BackgroundData from the first two National Surveys of Sexual Attitudes and Lifestyles, carried out in 1990–1991 (Natsal-1) and 1999–2001 (Natsal-2), have been extensively used to inform sexual health policy in Britain over the past two decades. Natsal-3 was carried out from September 2010 to August 2012 in order to provide up-to-date measures of sexual lifestyles and to extend the scope of the previous studies by including an older age group (up to 74 years), an extended range of topics and biological measures.MethodsWe describe the methods used in Natsal-3, which surveyed the general population in Britain aged 16–74 years (with oversampling of younger adults aged 16–34 years).ResultsOverall, 15 162 interviews were completed, with a response rate of 57.7% and a cooperation rate of 65.8%. The response rate for the boost sample of ages 16–34 years was 64.8%, only marginally lower than the 65.4% achieved for Natsal-2, which surveyed a similar age range (16–44). The data were weighted by age, gender and region to reduce possible bias. Comparisons with census data show the weighted sample to provide good representation on a range of respondent characteristics. The interview involved a combination of face-to-face and self-completion components, both carried out on computer. Urine samples from 4550 sexually-experienced participants aged 16–44 years were tested for a range of STIs. Saliva samples from 4128 participants aged 18–74 years were tested for testosterone.ConclusionsNatsal-3 provides a high quality dataset that can be used to examine trends in sexual attitudes and behaviours over the past 20 years.

The use of virtual reality (VR) in the training of operative dentistry is a recent innovation and little research has been published on its efficacy compared to conventional training methods. Two groups of dental students, with no experience in operative dentistry, were trained solely by either VR or conventional training in the preparation of conventional class 1 cavities. The subjects all used the same operative armamentarium and phantom heads, and were allocated the same duration of practice periods. At the completion of these training periods, both groups produced two class 1 cavities on the lower left first molar, which were subsequently coded and blindly scored for the traditional assessment criteria of outline form, retention form, smoothness, cavity depth and cavity margin angulation. An ordinal score of 0-3 or 0-4 was assigned for each assessment criterion: the higher the score, the worse the evaluation. After initial independent scoring, the two examiners discussed any notable differences until an agreed score was reached. Once the codes were broken, non-parametric analyses were performed on the data. Wilcoxon Tests for the semiquantitative scores indicated significant differences between the VR and conventional training groups for outline form, depth and smoothness but not for retention or cavity margin angulation at P < 0.05 level, with the VR group receiving the higher, i.e. worse, scores. Cavity margin angulation approached significance with a P-value of 0.0536. The results indicated that VR-based skills acquisition is unsuitable for use as the sole method of feedback and evaluation for novice students.

The use of virtual reality (VR) in the training of operative dentistry is a recent innovation and little research has been published on its efficacy compared to conventional training methods. To evaluate possible benefits, junior undergraduate dental students were randomly assigned to one of three groups: group 1 as taught by conventional means only; group 2 as trained by conventional means combined with VR repetition and reinforcement (with access to a human instructor for operative advice); and group 3 as trained by conventional means combined with VR repetition and reinforcement, but without instructor evaluation/advice, which was only supplied via the VR-associated software. At the end of the research period, all groups executed two class 1 preparations that were evaluated blindly by 'expert' trainers, under traditional criteria (outline, retention, smoothness, depth, wall angulation and cavity margin index). Analyses of resulting scores indicated a lack of significant differences between the three groups except for scores for the category of 'outline form', for group 2, which produced significantly lower (i.e. better) scores than the conventionally trained group. A statistical comparison between scores from two 'expert' examiners indicated lack of agreement, despite identical written and visual criteria being used for evaluation by both. Both examiners, however, generally showed similar trends in evaluation. An anonymous questionnaire suggested that students recognized the benefits of VR training (e.g. ready access to assessment, error identification and how they can be corrected), but the majority felt that it would not replace conventional training methods (95%), although participants recognized the potential for development of VR systems in dentistry. The most common reasons cited for the preference of conventional training were excessive critical feedback (55%), lack of personal contact (50%) and technical hardware difficulties (20%) associated with VR-based training.

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SummaryObjective To examine ethnic and social inequalities in women's experience of maternity care in England.Design A 2007 national survey of women (16 years or over) about their experience of maternity care. Multiple logistic regression analysis, controlling for several maternal characteristics, was used to examine inequalities by ethnicity, partner status and education.Setting Sample of records of 149 NHS acute trusts and two primary care trusts (PCTs) providing maternity services in England.Results A total of 26,325 women responded to the survey (response rate 59%). Ethnic minority women were more likely than White British women to access services late, not have a scan by 20 weeks, and experience complications during pregnancy and birth. They were more likely to initiate breastfeeding and say they were treated with respect and dignity. Single women responded more negatively to almost all questions than women with a husband/partner. They were less likely to access care within 12 weeks of pregnancy (OR 0.45, 95% CI 0.39-0.52), have a scan at 20 weeks (OR 0.49, 95% CI 0.39-0.63), attend NHS antenatal classes (OR 0.56, 95% CI 0.49-0.65), have a postnatal check-up (OR 0.67, 95% CI 0.60-0.75), and initiate breastfeeding (OR 0.57, 95% CI 0.51-0.62), and were more likely to experience complications. Women completing education at 19+ years were more likely to access services early (OR 1.21, 95% CI 1.04-1.40), attend antenatal classes (OR 1.48, 95% CI 1.31-1.67), have a postnatal check-up (OR 1.19, 95% CI 1.07-1.32) and initiate breastfeeding (OR 3.88, 95% CI 3.56-4.22) than those completing education at 16 years or younger, and were less likely to experience complications.Conclusions Ethnic minority women, single mothers, and those with an earlier age at completing education access maternity services late, have poorer outcomes, and report poorer experiences across some -though not alldimensions of maternity care. Ethnic differences were absent or inconsistent between groups for some aspects of care. We recommend these findings are used by commissioners, trusts and healthcare professionals to inform improvements in maternity services for high-risk groups and reduce inequalities.

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