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(1) BRITISH
ADOLESCENTS NEED GOVERNMENT SUPPORT
TO HELP CLEAN UP THEIR ACT
(2) KEEPING
ELECTRONIC PATIENT RECORDS WHILST
MAINTAINING PRIVACY IS FEASIBLE WITH
APPROPRIATE SYSTEMS IN PLACE
(1) BRITISH ADOLESCENTS
NEED GOVERNMENT SUPPORT
TO HELP CLEAN
UP THEIR ACT
(Sexual health of teenagers in England
and Wales: analysis of national
data)
http://www.bmj.com/cgi/content/full/318/7194/1321
(Sex and drugs and rock and roll)
http://www.bmj.com/cgi/content/full/318/7194/1300
British teenagers have the worst sexual
health in western Europe find
researchers in this week's BMJ. In addition
they have the highest
pregnancy rate and are more likely to
have used illicit drugs says
Professor Martin McKee in a linked editorial.
These factors, he says
are symptomatic of a wider malaise in
British adolescents and he calls
upon health professionals to welcome the
government's move to
address these issues in their entirety
rather than tackling them on an
individual basis.
In their paper Dr Angus Nicoll and colleagues
from the Public Health
Laboratory Service in London and Cardiff
report that the sexual
health of adolescents in England and Wales
worsened quite
significantly between 1995-6. In 1996
teenage females accounted for
20 per cent of all pregnancy terminations
and nine per cent of births.
Girls aged 16-19 years had the highest
rates of gonorrhoea, genital
chlamydia infection and warts, of all
women. These findings lead the
authors to conclude that there is substantial
sexual ill health among
teenagers in England and Wales and they
say that sexual health
should be a priority for co-ordinated
national and local health
promotion among young people.
Prof McKee suggests that the problem is
wider than sexual health
and cites teenage drug taking, smoking
and drinking as other areas of
concern, particularly when British teenagers'
behaviour is compared
with that of their western European counterparts.
He speculates that
the reasons British teenagers fair so
badly in the league may be down
to poor education amongst those teenagers
in lower socio-economic
groups; more families in the UK living
in poverty than in the rest of the
European Union and the lack of time British
families spend together,
due to British parents working the longest
hours in Europe.
The author says that to date the UK has
tackled teenage behavioural
problems on an isolated basis:- a drugs
"tsar" to co-ordinate action
on illicit drugs; a health policy which
aims to reduce rates of teenage
smoking and adolescent drinking is moving
up the government agenda
under pressure from senior police officers.
However, what is needed
is a more widespread approach to tackle
the general malaise, says
McKee and he welcomes the move by the
government's social
exclusion unit to tackle the complexities
derived from the interaction
between poverty, low educational achievement
and health.
He concludes that the unit offers real
hope for addressing teenage
behaviour and encourages other health
professionals to welcome the
initiative.
Contact:
Professor Martin McKee, Professor of European
Public Health,
European Centre on Health of Societies
in Transition, London School
of Hygiene and Tropical Medicine, London
c/o Alice Dickens Tel:
Email: m.mckee@lshtm.ac.uk
Dr Angus Nicoll, Consultant Epidemiologist,
HIV and Sexually
Transmitted Disease Division, Public Health
Laboratory Service,
Communicable Disease Surveillance Centre,
London c/o Simon
Gregor
Email: anicoll@phls.co.uk
or sgregor@phls.co.uk
(2) KEEPING ELECTRONIC
PATIENT RECORDS WHILST
MAINTAINING
PRIVACY IS FEASIBLE WITH
APPROPRIATE
SYSTEMS IN PLACE
(Privacy in clinical information
systems in secondary care)
(Commentary: Let's discuss wider
social and professional issues)
(Commentary: Organisational and
cultural aspects are also important)
http://www.bmj.com/cgi/content/full/318/7194/1328
The electronic patient record threatens
to make private health
information open to violation, either
by illegitimate users or by
inappropriate access by legitimate users,
say researchers in this
week's BMJ. However, controlled access
to confidential patient
information is possible so long as the
appropriate access systems are
created, say Ian Denley, a computer analyst
and Dr Simon Weston
Smith from the Conquest Hospital in Hastings.
In their paper the authors describe their
experiences of how control
over the perusal of private information
in large scale clinical
information systems is being achieved
in three British hospitals in
Hastings, Liverpool and Exeter. They show
that a clinical system's
knowledge of a patient's clinical contacts
and of a user's
responsibilities can be applied safely
to limit access to patients'
private information.
Denley and Weston Smith's proposal should
be applauded, says Dr
Martin Gardner from the University of
Glasgow in an accompanying
commentary. However, the implications
of spending patients' taxes on
sophisticated computer systems to protect
the privacy of their data,
as opposed to funding the provision of
services, must be taken into
consideration he says.
In a separate commentary Dr Rory O'Conor
from the Pinderfields
Hospital in Wakefield, writes that the
proposed approach to
restricting access to electronic patient
records may be overly
restrictive. He argues that it may deny
clinicians the ability to share
data, which he says is a missed opportunity,
especially when it is
perfectly feasible to collect data whilst
maintaining the anonymity of
the patient. O'Conor concludes that for
any electronic patient
information to work, good security design,
appropriate organisational
procedures and the right cultural approach
will all have to be
adopted.
Contact:
Dr Simon Weston Smith, Consultant Haematologist,
Conquest
Hospital, Hastings
Email: simon_weston_smith@compuserve.com
Dr Martin Gardner, Clinical Research Fellow,
Information Retrieval
Research Group, Department of Computing
Science, University of
Glasgow, Glasgow
Email: martin@dcs.gla.ac.uk
Dr Rory O'Conor, Consultant Clinical Epidemiologist,
Clinical Audit
Department, Pinderfields Hospital, Wakefield
Email: rory.oconor@panp-tr.northy.nhs.uk
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