTIVE: To investigate the use of digital rectal examination and prostate specific antigen (PSA) testing in a population-based sample of men in New Zealand. METHODS: A random selection of men aged 40-74 years, weighted by age, was chosen from the general electoral roll of New Zealand. Only men with a telephone who had been married at some time were eligible. Telephone interviews were conducted using a standard questionnaire. Crude and age-adjusted proportions were calculated. Logistic regression was used to explore associations between sociodemographic factors and digital rectal examination or PSA testing. RESULTS: Interviews were completed for 85% of the 1,486 eligible men and analyses were confined to the 1,225 European men. Many more men reported having a digital rectal examination (41%; 95% CI 33.8-48.2) than a PSA test (9%; 95% CI 4.2-14.2). Men in the lowest social class were significantly less likely to have had a digital rectal examination (OR 0.30; 95% CI 0.18-0.50) or PSA test (OR 0.25; 95% CI 0.11-0.60) compared with those in the highest social class. Men with vocational training or no post-school qualifications were approximately half as likely to report a digital rectal examination or a PSA test compared with men with degrees or diplomas. CONCLUSIONS: Although current New Zealand recommendations are that population screening for prostate cancer should not be introduced, many men are still having digital rectal examinations and PSA tests in the absence of symptoms. The frequency of PSA testing is considerably lower than in Australia and appears to be largely influenced by a man's social class.

Adult↗
PubMed2003

Sexual orientation and self-harm in men and women.

OBJECTIVE: Recent studies of homosexual people have found higher rates of nonfatal suicidal behavior than among heterosexuals. The purpose of this study was to determine associations between self-harm and sexual orientation for men and women separately, defining sexual orientation by sexual attraction rather than by behavior. METHOD: In a birth cohort of 1,019 New Zealand young adults eligible to be interviewed at age 26 years, 946 participated in assessments of both sexual attraction and self-harm. RESULTS: Both women and men who had experienced same-sex attraction had higher risks of self-harm. The odds ratios for suicidal ideation in the past year were 3.1 for men and 2.9 for women. Odds ratios for ever having deliberately self-harmed were 5.5 for men and 1.9 for women. Men with same-sex attraction were also significantly more likely to report having attempted suicide. In both sexes, a greater degree of same-sex attraction predicted increasing likelihood of self-harm, with over one-third of men and women with persistent major same-sex attraction reporting this. Men with even a minor degree of same-sex attraction had high rates of self-harm and resulting physical injury. One-quarter of deliberate self-harm among men and one-sixth among women was potentially attributable to same-sex attraction. CONCLUSIONS: This study provides evidence of a link between increasing degrees of same-sex attraction and self-harm in both men and women, with the possibility of some difference between the sexes that needs to be explored further.

Adult↗
PubMed2002

Vasectomy and risk of prostate cancer.

CONTEXT: Vasectomy is a common method of contraception, but concern exists about a reported association with risk of prostate cancer. OBJECTIVE: To examine whether vasectomy increases risk of prostate cancer. DESIGN, SETTING, AND PARTICIPANTS: National population-based case-control study of 923 new cases of prostate cancer among men aged 40 to 74 years from the New Zealand Cancer Registry who were on the general electoral roll. Controls (n = 1224) were randomly selected from the general electoral roll, with frequency matching to cases in 5-year age groups. Cases (3-15 months after diagnosis) and controls were interviewed by telephone between January 1997 and November 1999. MAIN OUTCOME MEASURES: Relative risk (RR) of prostate cancer for men who had had a vasectomy vs those who had not. RESULTS: There was no association between prostate cancer and vasectomy (RR, 0.92; 95% confidence interval [CI], 0.75-1.14) nor with time since vasectomy (RR, 0.92; 95% CI, 0.68-1.23 for > or = 25 years since vasectomy). Adjustment for social class, geographic region, religious affiliation, and a family history of prostate cancer did not affect these RRs. CONCLUSIONS: Vasectomy does not increase the risk of prostate cancer, even after 25 years or more.

Adult↗
PubMed2002

Unwanted pregnancies involving young women and men in a New Zealand birth cohort.

AIMS: To examine the circumstances of wanted and unwanted pregnancies before age 25 years for both women and men, and compare the circumstances of the most undesired pregnancies with all others. METHODS: Cross-sectional study within a birth cohort using a computer-presented questionnaire. RESULTS: Of the 477 women, 173 (36%) had been pregnant before age 25 years, and experienced 289 pregnancies of which 173 (60%) were unwanted. Of the 489 men, 142 (29%) reported 225 pregnancies before age 25, of which 165 (73%) were unwanted. By age 25 about a quarter of the study members (27% of women and 24% of men), had been involved in at least one unwanted pregnancy. Wantedness increased with age and length of relationship with the other parent; both factors remained significant in multivariate analysis for men, but not age for women. For women unwanted pregnancies were more likely to be due to non-use of contraception than failure. For both women and men the commonest single reason for not using contraception was not thinking about it, followed by alcohol use. CONCLUSIONS: An environment has emerged for men and women in their twenties in New Zealand where most are sexually active but do not want a pregnancy to occur. To delay pregnancy for a prolonged period requires dedication and commitment to effective contraception. While more attention needs to be paid to promotion of effective use of contraception, more understanding is called for over the difficulties of avoiding pregnancy with long-term reversible contraception. A further approach to the problem of unwanted pregnancies which should be investigated is to encourage committed sexual relationships.

Adolescent↗
PubMed2002

Evaluation of explicit prioritisation for elective surgery: a prospective study.

OBJECTIVES: To evaluate whether the Clinical Priority Assessment Criteria (CPAC), used to prioritise access to elective surgery, was associated with: (a) patients' access to surgery in practice; (b) patients' level of need; and (c) patients' ability to benefit from surgery. Patients' perceptions of the 'booking system' for surgery were also explored. METHODS: Prospective cohort study in New Zealand. Consecutive patients assessed for cataract (n = 101), prostate (n = 103) or hip or knee joint replacement (n = 137) surgery were interviewed close to the time of their CPAC prioritisation, and then six and 12 months later. RESULTS: CPAC scores were associated with access to surgery. There were weak-to-moderate correlations between CPAC scores and disease-specific health status before surgery (need) but almost no correlations with improvement in health status following surgery (ability to benefit). Change in health status was highly correlated with pre-surgery health status. Many patients supported prioritisation according to need, although the impersonal nature of the scoring system and the changing thresholds for surgery distressed some. CONCLUSIONS: While prioritisation systems for surgery have potential value the CPAC criteria investigated need modification. Ability to benefit should receive increased weight. The impact of an explicit prioritisation system upon the doctor-patient relationship needs to be explored as there is some evidence that it may impede the discussion of the risks and benefits of surgery, and of the treatment preferences of patients.

Elective Surgical Procedures↗