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

Civilisation and Human Niche Construction

This short paper introduces the special section "Civilisation and the Construction of the Human Niche", organised by the ‘Domestication, Niche Construction and the Anthropocene’ research network at the UCL Institute of Archaeology

A Projectile Telemetry System for In-Barrel Data

International Telemetering Conference Proceedings / October 13-15, 1970 / International Hotel, Los Angeles, CaliforniaSandia Corporation is developing a projectile telemetry system and required ground support to monitor the performance of components mounted in a 155 mm projectile. The telemetry system is to provide the data link required to monitor component performance during and following launch from a 155 mm "long-tom" cannon. The projectile experiences a 16,500g setback acceleration of 15 msec duration coupled with an angular acceleration of 328,000 rad/sec². A P band FM/FM telemetry system has been developed to provide a data link while the projectile is in the barrel as well as out of the barrel. The technique has been successfully tested in a 155 mm projectile with a setback acceleration of 12,500g 20 millisec duration and in a 81 mm mortar round with a setback acceleration of 7,000g 7.5 millisecond duration. A parachute recovery system is used to obtain a "soft" recovery of the 155 mm projectile mounted components and telemetry system.International Foundation for TelemeteringProceedings from the International Telemetering Conference are made available by the International Foundation for Telemetering and the University of Arizona Libraries. Visit http://www.telemetry.org/index.php/contact-us if you have questions about items in this collection

Health-related quality of life in women after colposcopy: results from a longitudinal patient survey

Background: Information concerning the health-related quality-of-life (HRQoL) consequences of colposcopy is limited, particularly over time. In a longitudinal study, we investigated women’s HRQoL at 4, 8 and 12 months post colposcopy and the factors associated with this. Methods: Women attending colposcopy at two large hospitals affiliated with the national screening programme in Ireland were invited to complete questionnaires at 4, 8 and 12 months post colposcopy. HRQoL was measured using the EQ-5D-3L and compared across a range of socio-demographic, clinical and attitudinal variables. A mixed-effects logistic multivariable model was employed to investigate associations between these variables and low HRQoL. Results: Of 584 women initially recruited, 429, 343 and 303 completed questionnaires at 4, 8 and 12 months, respectively. The mean overall HRQoL score for the sample across all time points was 0.90 (SD 0.16). Approximately 18% of women experienced low HRQoL at each of the three time points. In multivariable testing, over the entire 12-month follow-up period, non-Irish nationals (OR 8.99, 95% CI 2.35–34.43) and women with high-grade referral cytology (OR 2.78, 95% CI 1.08–7.13) were at higher odds of low HRQoL. Women who were past (OR 0.20, 95% CI 0.07–0.58) or never (OR 0.42, 95% CI 0.16–1.12) smokers were at lower odds of low HRQoL than current smokers. As women’s satisfaction with their healthcare increased their odds of experiencing low HRQoL fell (OR per unit increase 0.51, 95% CI 0.34–0.75). Conclusions: Women’s HRQoL did not change over the 12 months post colposcopy, but some subgroups of women were at higher risk of experiencing low HRQoL. These subgroups may benefit from additional support