Objectives: To evaluate the acceptability to young people of proactive Chlamydia trachomatis (CT) information and urine test. To discover the extent of CT infection and the practical implications for completing treatment and partner notification.
Design: Prospective screening with sexual health questionnaire.
Setting: Three family planning clinics for young people in Liverpool and South Sefton.
Participants: Nine hundred and five women and 53 men had urine tests and answered the questionnaire. All aged 20 years or under attending the clinics were given information about CT and safer sex.
Main outcome measures: The acceptability of proactive information and screening for CT using a urine test. Prevalence of CT infection. The time and effort incurred informing and managing those testing positive.
Results: The information and urine test were readily accepted. Prevalence of CT was 8.5% in women and 5.7% in men. More than three-quarters of those testing positive were treated, but it took much time and effort, as follow-up attendance was poor.
Conclusions: The prevalence of CT was high in this population. Young people participated in screening readily. They are interested in this health issue, but it was difficult to hold their attention long enough to complete the process of treatment and contact tracing. Completing this successfully either needs a huge input of resources or a new approach. These results have led to the piloting of an outreach health adviser administering treatment and carrying out partner notification at the screening site. Some of the questions raised by the CMO have been addressed.
{"title":"Chlamydia trachomatis screening in young people in Merseyside.","authors":"J Harvey, A Webb, H Mallinson","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the acceptability to young people of proactive Chlamydia trachomatis (CT) information and urine test. To discover the extent of CT infection and the practical implications for completing treatment and partner notification.</p><p><strong>Design: </strong>Prospective screening with sexual health questionnaire.</p><p><strong>Setting: </strong>Three family planning clinics for young people in Liverpool and South Sefton.</p><p><strong>Participants: </strong>Nine hundred and five women and 53 men had urine tests and answered the questionnaire. All aged 20 years or under attending the clinics were given information about CT and safer sex.</p><p><strong>Main outcome measures: </strong>The acceptability of proactive information and screening for CT using a urine test. Prevalence of CT infection. The time and effort incurred informing and managing those testing positive.</p><p><strong>Results: </strong>The information and urine test were readily accepted. Prevalence of CT was 8.5% in women and 5.7% in men. More than three-quarters of those testing positive were treated, but it took much time and effort, as follow-up attendance was poor.</p><p><strong>Conclusions: </strong>The prevalence of CT was high in this population. Young people participated in screening readily. They are interested in this health issue, but it was difficult to hold their attention long enough to complete the process of treatment and contact tracing. Completing this successfully either needs a huge input of resources or a new approach. These results have led to the piloting of an outreach health adviser administering treatment and carrying out partner notification at the screening site. Some of the questions raised by the CMO have been addressed.</p>","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"199-201"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-10-01DOI: 10.1783/147118900101194724
P. O'Brien, G. Wakley
Guidance for peer reviewers Peer review has been criticised because, in the absence of standardisation, it is idiosyncratic and open to bias. To improve the quality of reports we provide reviewers with checklists of important points for commentary (see Box 1). Reports can then be standardised and evaluated according to open criteria. A transparent process that is shared with authors and readers, and with a public audit, makes the Journal accountable to its contributors and readers.
