Releases Saturday 21 April 2001
No 7292 Volume 322

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(1)  EARLY GROWTH INFLUENCES RISK OF HEART
DISEASE IN LATER LIFE

(2)  HOSPITAL WARDS FOR ADOLESCENTS SHOULD BE
CONSIDERED

(3)  ANAEMIA STILL COMMON AMONG SOUTH ASIAN
AND CHINESE WOMEN IN THE UK

(4)  PATIENT CARE WILL SUFFER UNDER
GOVERNMENT'S PRIVATE FUNDING SCHEMES
 



 
(1)  EARLY GROWTH INFLUENCES RISK OF HEART
DISEASE IN LATER LIFE

(Early growth and coronary heart disease in later life: longitudinal
study)
http://bmj.com/cgi/content/full/322/7292/949

A study in this week's BMJ reports a strong association between
infant and childhood growth and the development of coronary
heart disease in later life. These findings suggest that
improvements in early growth could lead to substantial
reductions in the incidence of the disease.

The research team examined the infant and childhood growth of
357 men who were either admitted to hospital with coronary
heart disease or who died of the disease. All belonged to a
group of 4630 men, born in the Helsinki University Hospital
during 1934-44, whose growth was measured serially from birth
to age 12 years.

They found that, irrespective of body size at birth, low weight
gain in infancy was associated with increased risk of coronary
heart disease. In addition, after age 1 year, rapid weight gain was
associated with further increase in risk, but only among boys
who were thin at birth. The adverse effects of this association is
apparent at age 3 years in these boys, add the authors.

Despite some inevitable limitations, these findings are consistent
with other studies and add to the evidence that protection of
early growth is a key area in strategies for the prevention of
coronary heart disease. Further benefit will come from
preventing rapid weight gain after infancy, in boys who were thin
at birth, conclude the authors.

Contacts:

J G Eriksson, Senior Researcher, National Public Health
Institute, Helsinki, Finland
Email: johan.eriksson@ktl.fi

DJP Barker, Director, MRC Environmental Epidemiology Unit,
University of Southampton, Southampton, UK
Email: sld@mrc.soton.ac.uk
 

(2)  HOSPITAL WARDS FOR ADOLESCENTS SHOULD BE
CONSIDERED

(National survey of use of hospital beds by adolescents aged 12
to 19 in the United Kingdom)
http://bmj.com/cgi/content/full/322/7292/957

(Editorial: Do we need specialist adolescent units in hospital?)
http://bmj.com/cgi/content/full/322/7292/941

Enough 12 to 19 year-olds are admitted to British hospitals to
justify separate hospital facilities specifically for adolescents,
argues Russell Viner, Consultant in Adolescent Medicine at
University College London, in this week's BMJ.

By examining the numbers of hospital bed days of inpatients and
day case patients aged 12 to 19 years in 37 health authorities
and boards across Britain, he found that the use of hospital beds
increases rather than decreases through adolescence. This
contradicts the assumption that adolescents use hospitals rarely
and do not merit separate facilities.

Although dedicated wards for adolescents may not be possible
in many hospitals, says the author, the provision of other facilities
should be considered, he concludes.

This view is reiterated by adolescent health experts, Aidan
Macfarlane and Robert Blum, in an accompanying editorial.
They write, "even where the numbers do not justify a separate
ward for adolescents, a multidisciplinary approach from health
professionals with interest and expertise in adolescent health is
still feasible in every hospital."

Contacts:

[Paper]: Russell Viner, Consultant in Adolescent Medicine,
Department of Medicine, UCL Hospitals & UCL Medical
School, London, UK
Email:  R.Viner@ich.ucl.ac.uk

[Editorial]: Aidan Macfarlane, Consultant in strategic planning of
child and adolescent services, Oxford, UK
Email: Aidanmacfa@aol.com
 

(3)  ANAEMIA STILL COMMON AMONG SOUTH ASIAN
AND CHINESE WOMEN IN THE UK

(Anaemia in Chinese, South Asian, and European populations in
Newcastle upon Tyne: cross sectional study)
http://bmj.com/cgi/content/full/322/7292/958

Lack of awareness of the link between anaemia and diet may
partly explain why anaemia remains more common among
women of South Asian and Chinese ethnic origin in the United
Kingdom than in women of European ethnic origin, suggests a
study in this week's BMJ.

Researchers at the University of Newcastle assessed the
prevalence of anaemia in South Asian (Indian, Pakistani, and
Bangladeshi) and Chinese ethnic groups, using data from the
Newcastle heart project. The prevalence of anaemia was similar
among men of all ethnic groups. However, anaemia was three
times more prevalent in South Asian women than in European
women and twice as prevalent in Chinese women than in
European women.

The team also found that anaemia tended to be more common in
those who rarely or never ate meat. Interestingly, 87% of British
Indians described themselves as vegetarians in a recent survey,
add the authors.

Awareness of the link between anaemia and diet may be low,
say the authors. In a national lifestyle survey, less than 1% of
respondents mentioned anaemia as a problem related to diet.

Contact:

Raj Bhopal, Professor of Public Health, Department of Public
Health Sciences, University of Edinburgh, Scotland
Email: Raj.Bhopal@ed.ac.uk
 

(4)  PATIENT CARE WILL SUFFER UNDER
GOVERNMENT'S PRIVATE FUNDING SCHEMES

(How private finance is moving primary care into corporate
ownership)
http://bmj.com/cgi/content/full/322/7292/960

(Will primary care trusts lead to US-style health care?)
http://bmj.com/cgi/content/full/322/7292/964

The introduction of public-private partnerships is changing the
way in which primary care in the United Kingdom is financed.
Two papers in this week's BMJ examine the implications of
these changes and ask whether the government can safeguard
the goals and principles of the NHS when healthcare is provided
on a purely commercial basis.

Using private finance to fund capital investment will present
important new cost pressures, argue the authors. They report
that by 2007, NHS trusts will have to find £4.5bn from annual
revenue allocations to service their private finance debts and
capital charges. This, they say, will be at the expense of clinical
services and patient care, unless there is a commensurate level of
funding.

Furthermore, implementation of the Health and Social Care Bill -
which will allow the private sector to operate and run clinical and
social care services on behalf of the state - will force trusts to
find ways of constraining expenditure through rationing, user
charges and commercial activities. More patients are likely to
find themselves paying for elements of care that they once
received free under the NHS, say the authors.

If the principles of the NHS are to be upheld, the Health and
Social Care Bill must be amended to abolish charges for
personal care and prevent privatisation of clinical services and
staff, they conclude.

Contact:

Professor Allyson Pollock, School of Public Health Policy,
University College London, London, UK
Email: allyson.pollock@ucl.ac.uk
 


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