Trends in, and predictors of, anxiety and specific worries following colposcopy: a 12-month longitudinal study

Objective Little is known about which women are at greatest risk of adverse psychological after-effects following colposcopy. This study examined time trends in, and identified predictors of, anxiety and specific worries over 12 months. Methods Women attending two hospital-based colposcopy clinics for abnormal cervical cytology were invited to complete psychosocial questionnaires at 4, 8 and 12 months following colposcopy. General anxiety and screening-specific worries (about cervical cancer, having sex and future fertility) were measured. Generalised estimating equations were used to assess associations between socio-demographic, lifestyle and clinical variables and risk of psychological outcomes. Results Of 584 women initially recruited, 429, 343 and 303 completed questionnaires at 4, 8 and 12 months, respectively. Screening-specific worries declined significantly over time but were still relatively high at 12 months: 23%, 39% and 18% for worries about cervical cancer, fertility and having sex, respectively. Anxiety remained stable (20%) over time. Risks of cervical cancer worry and anxiety were both almost double in women without private health insurance (cervical cancer worry: OR = 1.80, 95% CI 1.25–2.61; anxiety: OR = 1.84, 95% CI 1.20–2.84). Younger women (<40 years) had higher risk of fertility worries. Non-Irish women had higher risk of anxiety (OR = 2.13, 95% CI 1.13–4.01). Conclusions Screening-specific worries declined over time but anxiety remained stable. Notable proportions of women still reported adverse outcomes 12 months following colposcopy, with predictors varying between outcomes. Women in socio-demographically vulnerable groups were at greatest risk of adverse psychological outcomes. This information could inform development of interventions to alleviate psychological distress post-colposcopy. Copyright © 2015 John Wiley & Sons, Ltd

Physical after-effects of colposcopy and related procedures and their inter-relationship with psychological distress: a longitudinal survey

OBJECTIVES: To estimate prevalence of post-colposcopy physical after-effects and investigate associations between these and subsequent psychological distress. DESIGN: Longitudinal survey. SETTING: Two hospital-based colposcopy clinics. POPULATION: Women with abnormal cytology who underwent colposcopy (+/- related procedures). METHODS: Questionnaires were mailed to women 4-, 8- and 12-months post-colposcopy. Details of physical after-effects (pain, bleeding and discharge) experienced post-colposcopy were collected at 4-months. Colposcopy-specific distress was measured using the Process Outcome Specific Measure at all time-points. Linear mixed effects regression was used to identify associations between physical after-effects and distress over 12-months, adjusting for socio-demographic and clinical variables. MAIN OUTCOME MEASURES: Prevalence of post-colposcopy physical after-effects. Associations between presence of any physical after-effects, awareness of after-effects and number of after-effects and distress. RESULTS: 584 women were recruited (response rate=73%, 59% and 52% at 4, 8 and 12-months, respectively). 82% of women reported one or more physical after-effect(s). Multiple physical after-effects were common (two after-effects=25%; three after-effects=25%). Psychological distress scores declined significantly over time. In adjusted analyses, women who experienced all three physical after-effects had on average a 4.58 (95% CI 1.10 to 8.05) higher distress scored than those who experienced no after-effects. Women who were unaware of the possibility of experiencing after-effects scored significantly higher for distress during follow-up. CONCLUSIONS: Prevalence of physical after-effects of colposcopy and related procedures is high. The novel findings of inter-relationships between awareness of the possibility of after-effects, and experiencing multiple after-effects, and post-colposcopy distress may be relevant to the development of interventions to alleviate post-colposcopy distress

On averting the tragedy of the commons

One of the enduring facts of the human condition is that the earth's resources are finite and its environment fragile. It is also evident that human behavior is rarely based on an appreciation of these facts. While the outlook may be bleak, so are some of the proposed solutions. Reasonable people have suggested that, to survive, an environmentally enlightened authoritarian government must be adopted. This article suggests that such a solution is unworkable, in part because it fails to consider critical aspects of human nature. A framework is proposed for developing solutions compatible with human capabilities.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/48163/1/267_2005_Article_BF01867519.pd

Early adversity, elevated stress physiology, accelerated sexual maturation, and poor health in females.