{"title":"Peer review at The British Journal of Family Planning","authors":"P. O'Brien, G. Wakley","doi":"10.1783/147118900101194724","DOIUrl":"https://doi.org/10.1783/147118900101194724","url":null,"abstract":"Guidance for peer reviewers Peer review has been criticised because, in the absence of standardisation, it is idiosyncratic and open to bias. To improve the quality of reports we provide reviewers with checklists of important points for commentary (see Box 1). Reports can then be standardised and evaluated according to open criteria. A transparent process that is shared with authors and readers, and with a public audit, makes the Journal accountable to its contributors and readers.","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"35 1","pages":"191 - 192"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85417004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-10-01DOI: 10.1783/147118900101194797
S MacMillan, H McKenzie, G Flett, A Templeton
This pilot study set out to determine the feasibility of using patient-collected vulval swabs, instead of urine, for the diagnosis of female Chlamydia trachomatis infection. Main outcome measures included prevalence of infection and sensitivity, specificity, and acceptability of both test methods. An assessment was also made of those who declined to be tested. Consecutive women under 25 years of age attending a single urban family planning clinic were invited to participate. Sixty-eight percent (103/152) agreed to undergo testing. Overall prevalence was 11.7%. The sensitivity/specificity for the ligase chain reaction (LCR) assayed patient-collected vulval swabs and urine was 100%/100% and 92%/100%, respectively. The acceptability of self-collection was high with 93% characterising the test as 'not bad', 79% recommending it to a friend, and 79% choosing the test next time. Significantly more women, however, would choose urine for testing on a subsequent occasion (p < 0.001). Less than 1/5 of the patients who declined did not take part because of concerns regarding the vulval swab. Patient-collected vulval swabs assayed by LCR represent a non-invasive, sensitive, and acceptable way to detect genital C. trachomatis infection in women attending a family planning clinic. Compared with urine testing, benefits in terms of transport and processing should encourage more widespread use of this approach.
{"title":"Feasibility of patient-collected vulval swabs for the diagnosis of Chlamydia trachomatis in a family planning clinic: a pilot study.","authors":"S MacMillan, H McKenzie, G Flett, A Templeton","doi":"10.1783/147118900101194797","DOIUrl":"https://doi.org/10.1783/147118900101194797","url":null,"abstract":"<p><p>This pilot study set out to determine the feasibility of using patient-collected vulval swabs, instead of urine, for the diagnosis of female Chlamydia trachomatis infection. Main outcome measures included prevalence of infection and sensitivity, specificity, and acceptability of both test methods. An assessment was also made of those who declined to be tested. Consecutive women under 25 years of age attending a single urban family planning clinic were invited to participate. Sixty-eight percent (103/152) agreed to undergo testing. Overall prevalence was 11.7%. The sensitivity/specificity for the ligase chain reaction (LCR) assayed patient-collected vulval swabs and urine was 100%/100% and 92%/100%, respectively. The acceptability of self-collection was high with 93% characterising the test as 'not bad', 79% recommending it to a friend, and 79% choosing the test next time. Significantly more women, however, would choose urine for testing on a subsequent occasion (p < 0.001). Less than 1/5 of the patients who declined did not take part because of concerns regarding the vulval swab. Patient-collected vulval swabs assayed by LCR represent a non-invasive, sensitive, and acceptable way to detect genital C. trachomatis infection in women attending a family planning clinic. Compared with urine testing, benefits in terms of transport and processing should encourage more widespread use of this approach.</p>","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"202-6"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1783/147118900101194797","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-10-01DOI: 10.1783/147118900101194652
S S Trivedi, M Goel, S Jain
We report a series of 38 patients with intra-uterine devices with lost strings where hysteroscopic aid was required after routine retrieval procedures failed. Thirty-five intra-uterine devices could be removed easily with hysteroscope. In one patient a fragmented Lippes Loop was removed piecemeal hysteroscopically. Laparotomy was required in only one patient, for an extra-uterine Copper T. Hysteroscopy is thus a simple, safe and effective method for removing misplaced intra-uterine devices.
