Releases Saturday 12 October 2002
No 7368 Volume 325
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(1) LARGER BLOOD RESERVES NEEDED FOR
AGEING POPULATION
(2) CHILDHOOD
CIRCUMSTANCES LINKED TO
HEALTH IN LATER
LIFE
(3) CHILD
HEALTH PROFESSIONALS STILL BELIEVE
IN "TEETHING"
(4) SUPPLY
OF MEDICAL STUDENTS MAY NOT
MEET FUTURE
DEMAND
(1) LARGER BLOOD
RESERVES NEEDED FOR
AGEING POPULATION
(Where does blood go? Prospective
observational study
of red cell transfusion in north
England)
http://bmj.com/cgi/content/full/325/7368/803
Larger reserves of blood will be needed
as the population
ages, predict researchers in this week's
BMJ.
They recorded the use of nearly 10,000
units of red blood
cells from all NHS hospital blood banks
in the north of
England. More than half (52%) of all units
were given to
medical patients, 41% to surgical patients,
and 6% to
obstetric and gynaecology patients.
Demand for blood transfusion increases
with age. The
average age of a patient receiving an
individual unit of
blood in this study was 63 years.
Using these figures of current patterns
of red cell use and
applying them to future population predictions,
the authors
calculate that regional demand will increase
by 2% in 2003
and 5% in 2008.
Such data are vital to help in planning
effective and efficient
use of the available blood supply, say
the authors.
Especially as the introduction of donor
testing for variant
Creutzfeldt-Jakob disease could have a
major impact on
the numbers of blood donors, with estimates
that up to
50% of active donors could be lost.
Small increases in the number of elderly
people will have
large effects on demand, add the authors.
Efforts to reduce
red cell use will need to be directed
at medical as well as
surgical patients, they conclude.
Contact:
Jonathan Wallis, Consultant Haematologist,
Newcastle
upon Tyne Hospitals NHS Trust, Freeman
Road Hospital,
Newcastle upon Tyne, UK
Email: jonathan.wallis{at}tfh.nuth.northy.nhs.uk
(2) CHILDHOOD
CIRCUMSTANCES LINKED TO
HEALTH IN LATER LIFE
(Socioeconomic position in childhood
and adulthood and
insulin resistance: cross sectional
survey using data from
British women's heart and health
study)
http://bmj.com/cgi/content/full/325/7368/805
Poor social circumstances in adulthood
have been known
for some time to increase heart disease
risk but less
attention has been paid to earlier life
circumstances. A
study in this week's BMJ finds that adverse
social
circumstances in childhood, as well as
adulthood, are
strongly associated with increased risk
of insulin resistance,
and other heart disease risk factors.
Most people know that the hormone insulin
is important
for health. But the commonest type of
diabetes (type 2
diabetes), which affects about 4% of the
British public,
occurs because these people are resistant
to the action of
insulin.
Researchers at the University of Bristol
investigated the
associations between social class in childhood
and
adulthood and insulin resistance in over
4,000 women
aged 60-79 years.
They found that belonging to a manual social
class in
childhood and in adulthood was associated
with increased
insulin resistance, dyslipidaemia, and
obesity. The
association between childhood social class
and insulin
resistance was stronger than that between
adult social
class and insulin resistance.
Women who were in manual social classes
as children
were still at increased risk of insulin
resistance and other
risk factors as adults even if they had
moved up into
non-manual social classes as adults. Childhood
factors
such as poor nutrition are the most likely
reasons for these
findings.
The results support the idea that poor
social circumstances
in childhood lead to insulin resistance,
with these risk
factors tracking through childhood resulting
in increased
risk of cardiovascular disease in later
life.
These findings highlight the importance
of a life course
approach to the prevention of cardiovascular
disease and
reducing socioeconomic inequalities in
cardiovascular
disease, they conclude.
Contact:
Debbie Lawlor, MRC Research Training Fellow,
Department of Social Medicine, University
of Bristol,
Bristol, UK
Email: d.a.lawlor{at}bristol.ac.uk
(3) CHILD HEALTH
PROFESSIONALS STILL BELIEVE
IN "TEETHING"
(Teething symptoms: cross sectional
survey of five groups
of child health professionals)
http://bmj.com/cgi/content/full/325/7368/814
Health professionals still attribute many
major ills to infant
teething, despite good evidence that teething
is associated
with, at most, minor and relatively infrequent
symptoms,
finds a study in this week's BMJ. These
beliefs may even
lead to late diagnosis of important illnesses.
Researchers in Australia surveyed representative
samples
of the five groups of professionals most
closely concerned
with the health of children (paediatricians,
dentists,
pharmacists, nurses, and general practitioners).
In every professional group most thought
that at least some
infants or young children suffer symptoms.
Paediatricians
attributed an average of 2.8 symptoms
to teething and
nurses an average of 9.8.
Paracetamol and teething gels were widely
recommended
by all groups, and 41% pharmacists recommended
sedating medication.
These beliefs may prevent professionals
from effectively
managing some of the common developmental
issues of
infancy and might lead to late diagnosis
of important
illnesses. They also illustrate how great
the distance may
be between research evidence and professional
practice,
say the authors.
They conclude: will these beliefs alter,
now that we know
how innocuous teething is?
Contact:
Melissa Wake, Director of Research and
Public Health,
Centre for Community Child Health, Royal
Children's
Hospital, Victoria, Australia Tel (secretary):
+61 3 9345
5761 Email: wakem@cryptic.rch.unimelb.edu.au
(4) SUPPLY OF
MEDICAL STUDENTS MAY NOT
MEET FUTURE DEMAND
(Medical school applications�a critical
situation)
http://bmj.com/cgi/content/full/325/7368/786
The supply of medical students may not
meet the demands
of medical school expansion in the United
Kingdom,
according to an editorial in this week's
BMJ.
Figures from the Universities and Colleges
Admissions
Service show that the number of applicants
for each place
at medical school (the selection ratio)
fell from 2.11 in
1995 to 1.55 in 2000. Yet medical education
in the United
Kingdom is currently expanding. Five new
medical schools
will have opened by 2005.
The worry is that, if in 2005 the number
of applicants is the
same as in 2000, then the selection ratio
will be a mere
1.18, supply barely meeting demand, writes
Chris
McManus, Professor of Psychology and Medical
Education at University College London.
Over 40% of 17 year olds now apply to university.
Although that large pool of university
applicants may seem
the place to find more applicants, few
have the right
qualifications.
The problem for medical schools could be
alleviated by
accepting students with lower A level
grades, yet evidence
shows that A levels predict performance
in basic medical
science examinations, finals, and longer
term in
postgraduate membership and fellowship
exams, says the
author.
Medicine undoubtedly has a problem. The
massive
university expansion in the United Kingdom
has not been
accompanied by more science students in
schools, and the
increasingly urgent solution for that
will have to come from
the Department for Education and Skills,
he concludes.
Contact:
Chris McManus, Professor of Psychology
and Medical
Education at University College London,
UK
Email: i.mcmanus{at}ucl.ac.uk
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