Sexual behaviours and their associated factors among young people in the Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana

Objective: This paper describes sexual behaviours and their associated factors among young people. Design: The study design is cross-sectional. Setting: Dodowa Health and Demographic Surveillance Site (DHDSS) in Ghana's Shai-Osudoku and Ningo Prampram districts. Participants: Young people aged 10 to 24 years, median age 17 years. Outcome measures: Self-reported to have ever had sex, non-use of a condom at last sex, and ever been pregnant or gotten someone pregnant. Results: Of the 1689 young people; 42% reported having ever had sex, not using a condom at last sexual activity (64%), and ever been pregnant or gotten someone pregnant (41%). The proportion of non-use of condoms at last sex was high across all age groups but was highest (93%) in a small proportion of 10 to 14-year-olds who have ever had sex. Higher proportions of females than males; were reported to have ever had sex (46%), not using a condom at their last sex (66%) and ever been pregnant or getting someone pregnant (56%). Age group (20 to 24), females, primary or junior high school, living alone and lower household socio-economic status were risk factors associated with all three outcome measures. Conclusion: Risky sexual behaviour is high among young people in the Dodowa HDSS. Therefore, interventions that promote safer sexual practices and help young people make timely decisions on their sexual and reproductive health care needs are required.

Beyond Broca's area: why undergraduate neuroscience education matters

: Patients with psychiatric illness often present a unique challenge to medical students: in contrast to some medical conditions, in which patients may seem to be stricken by a disease, patients with certain psychiatric illnesses may seem complicit with the illness. Questions of free will, choice, and the role of the physician can quickly become overwhelming. This may result in students feeling helpless, disinterested, or even resentful. Here we argue that integrating a modern neuroscience perspective into medical education allows students to conceptualize psychiatric patients in a way that promotes empathy and enhances patient care. Specifically, a strong grasp of neuroscience prevents the future physician from falling into dualistic thinking in which the psychosocial aspects of a patient's presentation are considered beyond the realm of medicine. The value of incorporating neuroscience into a full, biopsychosocial formulation is demonstrated with the case example of a "difficult patient."