Re: measuring pregnancy intention and its relationship with contraceptive use among women undergoing therapeutic abortion.
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Abortion, Therapeutic↗
Biomedical subjects
Geraldine Barrett
Publications and source records attributed to Geraldine Barrett.
National survey of British public's views on use of identifiable medical data by the National Cancer Registry.
OBJECTIVES: To describe the views of the British public on the use of personal medical data by the National Cancer Registry without individual consent, and to assess the relative importance attached by the public to personal privacy in relation to public health uses of identifiable health data. DESIGN: Cross sectional, face to face interview survey. SETTING: England, Wales, and Scotland. PARTICIPANTS: 2872 respondents, 97% of those who took part in the Office for National Statistics' omnibus survey, a national multistage probability sample, in March and April 2005 (response rates 62% and 69%, respectively). RESULTS: 72% (95% confidence interval 70% to 74%) of all respondents did not consider any of the following to be an invasion of their privacy by the National Cancer Registry: inclusion of postcode, inclusion of name and address, and the receipt of a letter inviting them to a research study on the basis of inclusion in the registry. Only 2% (2% to 3%) of the sample considered all of these to amount to an invasion of privacy. Logistic regression analysis showed that the proportions not concerned about invasion of privacy varied significantly by country, ethnicity, socioeconomic status, and housing tenure, although in all subgroups examined most respondents had no concerns. 81% (79% to 83%) of all respondents said that they would support a law making cancer registration statutory. CONCLUSIONS: Most of the British public considers the confidential use of personal, identifiable patient information by the National Cancer Registry for the purposes of public health research and surveillance not to be an invasion of privacy.
Access to Information↗
Research governance: regulating risk and reducing harm?
Risk assessment can be thought of as the lens through which we anticipate the consequences of research and the impact of the actions of researchers. The way in which risk of harm is managed in research is strongly influenced by the surrounding social and political environment, leading to differences in national and local styles of regulation and review. Different research studies carry different risks, so systems for review and approval must adapt to the question being asked and the nature of the study. Researchers can never wholly guarantee safety in any research but participants and researchers must be offered reasonable protection within any study, with appropriate arrangements in place should something go wrong.
Biomedical Research↗
Cesarean section and postnatal sexual health.
BACKGROUND: Cesarean delivery avoids perineal trauma and has therefore often been assumed to protect sexual function after childbirth. We sought to examine this assumption by using data from a study of women's sexual health after childbirth to assess whether women who underwent cesarean section experienced better sexual health in the postnatal period than women with vaginal births. METHODS: A cross-sectional study was conducted of 796 primiparous women, employing data from obstetric records and a postal survey 6 months after delivery. RESULTS: Any protective effect of cesarean section on sexual function was limited to the early postnatal period (0-3 months), primarily to dyspareunia-related symptoms. At 6 months the differences in dyspareunia-related symptoms, sexual response-related symptoms, and postcoital problems were much reduced or reversed, and none reached statistical significance. CONCLUSIONS: Outcomes from this study provide no basis for advocating cesarean section as a way to protect women's sexual function after childbirth.
Adult↗
Changes in the circumstances of young mothers in Britain: 1990 to 2000.
OBJECTIVES: To assess changes between 1990 and 2000 in the circumstances of women who became mothers before the age of 18. DESIGN: Two cross sectional probability sample surveys of the general population carried out in 1989-1991 (Natsal 1990) and 1999-2001 (Natsal 2000). SETTING: British households. PARTICIPANTS: Women aged 18 to 27 years at time of survey (Natsal 1990: 2575, Natsal 2000: 1757). MAIN OUTCOME MEASURES: Educational attainment, participation in education/work or training, living in social housing, social class, living as lone adult, parity, ill health, and health related behaviours at the time of the interview. RESULTS: The proportion of women who were sexually active before 18 increased between 1990 and 2000 from 58.9% to 71.3% (p<0.0001). There was no significant change in the proportion who had a child before the age of 18 (4.7% in 1990, 5.3% in 2000, p=0.390). The proportion who had attained no educational qualifications and were not participating in education/work or training was significantly lower in 2000 than in 1990 for all women aged 18-27, but higher among those who were mothers before age 18, although the relative difference was not statistically significant. The proportion living in social housing or reporting a recent long term illness at time of interview was higher and this trend was more pronounced among women who did not experience motherhood before 18 than those who did, but the differences between these groups of women were not statistically significant. CONCLUSION: Motherhood before the age of 18 continues to be related to a variety of adverse circumstances in adult life, including lack of educational attainment, not being in education/work or training, lone parenthood, and a reduced likelihood of home ownership. There is little evidence of improvement in the circumstances of young mothers between 1990 and 2000 despite improvements in life chances among young women in general.
