The special cervix clinic - abstract

The purpose of this study is to present the cumulation of experience in the organization, co-ordination, and value of a cervix clinic from its inception in 1966 to the end of 1971. The record sheets of the clinic have been reviewed in combination with other records such as cytology smears and in-patient records of the relevant patients. A description of the target the design, techniques and personnel is an essential preliminary to the results. To date more than 400 patients with positive cervical smears have been referred to the clinic for investigation and treatment. About 5 percent of these have had invasive cancer diagnosed at first biopsy. The vast majority, approximately 60 percent have been patients with cervical dysplasia diagnosed at cytology smear. Histologic samples taken as outpatients have confirmed the diagnosis in 45 percent. Outpatient treatment has been accompanied by a returned to normal smears in 40 percent. The remaining 5 percent have been proven to have a more advanced state and have had to be admitted for further investigation and treatment. Of the cases not confirmed and treated, there has been a small percentage in which subsequent smears have been normal. Another percentage fall into the category of spontaneous cures. The remainder, approximately 10 percent out of the original 60 percent, are still under investigation. In an area where invasive cervical cancer is statistically proven and clinically known to be a frequent cause of death, preventive programmes must, if possible, be instituted, The specific preventive programme shown by worldwide experience to be of value is based on cervical cytology. Cytology screening programmes will identify, especially in the early years, large numbers of women with cervical disease ranging from incidental and minor to death-dealing. It is of tremendous importance that provision be made for the further investigation and treatment of these women. The special cervix clinic is currently emerging as the most valuable way of doing this (AU)

Social and psychological factors associated with teenage pregnancy - abstract

At the Queen Elizabeth Hospital in Barbados at least 300 teenage girls have their first baby in her teens. The impact of teenage pregnancy upon the demographic data and also upon the social and economic furture of the girl are indicated. Significant factors associated with the phenomenon are indicated and some steps to avoid it are suggested (AU)

Insertion of lippes loop by nurse-midwives and doctors

Follow-up studies of 7 to 19 months of two groups of 500 women each in Barbados, in one of which a Lippes loop had been inserted by a doctor and in the other by a nurse-midwife, showed a slightly higher incidence of pregnancy and expulsion of the loop in the second group, though the difference was not statistically significant. The insertion of loops by paramedical personnel when this is an economic necessity is thought not to be contraindicated, but adequate training is essential.(AU)

An island-wide screening program for cervical neoplasia in Barbados

In an attempt to develop a cervical cancer screening program applicable to nonindustrialized nations, an island wide project was undertaken in Barbados, West Indies, utilizing paramedical personnel and existing health facilities. Among the first 5,000 women screened, 0.5 percent were found to have invasive carcinoma, 0.8 percent carcinoma in situ, and 4.2 percent dysplasia. The results of this project suggest that directing a screening program at those women who are undergoing a reproductive event is an efficient, effective, and relatively inexpensive method of detecting cervical neoplasia. (AU)

Knowledge and use of birth control in Barbados

Based on material collected in Barbados in 1964, this paper examines knowledge and use of birth control in terms of 3 types of family union - married, common law, and visiting. Analysis of knowledge of birth control is dealt with for the sample at large, for educational attainment, and for the average number of methods known by each woman. The relative importance of the different methods known is also treated by family type and education. The extent to which women in the sample make use of birth control is discussed from 4 aspects. First, the growing use of the different methods among younger-age cohorts is made evident from tabulations of methods-last used. Second, information on the agencies and individuals recommending the use of different contraceptives emphasizes the degree to which the partner's influence is responsible for resort to birth control. Third, the proportions of users in religious groups show that religion is not a barrier to the use of any method. Fourth, the material is treated from the standpoint of age cohorts, since there is, in many cases, a vagueness as to the age at which use began, although women are able to identify the inter-pregnancy period when use began

Population control in Barbados

Barbados, a small island in the Eastern Caribbean, has one of the higest population densities in the world. A family planning service was started in May, 1955, expanded in 1958, and extended further in 1961. An attempt is made to demonstrate the acceptance of the program, and to evaluate its effectiveness on population control. New registrations rose from 662 in 1956 to 2,055 in 1961-1962, while total attendances also increased from 1,656 to 5,574 for the same years. Recent trends in the population growth show that there has been a decline in the birth rate from 33.4 in 1955 to 29.6 in 1962. It seems that a fertility control program operating with limited resources will be most effective if specifically directed toward married and common-law unions (AU)

Bacteriuria, prematurity, and the hypertensive disorders of pregnancy

The occurrance of prematurity and the hypertensive disorders of pregnancy in bacteriuric and in non-bacteriuric women has been compared. In all age and parity groups the occurrance of prematurity and the hypertensive disorders of pregnancy was higher in bacteriurics than in non-bacteriurics. Prevalence rates for the emergence of the hypertensive disorders of pregnancy rose particularly rapidly with increasing age parity in bacteriuric subjects. The predictive value of bacteriuria as an index of subsequent clinical pyelonephritis has been confirmed. The possible implications of these observations are discussed. It is suggested that some of the perinatal mortality and morbidity associated with hypertension and prematurity may be preventable. (Summary)

Population control in Barbados

Since May 1955 an effort has been made in Barbados to control population growth by setting up family planning clinics. New registrations and attendances have increased steadily each year reaching a total of 2,055 new registrations and 5,574 attendances for the year April 1961 to March 1962. An attempt was made to evaluate the effect of this programme on birth rate (AU)

Carcinoma of the uterine cervix: some epidemiological data from a hospital in Jamaica

Epidemiological data collected at the University College Hospital of the West Indies have been examined in an attempt to determine the cause of cervical cancer. The risk of contracting the disease has been demonstrated to be high over a much wider range of ages than in a British population. Some deductions from the observed data lead to the conclusion that the predisposing factor is probably related to childbearing but not necessarily to the first pregnancy (Summary)

Caesarean section for eclampsia

The literature concerning Caesarean section for eclampsia has been reviewed. A small series of cases treated single-handed by an experienced practitioner in an isolated country hospital has been reviewed. The results recorded are encouraging. Some conclusions are drawn, leading to a suggestion that the method be given a further trial. (AU)