Journals Watch: Underage sex, fertility and cancer

If you are too busy to read through the journals allow Jonathan Holliday to guide you through the latest research

Teenage pregnancy and lifestyle
J Epidemiol Comm Health 2007; 61: 20-7

This study is a useful look at the associations between lifestyle, teenage pregnancy rates under the age of 16 and the effects of possible interventions.

Lifestyle issues associated included intended truancy and being drunk monthly or more (so-called clustering of risky behaviour).

Mindsets associated with higher rates included a belief that more than half their peers were sexually active, lack of expectation of being in education at age 20 and expectation of being a parent by 20; socioeconomic disadvantage was positively linked.

The two factors to come out reducing risk of teenage pregnancy were gaining information about sex from schools and good lines of communication between mother and child.

A high rate of underage sex
J Fam Plan Reprod Health Care 2007; 33: 23-6

We all know that the UK has the highest teenage pregnancy rate in Europe and that teenagers are experimenting with sex at a young age, but I was surprised to read this study from Newport, which looked at attendances of the under 14s at young peoples' and family planning clinics during a 12-month period.

The study found that 242 young people aged under 14 attended during the year. Of these, 41 per cent were male, of whom 30 per cent were already sexually active at registration. Some 96 per cent were requesting condoms, which is reassuring.

Of the girls attending, 72 per cent were requesting condoms and/or hormonal contraception while 35 per cent were requesting treatment for the consequences of sex, for example pregnancy testing, emergency contraception or screening for sexually transmitted infections.

As GPs we should be aware that some very young people are sexually active and take the opportunity to give some advice.

AF diagnosis, management and guidance
Heart 2007; 93: 23-52

From the NICE guideline on AF to the treatment options and care pathways this is a rare encompassing review, and highly relevant to GPs chasing quality points this year. 

What a shame then that such useful reading should only be available in ‘full' form on the web to subscribers.

Fertility and appearance
New Scientist 2007; 2,586: 15

I was interested to read this study from California. Researchers took two full-length photographs of 30 women, the first taken at a time in their menstrual cycle when they were close to ovulation and the second at a time of low fertility. Volunteers were asked which photograph they found more attractive.

A significant majority chose the women at her fertile time. This may be evidence that women openly advertise their fertility - as do female animals in the wild.

Cancer care in primary care
Fam Prac 2007; 23: 644-50

GPs have a pivotal role in diagnosis of cancer but what do the patients look for following diagnosis? A group of 18 patients with cancer in Scotland met monthly over a period of 12 months to discuss this issue.

They identified five key areas as significant - around diagnosis, during treatment, after discharge, at recurrence and the final weeks.

At each key time they identified five major issues of concern - information, communication, equity, a holistic approach and patient-centred care. Certainly as GPs we are in a good position to be able to provide many of these needs.

Dr Holliday is a GP in Eton, Berkshire, and a member of our team who review the journals

RESEARCH OF THE WEEK

Antibiotics and endocarditis

Heart 2007; 93: 5-6

  • How could one not think of offering antibiotic cover to anyone with known valvular abnormality when undergoing dental treatment?
  • The Working Party of the British Society for Antimicrobial Chemotherapy (BSAC) now recommend dental prophylaxis in only three circumstances: previous infective endocarditis, prosthetic valves and surgically constructed pulmonary shunts or conduits.
  • It seems that the potential harms and costs of penicillin outweigh any beneficial effect in the rest. Perhaps that is one less thing for us to concern ourselves with.

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