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(2) RISKY
SEXUAL BEHAVIOUR LINKED TO
PSYCHIATRIC
DISORDERS IN YOUNG ADULTS
(3) HEALTH
PROFESSIONALS AS PEACE ADVOCATES
IN AREAS OF
CONFLICT
(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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