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

Pre-natal development of the wool follicles in Rambouillet sheep

A study of the development of wool follicles during the pre-natal stage of the sheep was conducted on a group of Rambouillet fetuses. Factors studied were time of initiation and sequence of follicle development, density per square millimeter and secondary/primary follicle ratios, and the possibility of branching as derived follicles. Sixteen Rambouillet fetuses were obtained at 39, 42, 49, 56, 63, 72, 78, 84, 91, 98, 105, 112, 119, 133, 140 and 146 days of age. Skin samples were obtained from thirteen locations as described by Stephenson (1958) using a 0.65 cm. biopsy punch. Samples were fixed in 10% buffered formalin, dehydrated, embedded and sectioned. After staining with an hematoxylin and eosin stain, sections were studied and three fields counted per section. Follicles were classed as Pf (complete primary with a keratinized fiber), Pi (incomplete primary without fiber), Sf, a complete secondary (with fiber) or Si (an incomplete secondary without fiber). Secondary/primary ratios were derived from (Sf+Si)/ (Pf+Pi). Follicles were first initiated at 56 days of fetal age and appeared earliest on the nose, face and poll. The follicles of the extremities were next to develop, with the dorsal trunk area and hindquarter last. Follicle density ranged from a mean of 7.3 per sq. mm. at 56 days to 129.5 per sq. mm. at 146 days. Secondary/primary ratios at term ranged from 1.01 on the nose to 10.52 at mid-side. High correlations were obtained between primary and secondary density ranging from a low of 0.61 at 84 days to 0.97 at 98 and 119 days and 0. 96 at 140 days. Branching was observed from 105 days of pre-natal life to term, at which time it was obviously not complete. It was observed that during late pre-natal life, as many as six derived follicles may be formed from an original. The formation of branched follicles appears to have an important role in determining the follicle density of Rambouillet sheep

Pre-natal development of the wool follicles in Rambouillet sheep

A study of the development of wool follicles during the pre-natal stage of the sheep was conducted on a group of Rambouillet fetuses. Factors studied were time of initiation and sequence of follicle development, density per square millimeter and secondary/primary follicle ratios, and the possibility of branching as derived follicles. Sixteen Rambouillet fetuses were obtained at 39, 42, 49, 56, 63, 72, 78, 84, 91, 98, 105, 112, 119, 133, 140 and 146 days of age. Skin samples were obtained from thirteen locations as described by Stephenson (1958) using a 0.65 cm. biopsy punch. Samples were fixed in 10% buffered formalin, dehydrated, embedded and sectioned. After staining with an hematoxylin and eosin stain, sections were studied and three fields counted per section. Follicles were classed as Pf (complete primary with a keratinized fiber), Pi (incomplete primary without fiber), Sf, a complete secondary (with fiber) or Si (an incomplete secondary without fiber). Secondary/primary ratios were derived from (Sf+Si)/ (Pf+Pi). Follicles were first initiated at 56 days of fetal age and appeared earliest on the nose, face and poll. The follicles of the extremities were next to develop, with the dorsal trunk area and hindquarter last. Follicle density ranged from a mean of 7.3 per sq. mm. at 56 days to 129.5 per sq. mm. at 146 days. Secondary/primary ratios at term ranged from 1.01 on the nose to 10.52 at mid-side. High correlations were obtained between primary and secondary density ranging from a low of 0.61 at 84 days to 0.97 at 98 and 119 days and 0. 96 at 140 days. Branching was observed from 105 days of pre-natal life to term, at which time it was obviously not complete. It was observed that during late pre-natal life, as many as six derived follicles may be formed from an original. The formation of branched follicles appears to have an important role in determining the follicle density of Rambouillet sheep

Reproductive performance of ewes treated with flurogestone acetate and gonadotrophins

Introduction; Experimental procedure; Results and discussion; Summary and conclusions; Literature citedResearch report containing the results of a study to determine the effects of flurogestone acetate and gonadotrophins on the reproductive performance of ewes

Fertility characteristics of New Mexico range rams

Previous research; Procedures; Pre-ejaculatory measurements; Ejaculation; Semen evaluation; Statistical analysis; Results and discussion; Population studied; Breeds of rams; Semen characteristics and scrotal circumference; Breeds; Ages; Bacterial isoltes; Ratings of rams; Effect of breed; Effect of age; Scrotal size; Response to breeding soundness examination and vaccination for REO; Conclusions and recommendations; Literature citedBulletin containing the results of a study of fertility characteristics in New Mexico range rams for the improvement of reproductive efficiency in sheep

Relation of body weight, staple length, and horns in range rams

Research report containing the results of a study to determine any relationship between body weight and staple length in range rams, and any relationship between the potential to pass those traits on during production and the presence or absence of horns

Fertility characteristics of New Mexico range bulls

Summary; Introduction; Previous research; Procedures; Pre-ejaculatory measurements; Electroejaculation; Semen evaluation; Statistical analysis; Results and discussion; Semen characteristics; Effect of age; Effect of breed; Scrotal size; Effect of breed; Effect on semen characteristics; Rating of bulls; Effect of age; Effect of breed; Effect of scrotal size; Literature citedBulletin containing the results of a study of fertility characteristics in New Mexico range bulls for the improvement of reproductive efficiency in cattle

Effect of body weight, pelvic area and calf measurements on dystocia in beef heifers

Materials and methods; Results and discussion; Heifer measurement; Calf measurement; Relationships among measurements; Conclusions; Literature citedResearch report containing the results of a study to determine the effects of body weight, pelvic area, and calf measurement on the incidence of dystocia in beef heifers bred to calve early