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At least 415 records · Page 23Linked to original sources
PubMed1995

Contraceptive services for teenagers: do we need family planning clinics?

OBJECTIVE: To determine whether the effectiveness of contraceptive services for teenagers is related to the balance of service provision between general practitioners and specialist family planning services. DESIGN: Cross sectional study with routinely collected data from family planning clinics and family health services authorities and published data on births and abortions. SETTING: Eight health districts in the former Oxford region. SUBJECTS: Girls aged under 16 and women aged 16-19 who attended a contraceptive service during 1991-2 or who gave birth or had an abortion during 1990-2. MAIN OUTCOME MEASURES: Attenders at family planning clinics as a percentage of all users of contraceptive services. The conception rate:uptake of contraceptive services ratio was used as a measure of effectiveness. RESULTS: In comparisons between districts the percentage of all users of contraceptive services who attended a clinic varied from 38% (95% confidence interval 28% to 48%) to 79% (72% to 86%) among 13-15 year olds and from 14% (12% to 15%) to 44% (42% to 46%) among women aged 16-19 years. The conception rate: uptake of contraceptive services ratio varied twofold in the older age group and more than threefold in the younger age group. It was lowest in districts where clinic attenders comprised a large percentage of all users of contraceptive services. CONCLUSION: Contraceptive services for teenagers may be more effective in districts where clinics play a large part in delivering the service, particularly for girls aged under 16.

Abortion, Induced↗
PubMed1980

Sexually transmitted diseases in clinic patients in Lagos.

In a study of patients attending an STD referral clinic in Lagos, Nigeria, the age distribution was similar to that seen on other parts of the world and the male-to-female ratio was 1.3:1. Non-specific genital infection was diagnosed in about 59% of patients and gonorrhoea in 19%. Most strains of Neisseria gonorrhoeae were sensitive to penicillin (1 unit) and the six relatively penicillin-resistant strains did not produce penicillinase. Candidosis and trichomoniasis were each diagnosed in about 10% of patients and latent syphilis in 1.4% (four cases). Genital warts were also uncommon; venereophobia and other conditions accounted for 1% and 2.2% of cases respectively.

Adolescent↗
PubMed1992

Sexual behaviour among youth clinic visitors in Sweden: knowledge and experiences in an HIV perspective.

OBJECTIVE: To study the knowledge and experience of sexuality, contraception and sexually transmitted diseases among sexually active adolescents in Sweden. SUBJECTS: Youth clinic visitors. SETTING: Seventy-four youth clinics from all over the country of Sweden. METHODS: A questionnaire with 17 multiple choice and nine open questions was distributed to all visitors at participating youth clinics during a 2-month period. RESULTS: A total of 9277 young persons answered the questionnaire. Their mean age was 17.5 years. Ninety-three percent were females. Knowledge on STD and STD protection was wide-spread and good. Chlamydia and HIV was recognised as STDs by 90% and 87% respectively. More than 99% knew of the condom method as a means for STD protection. Knowledge on contraceptive methods for pregnancy protection was also good. Ninety-three percent of the investigated adolescents had had coitus. Nine percent had experienced pregnancies and 17% STDs. The mean number of life-time sexual partners was 3.2. CONCLUSIONS: In spite of good knowledge on preventive measures among Swedish youth clinic visitors their sexual behaviour carriers risks for future health. Further interventions are needed to minimise these risks.

Adolescent↗
PubMed1995

Evaluating a designated family planning clinic within a genitourinary medicine clinic.