Evolutionary-minded developmentalists studying predictive-adaptive-response processes linking childhood adversity with accelerated female reproductive development and health scientists investigating the developmental origins of health and disease (DOoHaD) may be tapping the same process, whereby longer-term health costs are traded off for increased probability of reproducing before dying via a process of accelerated reproductive maturation. Using data from 73 females, we test the following propositions using path analysis: (a) greater exposure to prenatal stress predicts greater maternal depression and negative parenting in infancy, (b) which predicts elevated basal cortisol at 4.5 years, (c) which predicts accelerated adrenarcheal development, (d) which predicts more physical and mental health problems at age 18. Results prove generally consistent with these propositions, including a direct link from cortisol to mental health problems. DOoHaD investigators should consider including early sexual maturation as a core component linking early adversity and stress physiology with poor health later in life in females

An Updated Procedure for Cecal Cannulation in Sheep and Cattle

Fifteen cattle (236-500 kg) and 38 sheep (36-55 kg) were fitted with 2 types of indwelling cecal cannulae. Cannulae were made of either clear silicone or plastic tubing. The surgery was conducted in a one-step procedure that involved pharmaceuticals and equipment that were readily available. Results indicated a success rate of 67% (33% failure due to inability to locate the cecum at the time of surgery) in cattle and 100% in sheep. Both cannula types tested were acceptable, but the cannula made from plastic tubing was more desirable because it was less bulky, more durable, and easier to construct. Animals fitted with cecal cannulae appeared to be healthy and to have normal life spans.This material was digitized as part of a cooperative project between the Society for Range Management and the University of Arizona Libraries.The Journal of Range Management archives are made available by the Society for Range Management and the University of Arizona Libraries. Contact [email protected] for further information.Migrated from OJS platform August 202

Early adversity, elevated stress physiology, accelerated sexual maturation, and poor health in females.

Evolutionary-minded developmentalists studying predictive-adaptive-response processes linking childhood adversity with accelerated female reproductive development and health scientists investigating the developmental origins of health and disease (DOoHaD) may be tapping the same process, whereby longer-term health costs are traded off for increased probability of reproducing before dying via a process of accelerated reproductive maturation. Using data from 73 females, we test the following propositions using path analysis: (a) greater exposure to prenatal stress predicts greater maternal depression and negative parenting in infancy, (b) which predicts elevated basal cortisol at 4.5 years, (c) which predicts accelerated adrenarcheal development, (d) which predicts more physical and mental health problems at age 18. Results prove generally consistent with these propositions, including a direct link from cortisol to mental health problems. DOoHaD investigators should consider including early sexual maturation as a core component linking early adversity and stress physiology with poor health later in life in females

Early adversity, elevated stress physiology, accelerated sexual maturation, and poor health in females.

Evolutionary-minded developmentalists studying predictive-adaptive-response processes linking childhood adversity with accelerated female reproductive development and health scientists investigating the developmental origins of health and disease (DOoHaD) may be tapping the same process, whereby longer-term health costs are traded off for increased probability of reproducing before dying via a process of accelerated reproductive maturation. Using data from 73 females, we test the following propositions using path analysis: (a) greater exposure to prenatal stress predicts greater maternal depression and negative parenting in infancy, (b) which predicts elevated basal cortisol at 4.5 years, (c) which predicts accelerated adrenarcheal development, (d) which predicts more physical and mental health problems at age 18. Results prove generally consistent with these propositions, including a direct link from cortisol to mental health problems. DOoHaD investigators should consider including early sexual maturation as a core component linking early adversity and stress physiology with poor health later in life in females