Changing patterns in women seeking terminations of pregnancy: a trend analysis of data from one service provider 1996-2006

Objectives: The purpose of this study was to assess emerging trends in five characteristics: age, first ever pregnancy, contraception at time of conception, contraception choices post-operatively and referral source of women presenting for a termination of pregnancy (1996–2006) from a southern service in Adelaide, South Australia. Method: A time-series study, from 1996 to 2006, using 3,434 cases from a termination of pregnancy service provider. Five characteristics associated with women attending for a termination of pregnancy were examined. Data were analysed using simple linear regression analyses and one-way ANOVA. Results: There was a significant increase in women aged 30–50 years having a pregnancy terminated (ANOVA F1,9 = 5.901, p=0.041), with 67% of women using contraception at the time of conception. An increasing percentage of women chose not to use any contraception post-operatively (ANOVA F1,9 = 14.409, p=0.006), although 90% of women left the service with contraception. Additionally, there was a significant decline in women using natural family planning methods (ANOVA F1,9 = 13.654, p=0.006). Referral patterns changed significantly over the ten years, with fewer women being referred by a general practitioner (ANOVA F1,9 = 46.492, p=0.000) and family planning clinics (ANOVA F1,9 = 13.011, p=0.007). Conclusions and implications: Termination of pregnancy patterns from a hospital based regional termination service have changed over the past ten years in this study population. There are implications for policy, strategic plans and health promotion activities in the southern region of Adelaide.Wendy Abigail, Charmaine Power and Ingrid Bela

Prevalence of peripheral arterial disease: persistence of excess risk in former smokers

Objective: To determine the age-standardised prevalence of peripheral arterial disease (PAD) and associated risk factors, particularly smoking. Method: Design: Cross-sectional survey of a randomly selected population. Setting: Metropolitan area of Perth, Western Australia. Participants: Men aged between 65-83 years. Results: The adjusted response fraction was 77.2%. Of 4,470 men assessed, 744 were identified as having PAD by the Edinburgh Claudication Questionnaire and/or the ankle-brachial index of systolic blood pressure, yielding an age-standardised prevalence of PAD of 15.6% (95% confidence intervals (CI): 14.5%, 16.6%). The main risk factors identified in univariate analyses were increasing age, smoking current (OR=3.9, 95% CI 2.9-5.1) or former (OR=2.0, 95% CI 1.6-2.4), physical inactivity (OR=1.4, 95% CI 1.2-1.7), a history of angina (OR=2.2, 95% CI 1.8-2.7) and diabetes mellitus (OR=2.1, 95% CI 1.7-2.6). The multivariate analysis showed that the highest relative risk associated with PAD was current smoking of 25 or more cigarettes daily (OR=7.3, 95% CI 4.2-12.8). In this population, 32% of PAD was attributable to current smoking and a further 40% was attributable to past smoking by men who did not smoke currently. Conclusions: This large observational study shows that PAD is relatively common in older, urban Australian men. In contrast with its relationship to coronary disease and stroke, previous smoking appears to have a long legacy of increased risk of PAD. Implications: This research emphasises the importance of smoking as a preventable cause of PAD

Prevalence and risk factors of hepatitis B and C virus infections in an impoverished urban community in Dhaka, Bangladesh

Viral hepatitis is a serious global public health problem affecting billions of people globally, and both hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are rapidly spreading in the developing countries including Bangladesh due to the lack of health education, poverty, illiteracy and lack of hepatitis B vaccination. Also there is lack of information on their prevalence among the general population. So, a population-based serological survey was conducted in Dhaka to determine the prevalence and risk factors of HBV and HCV infections