{"title":"Hysteroscopic management of intra-uterine devices with lost strings.","authors":"S S Trivedi, M Goel, S Jain","doi":"10.1783/147118900101194652","DOIUrl":"https://doi.org/10.1783/147118900101194652","url":null,"abstract":"<p><p>We report a series of 38 patients with intra-uterine devices with lost strings where hysteroscopic aid was required after routine retrieval procedures failed. Thirty-five intra-uterine devices could be removed easily with hysteroscope. In one patient a fragmented Lippes Loop was removed piecemeal hysteroscopically. Laparotomy was required in only one patient, for an extra-uterine Copper T. Hysteroscopy is thus a simple, safe and effective method for removing misplaced intra-uterine devices.</p>","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"229-30"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1783/147118900101194652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"'Last trance' baby experts register a first; FDA approves new contraception cap; licensed to chill; quitting smoking quantified; medical staff join the dot.com revolution","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"230"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-10-01DOI: 10.1783/147118900101194689
E Greenhall, J Bullock
Bodyzone is a young persons drop in service run in eight small market towns in Oxfordshire. It is based in secondary schools, or in youth centres nearby, and runs once a week during the school lunchtime. The service was initially developed to meet the needs of young people in a rural population. Many young people find it hard to use services primarily designed for adults. Additional problems for youngsters in rural localities arise from living in small, closely-knit communities where it is difficult to be anonymous, and from the lack of public transport into the towns from surrounding villages. There is now interest in developing similar services in larger towns.
{"title":"Report from the faculty of family planning and reproductive health care AGM, May 2000.","authors":"E Greenhall, J Bullock","doi":"10.1783/147118900101194689","DOIUrl":"https://doi.org/10.1783/147118900101194689","url":null,"abstract":"Bodyzone is a young persons drop in service run in eight small market towns in Oxfordshire. It is based in secondary schools, or in youth centres nearby, and runs once a week during the school lunchtime. The service was initially developed to meet the needs of young people in a rural population. Many young people find it hard to use services primarily designed for adults. Additional problems for youngsters in rural localities arise from living in small, closely-knit communities where it is difficult to be anonymous, and from the lack of public transport into the towns from surrounding villages. There is now interest in developing similar services in larger towns.","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"233-4"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1783/147118900101194689","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-10-01DOI: 10.1783/147118900101194698
J Tuckey
Since their introduction in the 1960s the safety of combined oral contraceptives (COCs) has been widely debated. The difficulty in determining if COC use increases the risk of developing cancer is due to: the long latent period between exposure to the potential carcinogen and overt malignant disease the fact that due to the developments in COCs women are likely to have taken a variety of different pills the paucity of data on the use of COCs in women over the age of 35.
{"title":"Combined oral contraception and cancer.","authors":"J Tuckey","doi":"10.1783/147118900101194698","DOIUrl":"https://doi.org/10.1783/147118900101194698","url":null,"abstract":"Since their introduction in the 1960s the safety of combined oral contraceptives (COCs) has been widely debated. The difficulty in determining if COC use increases the risk of developing cancer is due to: the long latent period between exposure to the potential carcinogen and overt malignant disease the fact that due to the developments in COCs women are likely to have taken a variety of different pills the paucity of data on the use of COCs in women over the age of 35.","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"237-40"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1783/147118900101194698","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Notes for contributors","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"242"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anti-D guidelines.","authors":"K Kanjilal, M Tasker","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"244"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2000-10-01DOI: 10.1783/147118900101194616
C Wilkinson, N Hampton, C Bradbeer
planning and genitourinary medicine (GUM) services are in many ways imperfect as neither deals with the broad spectrum of sexual health needs in an holistic way. Client centred care focuses on equity of access, the provision of quality care, appropriate referral and management and achieving client satisfaction. Is the solution an extension of the recent trend of traditionally separate disciplines sharing clinical space, or is a more fundamental examination of clients’needs required if we are to address the sexual health needs of 21st Century men and women? The integration of services is a complex process; identifying and understanding the similarities in relation to client care is important and is perhaps the easy part of the equation. In contrast, the origins and subsequent evolution of the specialities of GUM and family planning are, in many ways, worlds apart. This means we have