Releases Saturday 22 March 2003
No 7390 Volume 326
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(1) CONCERN OVER EXPANDING WAISTLINES OF
BRITISH YOUTH
(2) NEW
DOCTORS FEEL DEMORALISED BY
MEDIA CRITICISM
(3) SURVEY
HIGHLIGHTS EXTENT OF NHS
DOCTOR-MANAGER
DIVIDE
(4) INHALED
ASTHMA DRUGS MORE EFFECTIVE
THAN ORAL THERAPY
(1) CONCERN OVER
EXPANDING WAISTLINES OF
BRITISH YOUTH
(Central overweight and obesity in
British youth aged
11-16 years: cross sectional surveys
of waist
circumference)
http://bmj.com/cgi/content/full/326/7390/624
Waist circumference in young people has
risen more
steeply over the past 10-20 years than
body mass index,
particularly in girls. This is a cause
for concern because a
large waist circumference is linked to
a greater risk of
disorders such as diabetes and high cholesterol,
finds a
study in this week's BMJ.
Researchers obtained data for height, weight,
and waist
circumference, collected from surveys
of young people
over the past 10-20 years in Britain.
They selected data
on 4,560 young people aged 11-16 years
for analysis.
Measures of waist circumference increased
sharply over
the period between surveys, particularly
in girls. In 1997,
28% of boys and 38% of girls were defined
as
overweight by (against 9% for both sexes
in 1977-87)
and 14% of boys and 17% of girls were
defined as
obese (3% in 1977-87).
Increases in body mass index were smaller
and similar in
both sexes. In 1997, 21% of boys and 17%
of girls
were defined as overweight (against 8%
and 6% in
1977-87) and 10% of boys and 8% of girls
were
defined as obese (3% and 2% in 1977-87).
These findings suggest that the accumulation
of central
body fat has risen more steeply than whole
body fatness
based on weight and height, say the authors.
Body mass
index has therefore systematically underestimated
the
prevalence of obesity in young people.
Increases in waist circumference on current
and future
illness in young people should be a cause
for concern,
they conclude.
Contact:
David McCarthy, Senior Lecturer, Department
of Health
and Human Sciences, London Metropolitan
University,
London, UK
Email: d.mccarthy{at}londonmet.ac.uk
(2) NEW DOCTORS
FEEL DEMORALISED BY
MEDIA CRITICISM
(Media criticism of doctors: review
of UK junior
doctors' concerns raised in surveys)
http://bmj.com/cgi/content/full/326/7390/629
Some newly qualified doctors feel demoralised
by
criticism of the profession in the news
media, to the
extent that some think that medicine is
now held in low
esteem in the UK, finds a study in this
week's BMJ.
Researchers at the University of Oxford
sent
questionnaires to all junior doctors who
qualified from
any UK medical school in 1999 and 2000,
seeking
views about their work. They compared
the doctors'
responses with those from junior doctors
obtained in
previous surveys in the mid-1990s. Comments
about the
portrayal of doctors in the news media
emerged as a
new theme among the doctors who qualified
in 1999 and
2000.
Typical comments showed that these respondents
felt
demoralised or undermined by criticism
of doctors in the
media. One wrote, "I often feel very guilty
being a
doctor, or sometimes ashamed, as we have
such a bad
press." Another said, "It's particularly
difficult now that
doctors are being witch-hunted by the
UK press."
Some commented that such criticism was
making them
doubt whether they wished to continue
in medicine. One
doctor was, "Considering working abroad
because of
current "doctor bashing" in the media."
Another said, "I
would consider leaving medicine if current
anti-doctor
media worsens."
A few emphasised that they would not be
put off, saying
"I will stay in medicine, despite all
the doctor bashing in
the press, I am still proud to be part
of the profession."
Although the numbers were small, it would
be a pity if
these sentiments were becoming common
among young
doctors right at the start of their careers,
say the authors.
Moreover, if school students considering
a medical
career are similarly affected by adverse
media comment,
some may change their minds.
Although professions cannot expect to avoid
criticism, it
is clear that criticism considered to
be unfair has a real,
damaging effect on the morale of some
doctors, they
conclude.
Contact:
Michael Goldacre, Director, UK Medical
Careers
Research Group, Department of Public Health,
University of Oxford, Oxford, UK
Email: michael.goldacre{at}dphpc.ox.ac.uk
(3) SURVEY HIGHLIGHTS
EXTENT OF NHS
DOCTOR-MANAGER DIVIDE
(Views of doctors and managers on
the doctor-manager
relationship in the NHS)
http://bmj.com/cgi/content/full/326/7390/626
Doctors and managers differ widely in their
views about
the state of doctor-manager relationships
in the NHS,
with chief executives being the most optimistic
and
clinical directors the least, finds a
study in this week's
BMJ.
A total of 1,092 NHS doctors and managers
responded
to a survey about their views on the doctor-manager
relationship.
Three quarters of chief executives rated
the quality of
current doctor-manager relationships as
4 or more on a
scale of 1 (poor) to 5 (excellent), compared
with just
37% of clinical directors. Furthermore,
78% of chief
executives thought that doctor-manager
relationships
would improve over the next year, compared
with just
28% of clinical directors.
Clinical directors often seemed to have
views markedly
divergent from�and much less positive
than�the views
held across the other three groups. For
instance, they
were less likely than each of the other
groups to agree
that "management staff in this hospital
are consistently of
high quality," that "managers are well
versed in clinical
activity," and that "doctors have sufficient
influence on
hospital management."
The only statement that received near unanimous
approval from clinical director (90%)
was "medical staff
in this hospital are consistently of high
quality."
Clinical directors were easily the most
disaffected, with
many holding negative opinions about managers'
capabilities, the respective balance of
power and
influence between managers and clinicians,
and the
prospects for improved relations, say
the authors.
Unless such divergence is addressed, further
difficulties
in delivery of the government's ambitious
agenda for
modernisation are likely, they conclude.
Contact:
Huw Davies, Professor of Health Care Policy
and
Management, Centre for Public Policy and
Management,
University of St Andrews, Fife, Scotland
Email: hd{at}st-and.ac.uk
(4) INHALED ASTHMA
DRUGS MORE EFFECTIVE
THAN ORAL THERAPY
(Inhaled glucocorticoids versus leukotriene
receptor
antagonists as single agent asthma
treatment: systematic
review of current evidence)
http://bmj.com/cgi/content/full/326/7390/621
Inhaled glucocorticoid drugs are more effective
than the
newer anti-leukotriene tablets for adults
with mild or
moderate asthma, concludes a study in
this week's BMJ.
Professor Francine Ducharme reviewed 13
trials
comparing leukotriene receptor antagonists
with low
doses of inhaled glucocorticoids for 28
days or more in
children and adults.
She found that adults treated with leukotriene
receptor
antagonists were 60% more likely to suffer
worsening of
symptoms, whereas those treated with inhaled
glucocorticoids experienced fewer night
awakenings and
fewer days with symptoms.
Risk of side effects was no different between
groups, but
leukotriene receptor antagonists were
associated with a
2.5-fold increase risk of withdrawal because
of poor
asthma control.
There was insufficient evidence to draw
conclusions
about effectiveness in children.
Contact:
Professor Francine Ducharme, Montreal Children's
Hospital, McGill University Health Centre,
Montreal,
Quebec, Canada
Email: Francine.ducharme{at}mcgill.ca
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