Factors associated with consistent contraception and condom use among Maori secondary school students in New Zealand.

AIMS: The aims of this study are to provide a profile of sexual health behaviours of Maori youth and to identify factors associated with consistent condom and contraception use. METHODS: Multivariable analyses were conducted to determine relationships between consistent contraception and condom use among all 2059 sexually active Maori participants in the 2007 New Zealand youth health and well-being survey of secondary school students. RESULTS: Forty per cent of Maori students were currently sexually active; of these, 55.3% always used contraception, and 41.1% always used condoms. Risk factors for not using contraception were less than or equal to three sexual partners (males odds ratio (OR) 0.55, P = 0.04, females OR 0.35, P = 0.04) and regular cigarette use for females (OR 0.52, P = 0.02). Risk factors for not using condoms were 13- to 15-year-old females (OR 1.95, P < 0.01) and females who enjoyed sex (OR 0.52, P = 0.02). Family connection was associated with increased use of condoms among males (OR 1.07, P < 0.01). CONCLUSIONS: Reducing sexual risks, increasing opportunities for healthy youth development and family connectedness, alongside access to appropriate services, are required to improve the sexual health of Maori youth.

Permanent hypopituitarism is rare after structural traumatic brain injury in early childhood.

BACKGROUND: We sought to determine the incidence of permanent hypopituitarism in a potentially high-risk group: young children after structural traumatic brain injury (TBI). METHODS: We conducted a cross-sectional study with longitudinal follow-up. Dynamic tests of pituitary function (GH and ACTH) were performed in all subjects and potential abnormalities critically evaluated. Puberty was clinically staged; baseline thyroid function, prolactin, IGF-I, serum sodium, and osmolality were compared with age-matched data. Diagnosis of GH deficiency was based on an integrated assessment of stimulated GH peak (<5 µg/liter suggestive of deficiency), IGF-I, and growth pattern. ACTH deficiency was diagnosed based on a subnormal response to two serial Synacthen tests (peak cortisol <500 nmol/liter) and a metyrapone test. RESULTS: We studied 198 survivors of structural TBI sustained in early childhood (112 male, age at injury 1.7 ± 1.5 yr) 6.5 ± 3.2 yr after injury. Sixty-four of the injuries (33%) were inflicted and 134 (68%) accidental. Two participants had developed precocious puberty, which is within the expected background population rate. Peak stimulated GH was subnormal in 16 participants (8%), in the context of normal IGF-I and normal growth. Stimulated peak cortisol was low in 17 (8%), but all had normal ACTH function on follow-up. One participant had a transient low serum T(4). Therefore, no cases of hypopituitarism were recorded. CONCLUSION: Permanent hypopituitarism is rare after both inflicted and accidental structural TBI in early childhood. Precocious puberty was the only pituitary hormone abnormality found, but the prevalence did not exceed that of the normal population.