QUITE apart from the academic consideration that vital and medical statistics now form an obligatory part of the education of students seeking the University of London's diploma in public health, the demand for information about the methods of vital and medical statistics is increasing. The most casual reader of the newspapers is now aware that population problems are of serious practical importance and that the publications of the General Register Office cannot be ignored. It is scarcely an exaggeration to say that the recently issued preliminary report on the census of 1931 is one of the most sensational documents which has appeared for years, and that he who reads it intelligently will understand what is meant by saying that civilisation is in the melting pot. An Introduction to Medical Statistics. By Hilda M. Woods William T. Russell. Pp. x + 125. (London: P. S. King and Son, Ltd., 1931.) 7s. 6d.

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An Introduction to Medical Statistics

Grief counseling and grief therapy: A handbook for the mental health practitioner

BACKGROUND Across the developed world couples are postponing parenthood. This review assesses the consequences of delayed family formation from a demographic and medical perspective. One main focus is on the quantitative importance of pregnancy postponement. METHODS Medical and social science databases were searched for publications on relevant subjects such as delayed parenthood, female and male age, fertility, infertility, time to pregnancy (TTP), fetal death, outcome of medically assisted reproduction (MAR) and mental well-being. RESULTS Postponement of parenthood is linked to a higher rate of involuntary childlessness and smaller families than desired due to increased infertility and fetal death with higher female and male age. For women, the increased risk of prolonged TTP, infertility, spontaneous abortions, ectopic pregnancies and trisomy 21 starts at around 30 years of age with a more pronounced effects >35 years, whereas the increasing risk of preterm births and stillbirths starts at around 35 years with a more pronounced effect >40 years. Advanced male age has an important but less pronounced effect on infertility and adverse outcomes. MAR treatment cannot overcome the age-related decline in fecundity. CONCLUSIONS In general, women have partners who are several years older than themselves and it is important to focus more on the combined effect of higher female and male age on infertility and reproductive outcome. Increasing public awareness of the impact of advanced female and male age on the reproductive outcome is essential for people to make well-informed decisions on when to start family formation.

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Demographic and medical consequences of the postponement of parenthood

Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss

Objective. To review the findings on quality of life (QOL) and health-related quality of life (HRQOL) among infertile women, men and couples.Design. Systematic review.Methods. Publications between January 1980 and July 2009 in Medline, PsycInfo, Embase and Health and Psychosocial Instruments were compiled using the following inclusion criteria: papers published in peer-reviewed journals; written in English, French, Spanish or Portuguese; presented original findings; assessed quality of life or health-related quality of life as an outcome; included infertile subjects without other clinical conditions; used validated measures.Interventions. None.Main Outcome Measures. Quality of life and health-related quality of life.Results. Fourteen studies were included in the review. Educational level, will to have children, poor marital relationship, previous in-vitro fertilisation attempt and duration of the infertility were predictors of lower mental health scores in infertile men. Women had significant lower scores...

Investigating quality of life and health-related quality of life in infertility: a systematic review

Introduction:Ambulance staff face complex and sometimes stressful or potentially traumaticsituations, not only in disasters but also in theirroutine daily work The aim of this study wasto survey a 

Swedish Ambulance Managers' Descriptions of Crisis Support for Ambulance Staff After Potentially Traumatic Events

One of the main priorities of the child healthcare services in Sweden is a home visit by the Child Health Care (BVC) nurse to newborn babies and their parents. It is essential that the BVC nurses have a comprehensive knowledge of the parent’s need of support and their expectations as new parents in order to be able to fulfill their needs. The aim of this study was to describe what type of support the mothers of infant children are in need of and what their expectations are of the BVC nurse when it is time for the home visit from the nurse. In this qualitative study twelve women were interviewed within one to two weeks after delivering a baby. The transcripts were analyzed using qualitative content analysis. The study shows that mothers who have previously given birth to children feel more secure in their parental role compared to what they experienced as first time mothers. The findings include that first time mother’s experienced uncertainty in their new role as a mother and caring for a baby. Parents seek support from the BVC nurse and they expect her behavior and attitude towards them to be friendly and professional. The fact that she is privy to personal knowledge of the family gives the parents a feeling of security when they contact the child healthcare center for various reasons. The mother’s need for support to develop as a parent and to feel secure in the parental role was a reoccurring theme in the interviews and became the theme of the study.

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Mother’s need of support and their expectations of the BVC nurse at the first home visit—an interview study

Objective: The aim of this paper is to describe the process of developing web information on miscarriage based on scientific evidence, for women and couples in Sweden experiencing miscarriage. Method: A participatory design was used which included researchers, professional experts and users. A participatory design was used involving researchers, professional experts and users. The information was developed in six stages: 1) identifying the needs of information; 2) identifying and constructing the main areas of information and its paths; 3) identifying and inviting experts for revision; 4) developing the text; 5) reviewing the text; 6) design and structuring for adaption to website. Results: The text of information developed gradually based on the seven steps. The final text comprised three parts: 1) what is miscarriage; 2) experiences of miscarriage; 3) processing and planning for new pregnancy. Conclusion: Using participatory design was time and resource consuming, however it was functional for producing appropriate information for the target group. The developed evidence based facts text is assumed to be a complement to the information that is provided by the health care system.

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Miscarriage－Evidence Based Information for the Web and Its Development Procedure

Mental Disorders in Peyronie's Disease: A Swedish Cohort Study of 3.5 Million Men.

Cervical cancer is the second most common type of cancer among women worldwide. In Sweden cervical cancer is the fifteenth most common cancer among women and accounts for 1.9 percent of all female cancers. The Swedish Pap smear screening program is enabling early detection of cell changes in order that treatment may be administered to prevent the development of cancerous cells. There are approximately four hundred and fifty cases of cervical cancer detected each year in Sweden and of these cases, approximately seventy five percent occur in women who do not participate in the screening and testing program. The purpose of this study was to illustrate and examine the reasons why women did not participate in the program even though they had received a notice that they had an appointment for a Pap smear test. In the study fourteen women from a district in the west of Sweden were interviewed. In order to analyse the interviews a qualitative content analysis according to Lundman and Graneheim was used. The analysis resulted in the development of three categories which were identified as communication, treatment and subterfuge (reasons or excuses for not participating). The theme of the study was the professional treatment of the women’s conditions. In the interviews the women emphasize the importance of professional treatment that is administered with respectful and sympathetic care throughout the whole healthcare system regardless of where and when the visit was conducted. Efficient organization and clear communication would minimize the inconvenience for the women during their visit.

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Annsofie Adolfsson

Papers

Swedish Ambulance Managers' Descriptions of Crisis Support for Ambulance Staff After Potentially Traumatic Events

Mother’s need of support and their expectations of the BVC nurse at the first home visit—an interview study

Miscarriage－Evidence Based Information for the Web and Its Development Procedure

Mental Disorders in Peyronie's Disease: A Swedish Cohort Study of 3.5 Million Men.

The reasons why women do not participate in the papsmear screening and testing program in Sweden