Releases Saturday 29 July 2000
No 7256 Volume 321

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(1) BABIES BORN AT NIGHT ARE AT GREATER RISK
OF EARLY DEATH

(2) RISKY SEXUAL BEHAVIOUR LINKED TO
PSYCHIATRIC DISORDERS IN YOUNG ADULTS

(3) HEALTH PROFESSIONALS AS PEACE ADVOCATES
IN AREAS OF CONFLICT



(1) BABIES BORN AT NIGHT ARE AT GREATER RISK
OF EARLY DEATH

(Early neonatal mortality, asphyxia related deaths, and timing
of low risk births in Hesse, Germany, 1990-8: observational
study)
http://bmj.com/cgi/content/full/321/7256/274

Babies born at night are almost twice as likely to die as
babies born during the day, according to a study in this
week's BMJ.

Researchers in Germany assessed the effect of night and day
on death rates in over 380,000 low risk births born in clinics
between 1990 and 1998. A total of 57 early deaths (during
labour or within the first seven days of life) were found,
reflecting the overall low risk of death of these births.
However, babies born between 9pm and 6.59am - defined
as night time births - were almost twice as likely to die as
babies born at any other time. A clear link between time of
birth and deaths related to asphyxia was also seen. These
findings are almost identical to previously reported British
results, say the authors, even allowing for some differences in
the way the studies were conducted.

The authors suggest several explanations, such as staff's
increased physical and mental fatigue during the night or
over-reliance on less experienced staff during night shifts - a
situation not specific to the NHS or the British population,
they add. Better designed shifts, resulting in shorter working
hours, or decreased workload with greater supervision by
experienced staff at night, should be considered to reduce the
risk of death during the night, they conclude.

Contact:

Gunther Heller, Assistant Professor, Medical Centre of
Methodology and Health Research, Philipps-University of
Marburg, Medical School, D 35033 Marburg, Germany
Email: hellerg@mailer.uni-marburg.de

(2) RISKY SEXUAL BEHAVIOUR LINKED TO
PSYCHIATRIC DISORDERS IN YOUNG ADULTS

(Paper: Psychiatric disorders and risky sexual behaviour in
young adulthood: cross sectional study in birth cohort)
http://bmj.com/cgi/content/full/321/7256/263

(Editorial: Adolescent mental health and risky sexual
behaviour)
http://bmj.com/cgi/content/full/321/7256/251

Common psychiatric disorders, such as depression and
substance dependence, are associated with risky sexual
behaviour in young people, according a study in this week's
BMJ.

Researchers in New Zealand examined the links between a
range of psychiatric problems and aspects of sexual
behaviour in over 900 men and women, all aged 21 years.
The authors found that young people with depression,
substance dependence, symptoms of schizophrenia or
antisocial disorders were more likely to engage in risky sexual
intercourse, contract sexually transmitted diseases and have
sexual intercourse before 16 years of age, than those with no
psychiatric disorder. The likelihood of risky behaviour was
also increased in young people with more than one
psychiatric disorder. These results are similar to those found
among young adults in both the UK and the United States.

The fact that depression was linked to these three outcomes
is of particular concern, say the authors, as rates of
depression are known to escalate from age 15 to 21 years -
the period when sexual activity likewise emerges. Ultimately,
the damaging consequences of such behaviour to health -
such as unplanned pregnancy and sexually transmitted
diseases ± can only add to the difficulties already faced by
young people with a psychiatric disorder in society, say the
authors. Co-ordination of sexual medicine with mental health
services is urgently needed in the treatment of young people,
they conclude.

In an accompanying editorial, David Bennett of the Royal
Alexandra Hospital for Children in Sydney and Adrian
Bauman of the Liverpool Hospital in Sydney report similar
findings and suggest that "the coexistence of drugs, risky sex
and mental health problems remains a consistent
observation." For clinicians, they say, "the challenge is to
address the health issues of young people in a sensitive and
comprehensive manner" but, most importantly, they reiterate
"the need for co-ordinated health care for adolescents and
young people."

Contacts:

[Paper] Sandhya Ramrakha, Research Fellow, Dunedin
Multidisciplinary Health and Development Research Unit,
Department of Preventative and Social Medicine, University
of Otago Medical School, PO Box 913, Dunedin, New
Zealand
Email: sramrakha@gandalf.otago.ac.nz

[Editorial] David L Bennett, Department of Adolescent
Medicine, Royal Alexandra Hospital for Children, Sydney,
Australia
Email: DavidB3@nch.edu.au

Adrian Bauman, Epidemiology Unit, Liverpool Hospital,
Sydney, Australia
Email: a.bauman@unsw.edu.au

(3) HEALTH PROFESSIONALS AS PEACE ADVOCATES
IN AREAS OF CONFLICT

(Peace building through health initiatives)
http://bmj.com/cgi/content/full/321/7256/293

Health initiatives can be successfully used as peace-building
mechanisms in war-affected zones, according to research in
this week's BMJ.

In the last of four BMJ articles looking at conflict and health,
researchers at the Centre for Peace Studies at McMaster
University, Canada examine the links between health and
peace and show evidence of effectiveness for some
health-peace initiatives.

They argue that conflict between groups may be resolved,
lessened or contained by health care professionals in several
ways. For instance, doctors are able, at times, to gain access
to the highest political offices and may well be placed to
undertake "medical diplomacy" activities such as mediation
and high level advocacy. Similarly, shared health goals may
create a peace-building opportunity. For example, in the
1980s, fighting was suspended for three days each year in El
Salvador for the immunisation of children, following
negotiations between government, the army and rebel forces.
Not only did the levels of measles, tetanus and polio drop
dramatically, the dialogue contributed to the achievement of
peace.

Healthcare workers have been successful in promoting peace
and security by reporting human rights violations and by
redefining conflict as a public health problem, add the
authors. For example, the strategies used by physicians to
redefine nuclear war as a public health issue contributed to a
shift away from the Cold War.

With the recent surge of interest in "peace-building" as a
theme of foreign policy, such evidence demonstrates the
considerable influence of health care professionals in helping
to initiate and spread peace in areas of conflict, conclude the
authors.

Contact:

Joanna Santa-Barbara, Centre for Peace Studies, McMaster
University, 1280 Main St West, Hamilton, ON, Canada L8S
Email: joanna@web.net


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