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(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
(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
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs Division
BMA House
Tavistock Square
London WC1H 9JR
(contact: pressoffice@bma.org.uk)
and from:
the EurekAlert website, run by the American Association for the
Advancement of Science
(http://www.eurekalert.org)