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(2) ADVERSE
EVENTS IN HOSPITALS MAY COST NHS £1
BILLION A YEAR
(3) MORE
INFORMATION NEEDED TO IMPROVE
WOMEN'S UNDERSTANDING
OF SMEAR RESULTS
(4) CLIENT
VIOLENCE TOWARDS PROSTITUTES MUST
BE ADDRESSED
(1) MORE AWARENESS
OF AND INVOLVEMENT WITH
TOBACCO MARKETING ENCOURAGES TEENAGE
SMOKING
(Cross sectional study of young people's
awareness of and
involvement with tobacco marketing)
http://bmj.com/cgi/content/full/322/7285/513
Teenagers are aware of, and are participating
in, many forms of
tobacco marketing, and this phenomenon
is consistently
associated with being a smoker, finds
a study in this week's
BMJ. These findings confirm the need for
statutory controls on
tobacco marketing to protect young people.
A random sample of 629 young people aged
15 and 16 years
completed a questionnaire about their
awareness of and
involvement with different types of tobacco
marketing. Around
95% were aware of advertising and all
had seen some form of
advertising at point of sale. Awareness
of and involvement with
tobacco marketing were both significantly
associated with being
a smoker: for example, 30% of smokers
had received free gifts
through coupons in cigarette packs, compared
with 11% of
non-smokers.
When other factors known to be linked with
teenage smoking
were held constant, awareness of coupon
schemes, brand
stretching (the attachment of tobacco
brands to non-tobacco
products) and tobacco marketing in general
were all
independently associated with current
smoking.
This suggests that the current voluntary
regulations designed to
protect young people from smoking are
clearly not working.
Comprehensive statutory regulations, which
outlaw all forms of
tobacco marketing, and are rigorously
monitored and policed,
are required, say the authors.
They conclude: "The findings of the study
clearly show that the
current (voluntary) codes are being easily
circumvented; we
need to ensure that the same thing doesn't
happen when the
Government's new Tobacco Advertising and
Promotion Bill
becomes law."
Contacts:
Lynn MacFadyen, Research Officer or Gerard
Hastings,
Director, Centre for Tobacco Control Research,
University of
Strathclyde, Glasgow, UK
Email: l.macfadyen@csm.market.strath.ac.uk
(2) ADVERSE EVENTS
IN HOSPITALS MAY COST NHS £1
BILLION A YEAR
(Adverse events in British hospitals:
preliminary retrospective
record review)
http://bmj.com/cgi/content/full/322/7285/517
(Editorial: Medical errors: a common
problem?)
http://bmj.com/cgi/content/full/322/7285/501
(Personal View: How the Atlantic
barons learnt teamwork)
http://bmj.com/cgi/content/full/322/7285/563
Ten per cent of patients admitted to British
hospitals experience
an adverse event, about half of which
are preventable,
according to preliminary findings from
a pilot study in this
week's BMJ. These events could cost the
NHS around £1bn a
year in extra bed days alone.
A review of 1,014 medical and nursing records
was carried out
at two acute hospitals in the London area.
In all, 110 (10.8%)
patients experienced an adverse event,
with an overall 11.7%
rate of adverse events when multiple adverse
events were
included. About half of these events were
judged preventable
with ordinary standards of care. A third
of these events led to
moderate or greater disability or death.
Some adverse events are serious and are
traumatic for both
staff and patients. Others are frequent,
minor events that go
unnoticed in routine clinical care and
yet together have massive
economic consequences, explain the authors.
These results
suggest that adverse events are a serious
source of harm to
patients and could cost the NHS around
£1bn a year in 3
million extra bed days, they conclude.
The need to put in place a national system
for recording adverse
events is highlighted by Professor George
Alberti, President of
the Royal College of Physicians in an
accompanying editorial.
"Only then will we really learn and improve
our practice to the
ultimate benefit of the public," he writes.
Finally, in a personal view, David Johnson,
senior route check
captain with British Airways, discusses
how the experience of
the aviation industry can help the NHS
address the problems of
safety.
Contacts:
[Paper]: Charles Vincent, Professor of
Psychology, Clinical
Risk Unit, University College London,
UK.
Email: c.vincent@ucl.ac.uk
[Editorial]: George Alberti, President,
Royal College of
Physicians, London, UK.
(3) MORE INFORMATION
NEEDED TO IMPROVE
WOMEN'S UNDERSTANDING OF SMEAR RESULTS
(Women's understanding of a "normal
smear test result":
experimental questionnaire based
study)
http://bmj.com/cgi/content/full/322/7285/526
Only about half of women understand that
the term "normal
smear result" means there is a low risk
of having or developing
cervical cancer in the next five years,
finds a study in this week's
BMJ. These findings suggest that NHS policy
for reporting
normal smears needs to change.
A total of 1027 women, aged 20-64, were
asked to imagine
that they had received a normal smear
result. The meaning of
this result was then presented using different
combinations of
verbal and numerical explanations.
When informed only that their smear result
was normal, just
52% correctly understood that this entailed
a residual risk of
cervical cancer, compared with 70% given
an additional
statement explaining that a normal test
result means there is a
low risk of cervical cancer. However,
understanding was not
improved further by the use of a numerical
absolute (1 in 5000)
or a relative probability (five times
lower).
In light of these findings, the reporting
of a "normal smear result"
should be accompanied by a sentence stating
that this means a
low risk for having or developing cervical
cancer in the next five
years, say the authors.
They conclude: "Adopting our recommendation
has the potential
to avoid as many as half a million women
a year being falsely
reassured."
Contact:
Theresa Marteau, Professor of Health Psychology,
King's
College London, UK
Email: theresa.marteau@kcl.ac.uk
(4) CLIENT VIOLENCE
TOWARDS PROSTITUTES MUST
BE ADDRESSED
(Violence by clients toward female
prostitutes in different work
settings: questionnaire survey)
http://bmj.com/cgi/content/full/322/7285/524
Half of prostitutes working outdoors and
over a quarter of those
working indoors routinely experience some
form of violence by
clients, according to a study in this
week's BMJ. These levels of
violence need to be addressed and reported
attacks responded
to more effectively, say the authors.
Researchers at Glasgow University contacted
240 female
prostitutes; 115 worked outdoors and 125
worked indoors in
saunas or flats in three British cities.
They found that prostitutes
working outdoors were younger, involved
in prostitution at an
earlier age, reported more illegal drug
use, and experienced
significantly more violence from their
clients than those working
indoors. Only 34% of prostitutes reported
violence by clients to
the police, and this was reported more
often by prostitutes
working outdoors than indoors.
Violence by clients towards prostitutes
has seldom been the
focus of public and academic interest,
yet it is a major health
issue, say the authors. Health services
for prostitutes is an area
that should be urgently addressed if levels
of injury and death
from violence by clients is to be reduced,
they conclude.
Contact:
Dr Marina Barnard, Centre for Drug Misuse
Research,
University of Glasgow, Scotland, UK
Email: M.A.Barnard@socsci.gla.ac.uk
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