OBJECTIVE: To evaluate an integrated family planning clinic (FPC) established by genitourinary medicine (GUM) staff held within a GUM women-only clinic (WOC). DESIGN: A retrospective case note review of women attending the FPC during the first year January-December 1992. RESULTS: One hundred and thirteen women, aged 13-41 years, attended the FPC; 45 were new attenders, six had previously tested antibody positive for the human immunodeficiency virus (HIV), seven were intravenous drug users; 54% had a history of sexually transmitted disease (STD); 17.7% were using no contraception; 32.7% had previous termination of pregnancy (TOP) with 70 TOPs in total. Within three months of FPC attendance 89 (78.8%) women had genital STD screening performed; syphilis, HIV and hepatitis B serology, together with cervical cytology were performed in 77, 18, 13 and 62 women respectively. Infections identified were similar to those identified in the GUM clinic but the prevalence of Chlamydia trachomatis in diagnosed infections was commoner in FPC attenders and epidemiological treatment commoner in GUM attenders. No high grade cytology abnormalities were detected. No positive syphilis or new HIV positive results were identified; five women were found to be hepatitis B surface antibody positive. Contraception was changed in 60.8%. Most frequently supplied was the combined oral contraceptive pill (COCP). At the first FPC attendance six women required post coital contraception (PCC) and five were already pregnant, three suspected it, two were unaware. During the year three women conceived; two used COCP, but were non compliant; one used a diaphragm with unclear compliance. Seven of the eight pregnancies were terminated. Over the following year, 1992-93, contraception was supplied to 42 women; four required PCC; two intentional pregnancies occurred. Only one of the TOP women returned. CONCLUSION: An integrated FPC provides co-ordinated sexual health care. Pregnancy, TOP and FPC re-attendance rates together with improvement strategies are discussed. Avoiding unwanted pregnancy remains a universal challenge.

Adolescent↗
PubMed1983

The significance of ritual in a church-based healing model.

Four major ritual patterns are exhibited in a church-based clinic in Jamaica that represents a model of collaborative clinical care catering to spiritual, psychological, and orthodox medical needs. Three of the ritual patterns correspond to the three sectors of care, with their different beliefs and values, and this creates tension. The fourth pattern has the potential to be a superordinate ritual that could bring the clinic together in a cohesive approach to the task of health care, but this does not occur, as staff and patients remain bound in their unique sociocultural traditions and heritage.

Delivery of Health Care↗
PubMed2001

A randomized controlled trial of postcrisis suicide prevention.

OBJECTIVE: This study tested the hypothesis that professionals' maintenance of long-term contact with persons who are at risk of suicide can exert a suicide-prevention influence. This influence was hypothesized to result from the development of a feeling of connectedness and to be most pertinent to high-risk individuals who refuse to remain in the health care system. METHODS: A total of 3,005 persons hospitalized because of a depressive or suicidal state, populations known to be at risk of subsequent suicide, were contacted 30 days after discharge about follow-up treatment. A total of 843 patients who had refused ongoing care were randomly divided into two groups; persons in one group were contacted by letter at least four times a year for five years. The other group-the control group-received no further contact. A follow-up procedure identified patients who died during the five-year contact period and during the subsequent ten years. Suicide rates in the contact and no-contact groups were compared. RESULTS: Patients in the contact group had a lower suicide rate in all five years of the study. Formal survival analyses revealed a significantly lower rate in the contact group (p=.04) for the first two years; differences in the rates gradually diminished, and by year 14 no differences between groups were observed. CONCLUSIONS: A systematic program of contact with persons who are at risk of suicide and who refuse to remain in the health care system appears to exert a significant preventive influence for at least two years. Diminution of the frequency of contact and discontinuation of contact appear to reduce and eventually eliminate this preventive influence.

Adult↗
PubMed1984

Supply of essential drugs for church hospitals in Ghana.

Based on the results of an inquiry, answered by 39 out of the 53 rural Church hospitals and clinics in Ghana, a list of 34 indispensable drugs was compiled. At a cost of less than US $600 000 it is possible to provide all Church health institutions (30% of all health facilities in Ghana) with these 34 essential drugs for one year (at 1982 prices). When the drugs are prepacked in Units, distribution can easily be carried out from a very limited number of distribution points, without the need for extensive logistic provisions such as trucks, stores, personnel and security checks.

Christianity↗
PubMed1991

Social deprivation and rates of treated mental disorder. Developing statistical models to predict psychiatric service utilisation.

