Press Releases Saturday 15 May 1999
No 7194 Volume 318

Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on the
journal's web site (http://www.bmj.com).

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the source BMJ article (URL's are given under titles).


(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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