Press Releases Saturday 12 June 1999
No 7198 Volume 318
Please remember to credit the BMJ as source when publicising
an
article and to tell your readers that they can read its full text on
the
journal's web site (http://www.bmj.com).
If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).
(1) NO LINK
BETWEEN ORAL CONTRACEPTIVES AND
MYOCARDIAL INFARCTION
(2) HEALTH
SERVICES AND LOCAL AUTHORITIES CAN WORK
TOGETHER
TO HELP PREVENT PLAYGROUND INJURIES
(3) PATIENT
COMPLAINTS MAY BE HARMFUL TO GPs'
HEALTH AND PRACTICE
(1) NO LINK BETWEEN
ORAL CONTRACEPTIVES AND
MYOCARDIAL INFARCTION
(Oral contraceptives and myocardial
infarction: results of the MICA
case-control study)
http://www.bmj.com/cgi/content/full/318/7198/1579
(Commentary: Oral contraceptives
and myocardial infarction:
reassuring new findings)
http://www.bmj.com/cgi/content/full/318/7198/1579#resp1
There is no significantly increased risk
of myocardial infarction (heart
attack) in women who use oral contraceptives,
say researchers in this
week's BMJ. The team led by Dr Nicholas
Dunn from the Drug
Safety Research Unit in Southampton studied
2176 aged between 16
and 44 years of whom 448 had experienced
a myocardial infarction.
Of these women 87 per cent had not been
taking any oral
contraceptives but 88 per cent had one
or more known cardiovascular
risk factors. The authors also found that
there was no evidence of a
difference between second and third generation
oral contraceptives on
the risk of myocardial infarction. The
authors conclude that myocardial
infarction is rare in this age group but
that if young women wish to
preserve cardiovascular health, they should
above all else be advised
to stop smoking.
Contact:
Dr Nicholas Dunn, Senior Research Fellow,
Drug Safety Research
Unit, Bursledon Hall, Southampton
Email: ndunn{at}drsu.u-net.com
Professor RD Mann, Director, Drug Safety
Research Unit,
Southampton.
Email: drmann{at}dsru.u-net.com
Professor jvind Lidegaard, Assistant Professor,
Department of
Obstetrics and Gynaecology, Herlev Hospital,
University of
Copenhagen, Denmark
Email: lidcgaard{at}dadlnet.dk
(2) HEALTH SERVICES
AND LOCAL AUTHORITIES CAN WORK
TOGETHER TO HELP PREVENT PLAYGROUND INJURIES
(Preventing injuries in public playgrounds
through partnership between
health services and local authority:
community intervention study)
http://www.bmj.com/cgi/content/full/318/7198/1595
One way of improving safety in children's
playgrounds is for health
services and local authorities to form
a partnership in the surveillance
of injuries and the making of improvements
to facilities, say
researchers from Cardiff. Writing in this
week's BMJ Professor Jo
Sibert and colleagues from the University
of Wales College of
Medicine, Cardiff County Council and the
University Hospital of
Wales report the outcome of such an initiative
undertaken in Cardiff.
Professor Sibert and his team identified
injuries in public playgrounds
from accident and emergency departments
in the local area. They
then liaised with the local council which
made several changes to its
largest playgrounds, in light of the injuries
sustained. Changes included
increasing the depth of bark in the play
area and replacing "monkey
bars" (overhead horizontal ladders) with
a rope climbing frame.
Injuries in playgrounds where changes had
been made fell from 53 in
the 18 months before changes to 21 in
the 18 months after. There was
only a small fall from 35 to 28 in control
playgrounds. The authors
conclude that such a partnership is simple
to apply, does not need
expensive resources and could be introduced
widely to help reduce
playground injuries.
Contact:
Professor Jo Sibert, Professor of Community
Health, Department of
Child Health, University of Wales College
of Medicine, Academic
Centre, Llandough Hospital, Penarth, Vale
of Glamorgan
Email: sibert{at}cardiff.ac.uk
(3) PATIENT COMPLAINTS
MAY BE HARMFUL TO GPs'
HEALTH AND PRACTICE
(General practitioners' experiences
of patients' complaints:
qualitative study)
http://www.bmj.com/cgi/content/full/318/7198/1596
(Learning from complaints about general
practitioners)
http://www.bmj.com/cgi/content/full/318/7198/1567
General practitioners (GPs) find patients'
complaints stressful and the
increase in their number is leading to
more defensive clinical practice,
say researchers in this week's BMJ. Dr
Ashok Jain and Dr Jane
Ogden from Kings College, London report
the findings of their
qualitative study of 30 GPS from South
East London who had had
complaints made against them.
They found that the doctors they studied
experienced feelings of
shock, panic and a sense of being out
of control followed by anger,
depression and even suicide. Some began
to doubt their own clinical
competence and experienced conflicts with
their families and
colleagues, say the authors. This led
to many doctors practicing
defensively and for others it meant planning
to leave general practice.
Jain and Ogden conclude that the initial
impact of a complaint and the
conflicts arising are distressing for
GPs, with the resolution often being
unsatisfactory. They say that research
indicates that many GPs
experience psychological problems such
as burnout, depression and
marital breakdowns and that support structures
should be put in place
to help GPs when they experience such
problems.
Also see linked editorial by Dr Richard Baker.
Contact:
Dr Jane Ogden, Senior Lecturer in Health
Psychology, Department of
General Practice, Guy's, Kings and St
Thomas's Medical Schools,
Kings College, London
Email: jane.ogden{at}kcl.ac.uk
Dr Ashok Jain, General Practitioner, Department
of General Practice,
Guy's, Kings and St Thomas's Medical Schools,
Kings College,
London
Dr Richard Baker, Director, Clinical Governance
Resaerch and
Development Unit, Department of General
Practice and Primary
Health Care, University of Leicester,
Leicester
Email: rb14{at}le.ac.uk
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