to consider several contrasting elements gynaecologists and physicians; sessional staff and full time staff; preventative medicine and managing disease, and the role of the doctor and of the nurse. Thus we have, at this moment in time, two specialities that are in many ways doing similar work and have similar aims for client care, but which work in different ways. The challenges for integration lie within ourselves, not with the medical problems or with the clients. For very good reasons GUM services developed along a medical model within hospitals and later within the NHS at its inception, initially to meet the needs of men returning from the army with venereal diseases at the end of the Great War; the emphasis being to provide confidential services free of charge. It is interesting that an early recommendation from the medical establishment on the prevention of the spread of STIs was to detain some women with STIs, not men, as hospital inpatients. Women’s rights campaigners successfully changed opinion on this matter. Family planning services evolved from female empowerment and, to begin with, had only limited support from much of the medical profession. The latter deemed the field too ‘social’ for medical responsibility. Family planning services only became freely available to all in the mid 1970s when FPA clinics were absorbed into the NHS and primary care providers started to receive remuneration for providing contraceptive care. When considering the integration of family planning and sexual health services, it is important to remember the breadth of providers involved – pharmacists (condoms, pregnancy tests, female barriers, Persona and, in the future, emergency contraception), obstetricians and gynaecologists, midwives, health visitors and health promotion staff, as well as doctors and nurses working in family planning services and GUM services in acute and community trusts and in primary care. Unlike in family planning, in GUM specific legislation exists to protect confidentiality. However, in practice, most family planning and GUM services work to similar stan
{"title":"The integration of family planning and genitourinary medicine services.","authors":"C Wilkinson, N Hampton, C Bradbeer","doi":"10.1783/147118900101194616","DOIUrl":"https://doi.org/10.1783/147118900101194616","url":null,"abstract":"planning and genitourinary medicine (GUM) services are in many ways imperfect as neither deals with the broad spectrum of sexual health needs in an holistic way. Client centred care focuses on equity of access, the provision of quality care, appropriate referral and management and achieving client satisfaction. Is the solution an extension of the recent trend of traditionally separate disciplines sharing clinical space, or is a more fundamental examination of clients’needs required if we are to address the sexual health needs of 21st Century men and women? The integration of services is a complex process; identifying and understanding the similarities in relation to client care is important and is perhaps the easy part of the equation. In contrast, the origins and subsequent evolution of the specialities of GUM and family planning are, in many ways, worlds apart. This means we have to consider several contrasting elements gynaecologists and physicians; sessional staff and full time staff; preventative medicine and managing disease, and the role of the doctor and of the nurse. Thus we have, at this moment in time, two specialities that are in many ways doing similar work and have similar aims for client care, but which work in different ways. The challenges for integration lie within ourselves, not with the medical problems or with the clients. For very good reasons GUM services developed along a medical model within hospitals and later within the NHS at its inception, initially to meet the needs of men returning from the army with venereal diseases at the end of the Great War; the emphasis being to provide confidential services free of charge. It is interesting that an early recommendation from the medical establishment on the prevention of the spread of STIs was to detain some women with STIs, not men, as hospital inpatients. Women’s rights campaigners successfully changed opinion on this matter. Family planning services evolved from female empowerment and, to begin with, had only limited support from much of the medical profession. The latter deemed the field too ‘social’ for medical responsibility. Family planning services only became freely available to all in the mid 1970s when FPA clinics were absorbed into the NHS and primary care providers started to receive remuneration for providing contraceptive care. When considering the integration of family planning and sexual health services, it is important to remember the breadth of providers involved – pharmacists (condoms, pregnancy tests, female barriers, Persona and, in the future, emergency contraception), obstetricians and gynaecologists, midwives, health visitors and health promotion staff, as well as doctors and nurses working in family planning services and GUM services in acute and community trusts and in primary care. Unlike in family planning, in GUM specific legislation exists to protect confidentiality. However, in practice, most family planning and GUM services work to similar stan","PeriodicalId":22378,"journal":{"name":"The British journal of family planning","volume":"26 4","pages":"187-8"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1783/147118900101194616","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21882597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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