Seventy years of sex education in Health Education Journal: a critical review

This paper examines key debates and perspectives on sex education in Health Education Journal (HEJ), from the date of the journal’s first publication in March 1943 to the present day. Matters relating to sexuality and sexual health are revealed to be integral to HEJ’s history. First published as Health and Empire (1921 – 1942), a key purpose of the journal since its inception has been to share information on venereal disease and its prevention within the UK and across the former British Empire. From 1943 to the present day, discussions on sex education in the newly-christened HEJ both reflect and respond to evolving socio-cultural attitudes towards sexuality in the UK. Changing definitions of sex education across the decades are examined, from the prevention of venereal disease and moral decline in war-time Britain in the 1940s, to a range of responses to sexual liberation in the 1960s and 1970s; from a focus on preventing sexually-transmitted infections, teenage pregnancy and HIV in the 1980s, to the provision of sexual health services alongside sex education in the 2000s. Over the past 70 years, a shift from prevention of pre-marital sexual activity to the management of its outcomes is apparent; however, while these changes over time are notable, perhaps the most striking findings of this review are the continuities in arguments for and against the discussion of sexual issues. After more than 70 years of debate, it would seem that there is little consensus concerning motivations for and the content of sex education

Double-layer shocks in a magnetized quantum plasma

The formation of small but finite amplitude electrostatic shocks in the propagation of quantum ion-acoustic waves (QIAWs) obliquely to an external magnetic field is reported in a quantum electron-positron-ion (e-p-i) plasma. Such shocks are seen to have double-layer (DL) structures composed of the compressive and accompanying rarefactive slow-wave fronts. Existence of such DL shocks depends critically on the quantum coupling parameter $H$ associated with the Bohm potential and the positron to electron density ratio $\delta$. The profiles may, however, steepen initially and reach a steady state with a number of solitary waves in front of the shocks. Such novel DL shocks could be a good candidate for particle acceleration in intense laser-solid density plasma interaction experiments as well as in compact astrophysical objects, e.g., magnetized white dwarfs.Comment: 4 pages, 1 figure (to appear in Physical Review E

Quantum black holes from null expansion operators

Using a recently developed quantization of spherically symmetric gravity coupled to a scalar field, we give a construction of null expansion operators that allow a definition of general, fully dynamical quantum black holes. These operators capture the intuitive idea that classical black holes are defined by the presence of trapped surfaces, that is surfaces from which light cannot escape outward. They thus provide a mechanism for classifying quantum states of the system into those that describe quantum black holes and those that do not. We find that quantum horizons fluctuate, confirming long-held heuristic expectations. We also give explicit examples of quantum black hole states. The work sets a framework for addressing the puzzles of black hole physics in a fully quantized dynamical setting.Comment: 5 pages, version to appear in CQ

Constraining Alternate Models of Black Holes: Type I X-ray Bursts on Accreting Fermion-Fermion and Boson-Fermion Stars

The existence of black holes remains open to doubt until other conceivable options are excluded. With this motivation, we consider a model of a compact star in which most of the mass consists of dark particles of some kind, and a small fraction of the mass is in the form of ordinary nucleonic gas. The gas does not interact with the dark matter other than via gravity, but collects at the center as a separate fermionic fluid component. Depending on whether the dark mass is made of fermions or bosons, the objects may be called fermion-fermion stars or boson-fermion stars, respectively. For appropriate choices of the mass of the dark matter particles, these objects are viable models of black hole candidates in X-ray binaries. We consider models with a dark mass of 10 solar masses and a range of gas mass from 10^{-6} to nearly one solar mass, and analyse the bursting properties of the models when they accrete gas. We show that all the models would experience thermonuclear Type I X-ray bursts at appropriate mass accretion rates. Since no Type I bursts have been reported from black hole candidates, the models are ruled out. The case for identifying black hole candidates in X-ray binaries as true black holes is thus strengthened.Comment: 29 pages, 7 figures, to appear in The Astrophysical Journa

Scattering in the vicinity of relativistic jets: a method for constraining jet parameters