Adolescent↗
Population ideals and sample realities--why we still need access to comprehensive information about populations.
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Confidentiality↗
Postnatal depression and sexual health after childbirth.
OBJECTIVE: To investigate the sexual health experiences of depressed and nondepressed postnatal women within a 6-month postnatal period. METHODS: This cross-sectional study used obstetric records and postal survey 6 months after delivery from a cohort of primiparous women (n = 796) delivering a live-born infant at St. George's NHS Trust, London. Women self-reported sexual problems and sexual behaviors and completed the Edinburgh Postnatal Depression Scale. RESULTS: Of the 796 parturients, 484 responded (61%), and 468 completed the survey questions on depression and sexual health (97%). Of the latter, 57 (12%) fit the Edinburgh Postnatal Depression Scale criteria. Comparing the depressed with nondepressed women, resumption of sexual activity occurred with 77% versus 90% (P =.003), and the median number of specific sexual problems reported was two versus one, respectively (P =.009). CONCLUSION: Sexual health problems were common after childbirth in both depressed and nondepressed women; however, depressed women were less likely to have resumed intercourse at 6 months and more likely to report sexual health problems. Given the frequency of sexual health problems, postnatal sexual morbidity cannot be assumed to be simply a product of the depressed mental state.
Adolescent↗
What is a 'planned' pregnancy? Empirical data from a British study.
The terms "planned", "unplanned", "intended", "unintended", "wanted" and "unwanted" are often used in relation to pregnancy in health policy, health services and health research. This paper describes the findings relating to women's understanding of these terms from the qualitative stage of a British study. We found that when discussing the circumstances of their pregnancies, women tended not to use the above terms spontaneously. When asked to explain the terms, women were able to do so but there was considerable variation in understanding. Most, but not all, were able to apply the terms. Women applied the term "planned" only if they had met four key criteria. Intending to become pregnant and stopping contraception were not sufficient criteria, in themselves, to apply the term; partner agreement and reaching the right time in terms of lifestyle/life stage were also necessary. In contrast, "unplanned" was a widely applied term and covered a variety of circumstances of pregnancy. The other terms were less favoured, "unwanted" being positively disliked. We recommend that survey questions eliciting information on women's circumstances of pregnancy do not rely on the above terms in isolation and, further, that a more circumspect use of the terms in policy and clinical settings is required.
Adolescent↗
Changes in household composition among the over sixties: a longitudinal analysis of the Health and Lifestyles Surveys.
Analyses of longitudinal data from the Health and Lifestyles Surveys (HALS) were carried out in order to examine the household changes of older people. Respondents who were interviewed at both the first HALS survey in 1984/85 (HALS1) and the second survey 7 years later (HALS2) and were aged 60 or over in HALS1 were selected (1156). Changes in household composition between the two surveys were examined and the relationship of these changes to socio-demographic factors and to both cross-sectional and longitudinal health factors investigated. Results of the analysis showed there was great diversity of experience and a considerable amount of change in what is often considered a fairly stable and homogeneous section of the population. Almost one-third of respondents changed household type, the majority changing to live alone and only a small proportion changing to live in households with their child/children or with others. Household changes were associated with poor and declining health (both physical and mental) and the rate of change was found to increase with age. In the case of ill health the first source of practical support and care is generally from within the household. Where this is not available it is sought from the wider community or the state. An increase in the proportion of the population aged over 60 and in the numbers of the oldest people, coupled with a rate of household change that increases with age, means that demand on health and community services can only be expected to increase.
Journal Article↗
Confidentiality and the public interest in medical research--will we ever get it right?
Developments over the last decade in legislation and professional guidance on confidentiality and medical research in the UK are reviewed. Despite the General Medical Council's guidance, and recent changes to the common law on confidentiality in England and Wales, confusion remains about what is lawful and professionally acceptable in the handling of identifiable data. The GMC has contributed to this confusion. Professional bodies should jointly produce new guidance. The Health and Social Care Act 2001 is a temporary legislative solution. Public consensus is required on an acceptable balance between the citizen's right to privacy and the responsibility of society--to which all citizens belong--to protect the public health. The Government should survey public opinion, inform NHS patients better, initiate wide public debate, and legislate to protect both citizens' rights and medical research that is demonstrably in the public interest. Registration of cancer and communicable diseases should become statutory.
Access to Information↗