BMJ Press Releases, Saturday 24 August 1996
Volume 313 No 7055

EMBARGOED 00.01 HRS 23 AUGUST 1996

BREAST REDUCTION SURGERY SHOULD BE AVAILABLE ON THE NHS

[Should breast reduction surgery be rationed? A comparison of the health status of patients before and after treatment: postal questionnaire survey]

Cosmetic surgery is one of the few areas of health care that have been explicitly rationed in the NHS. But researchers from Oxford argue in this week's BMJ that breast reduction surgery should be available on the NHS because the procedure substantially improves a patient's physical, social and psychological well-being.

A survey of 166 women referred for breast reduction surgery to the former Oxford Regional Health Authority showed that 86 per cent were very satisfied with the result. The most common reason for referral was pain in the back, shoulder or neck which improved greatly following surgery. Women also experienced less discomfort, were more able to engage in sport and other activities and showed other physical improvements after treatment. There was also an improvement in self esteem and psychological well-being.

Contact: Prof. Ray Fitzpatrick

Dept. of Public Health and Primary Care
University of Oxford
Oxford

Tel: 01865 278565
Fax: 01865 278621

INNER CITY AND DEPRIVED AREAS POSE BIGGEST PROBLEM FOR RECRUITMENT OF DOCTORS

[Factors influencing the response to advertisements for general practice vacancies]

The widespread problem in recruiting general practitioners (GPs) is confirmed in a study in this week's BMJ. A survey of 442 practices that had advertised for a partner in the BMJ between January to April 1995 showed that 60 per cent were not very satisfied or very dissatisfied with the number of applications received. Fifteen of the practices received no response at all to their advertisement. Practices in the inner city and deprived areas had the most recruitment problems, getting on average half the number of applicants that practices in more affluent areas received.

Contact: Dr Robin Carlisle

c/o Nottingham University
Dept. of General Practice
Queen Medical Centre
Nottingham NG7 2UH

Tel: c/o Roundwood Surgery 01623 648880
Fax: 01623 631761

LIFETIME SOCIOECONOMIC CIRCUMSTANCES ACCOUNT FOR SOCIAL INEQUALITIES IN HEALTH

[Inequalities in self rated health in the 1958 birth cohort: lifetime social circumstances or social mobility?]

This week's BMJ features a study on inequalities in health which finds that health and social mobility are related. Researchers found young adults with poor health tend to move downwards and men with poor health were less likely to be upwardly mobile. The findings are the latest to come from a national cohort study of all people born in England, Wales and Scotland between 3-9 March 1958 which has reported on data accumulated at birth, and ages 16, 23 and 33.

The authors found that inequalities in health are due mainly to lifetime socioeconomic circumstances rather than to health related social mobility. Although health status influences subsequent social mobility, the numbers of people who are socially mobile because of poor health, especially those moving downward, are too small to influence the overall trends of health in the social class they join. The authors had previously shown that at an earlier age (23) people who were upwardly mobile had better health, while downwardly mobile people had poorer health.

Contact: Dr Chris Power
Senior lecturer in epidemiology and Biostatistics

Institute of Child Health
London WC1N 1EH

Tel: 0171 242 9789 x 2106
Fax: 0171 813 8233
E-mail: vccaclp@cs6400.mcc.ac.uk

STUDY EXAMINES RELATIONSHIP BETWEEN UNEMPLOYMENT AND LEVELS OF PERMANENT SICKNESS

[Relationship between socioeconomic status, employment, and health during the economic change, 1973-93]

There is another paper in this week's issue on the above topic. A copy of the paper is available in advance but the authors are on holiday.

COPING WITH PREGNANCY AFTER DIAGNOSIS OF LETHAL ABNORMALITIES

[Continuing with pregnancy after a diagnosis of lethal abnormality: experience of five couples and recommendations for management]

Many parents faced with the difficult decision of whether to terminate a pregnancy when lethal abnormalities of the fetus are diagnosed will elect for a termination but others will decide to let nature takes its course.

A paper in this week's Education and Debate section of the BMJ emphasises what can be done by the medical profession to ease the distress of parents electing to continue with the pregnancy despite the knowledge that it will not survive. Researchers report on the experiences of five couples who decided against a termination. From their findings the authors make a number of recommendations including the need for special antenatal care facilities for couples in this position and better training programmes for health professionals.

Contact: Dr Lyn Chitty

Fetal Medicine Unit
Obstetric Hospital
University College Hospital
London WC1E 6AU

Tel: 0171 380 9872/9873
Fax: 0171 380 9984

HEPATITIS C VIRUS IS NOT EASILY TRANSMITTED BY SEXUAL CONTACT

[Prevalence and determinants of antibodies to hepatitis C virus and markers for hepatitis B virus infection in patients with HIV infection in Aquitaine]

The hepatitis C virus can be transmitted by blood transfusion but little is known about how else it can be spread. A study in this week's BMJ supports the hypothesis that it is likely to be sexually transmitted much less commonly than either HIV or the hepatitis B virus.

Contact: Prof F Dabis
Professor of epidemiology

Unite INSERM No330
Universite de Bordeaux II
33076 Bordeaux Cedex
France

Tel: 00 33 57571767
00 33 57571436
Fax: 00 33 56991360

Issued on behalf of the authors by: Public Affairs Division, British Medical Association, BMA House, Tavistock Square, London, WC1H 9JP
Telephone: 0171 383 6254, (between 08.30 - 18.00), (After 6pm & at weekends): 01895 239687, 0171 727 2897, 0181 674 6294, 0171 727 2897, 01491 651405

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