Relativistic jets of radio loud active galactic nuclei (AGN) produce highly directed, intense beams of radiation. A fraction of this beamed radiation scatters on the thermal plasma generally surrounding an AGN. The morphology of the scattered emission can thus provide constraints on the physical properties of the jet. We present a model to study the feasibility of constraining the parameters of a jet, especially its inclination angle and bulk Lorentz factor in this way. We apply our model to the well studied jet of M87 and the surrounding diffuse gas and find that the observational limits of the surface brightness measured in the region of the putative counterjet provide the tightest constraints on the jet parameters consistent with constraints derived by other methods. We briefly discuss the applicability of our model to other sources exhibiting relativistic motionsComment: 17 pages, 15 figures, to appear in A&A, 420, 33 (2004

High body mass index in children with sickle cell disease- a retrospective single-centre audit

Objective To assess the prevalence of high body mass index (BMI) in children with sickle cell disease and assess correlation between BMI and disease severity. Design Retrospective chart review followed by statistical analysis. Setting A single tertiary paediatric clinic in inner city London. Patients All patients with sickle cell disease, including homozygous haemoglobin (HbSS) and compound heterozygous Hb (HbSC), age 2–18 years receiving clinical care at the centre, were included in the study. Interventions Height and weight measurements, steady-state laboratory blood tests, hospital admission rates, adjunct therapy such as hydroxycarbamide or blood transfusions and obstructive sleep apnoea (OSA) data were obtained from the hospital electronic patient records. Main outcome measures To study the prevalence of high BMI and to identify any correlation between BMI and disease severity. Results 385 patients were included. 64 children (17%) were overweight or obese, of which a significantly higher number of children with HbSC were obese or overweight (23 out of 91, 25%) compared with those with HbSS (36 out of 273, 13%), p≤0.001. No correlation was found between high BMI and presence of OSA, and markers of disease severity such as admission rates, fetal haemoglobin or lactate dehydrogenase levels. Conclusions High BMI did not correlate with disease severity in this cohort of patients with sickle cell disease. Obesity was more prevalent in females and those with HbSC. Further prospective studies are needed to determine long-term effects of BMI in disease severity and outcome

Dermatology undergraduate skin cancer training: a disconnect between recommendations, clinical exposure and competence

<p>Abstract</p> <p>Background</p> <p>Skin cancers are the most common malignancies in Caucasian populations. Non-specialists are responsible for the initial assessment of skin lesions and are required to act as the gatekeepers to dermatological cancer services in many healthcare systems. The majority of such physicians receive very limited formal undergraduate or postgraduate dermatology training. The British Association of Dermatologists (BAD) has produced guidelines that list the lesions that students should be able to diagnose on graduation and the majority of UK medical schools’ operate curricula in keeping with these. There is, however, virtually no evidence as to whether these competencies are being achieved. We set out to determine students’ competence at skin lesion diagnosis and to quantify their clinical exposure to examples of such lesions during their dermatology attachment.</p> <p>Methods</p> <p>Three linked studies were undertaken. In the first, students’ competence was tested by randomized slideshows of images containing the 16 lesions recommended in the UK guidelines. Students’ accuracy was tested at the beginning (Day 1) and end (Day 10) of their clinical placement, with a random sample of students retested 12 months later. Secondly, students’ exposure to these lesions was recorded during their attachments. Finally a survey of the additional dermatological resources used by the students was undertaken.</p> <p>Results</p> <p>Study 1: Students’ diagnostic accuracy increased from 11% on Day 1 to 33% on Day 10 (effect size +2.72). After 12 months half of this effect had disappeared and the students accuracy had dropped to 24%. Study 2: Students’ exposure to the recommended lesions was poor with 82% not even witnessing a single example of each of the 3 major skin cancers. Despite these measurements, only a minority of students reported that they were not confident at diagnosing skin tumours. Study 3: The majority of students use additional resources to supplement their learning.</p> <p>Conclusions</p> <p>In the light of what we know about learning in dermatology, our data would suggest, that the current (traditional) undergraduate attachment is inadequate to meet the UK recommendations for graduate competence. As well as critically examining the basis for these recommendations, we need more empirical data on student performance and exposure, in order to improve teaching and learning.</p