A review of the literature shows that there are strong associations of treated prevalence rates of psychiatric disorder with social class, sex, marital status, ethnic group and living alone; and moderate associations with living in inner-city areas and a high degree of residential mobility. The Jarman-8 index of social deprivation correlates with psychiatric admission rates for patients aged less than 65 years (R2 = 0.38). Individual census variables can themselves account for up to 0.71 of the variance in the admission rates, while combined in a stepwise multiple regression the census variables will account for over 0.95 of this variation. Multiple regression models using individual census variables and derived indices should be applied next on a wider geographical basis, and to narrower age, sex and diagnosis-specific psychiatric morbidity rates.

Adolescent↗
PubMed1997

Family planning needs and STD risk behaviours of female psychiatric out-patients.

BACKGROUND: There are few studies concerning the family planning needs of female chronic psychiatric patients. We aimed to determine the contraceptive needs and sexually transmitted disease (STD) risk-behaviours of female psychiatric out-patients. METHOD: Sixty-six female out-patients with major psychiatric disorders, including schizophrenia, bipolar disorder and mood disorders, completed a semi-structured interview (response rate = 63%) and were individually matched for age and ethnicity with 66 women who had never been treated for psychiatric illness. They answered questions on child-rearing and on their methods of contraception in relation to their attitudes towards pregnancy, as well as on their risk for STDs. RESULTS: Compared with controls, the female patients reported having had significantly more induced abortions and were significantly more likely to have given up their own children for others to raise. Heterosexually active psychiatric patients were significantly more likely than controls to have had more than one male sexual partner, to have been pressured into unwanted sexual intercourse, and to report having had sexual intercourse with a suspected bisexual over the preceding year. CONCLUSIONS: These results underscore the priority for developing programmes that reduce female psychiatric patients' risk for unwanted pregnancies and STDs.

Adult↗
PubMed1998

An assessment of care provided by a public sector STD clinic in Cape Town.

A study was undertaken in a Cape Town public sector STD clinic to evaluate the content and quality of care provided since it has been recognized that appropriate improvements in the management of conventional sexually transmitted diseases (STDs), including provision of correct therapy, health education, condom promotion and partner notification, could result in a reduced incidence of HIV infection. Our objectives were to assess patients' needs for health education and to assess the quality of STD management in terms of health education, condom promotion, partner notification, the validity of the clinical diagnoses and the adequacy of the treatments prescribed. The study subjects were sampled systematically, according to their gender. Patients included in the study were given a standardized interview and their clinical records reviewed. Specimens were collected for laboratory investigations. For each STD detected, the treatment was defined as adequate if drugs currently known to be active against that infection were prescribed. One hundred and seventy men and 161 women were included in the study (median age: females 22 years, males 26 years). While almost all patients believed their STD may have been caused by unprotected sexual intercourse, many also believed it may have been caused by other factors, such as bewitchment with traditional medicine. Only 21% of male and 37% of female patients received any education about STD transmission during the clinic visit, and only 25% of male and 36% of female patients received education about condom use. As a result of the low sensitivity of the clinicians' diagnoses, 16% of men and 61% of women left the clinic with at least one infection inadequately treated. The majority of patients were not receiving education for the prevention of STDs including HIV. Many were not receiving adequate treatment for their infections. The introduction of a syndromic management protocol in this setting would substantially reduce the proportion of inadequately-treated patients. However, syndromic protocols, and the means by which they are implemented, need to take into account problems with the clinical detection of genital ulcerative disease and candidiasis in women.

Adult↗
PubMed1985

A manual for the administration, scoring, and interpretation of the homemaker-home health aide program evaluation questionnaire.

It is timely and now possible with the publication of the Homemaker-Home Health Aide Program Evaluation Questionnaire (H/HHA-PEQ), for administrators of homemaker programs to evaluate their programs. Any agency administrator can inexpensively evaluate the quality and adequacy of services rendered, the extent to which the program is achieving objectives, the homemaker/client relationship, a homemakers job performance and changes in patterns of consumption of services. The major focus of this article is to describe the administration, scoring and interpretation of results obtained from an evaluation based on the H/HHA-PEQ.

Consumer Behavior↗