Releases Saturday 8 November 2003
No 7423 Volume 327

Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on the
journal's web site (http://bmj.com).

If your story is posted on a website please include a link back to
the source BMJ article (URL's are given under titles).


(1) 1 IN 3 INJECTIONS GIVEN IN DEVELOPING
COUNTRIES IS UNSAFE

(2) TRAINING GPS TO MANAGE OBESITY DOES
NOT AFFECT WEIGHT LOSS

(3) ADDRESSING MEDICAL STUDENTS AS
'STUDENT DOCTORS' MAY HELP QUELL
PATIENT FEARS

(4) AIDS EPIDEMIC SHOULD BE TREATED AS A
DISASTER



(1) 1 IN 3 INJECTIONS GIVEN IN DEVELOPING
COUNTRIES IS UNSAFE

(Use of injections in healthcare settings worldwide,
2000: literature review and regional estimates)
http://bmj.com/cgi/content/full/327/7423/1075

Overuse of injections and unsafe practices are still
common in developing and transitional countries, find
researchers in this week's BMJ.

They reviewed published studies and unpublished
reports to describe the frequency and safety of injection
practices in 14 regions of the world.

They found that up to 75% of injections were given with
reused, unsterilised equipment. Reuse was highest in the
South East Asia region, the Middle East, and the
Western Pacific region.

An urgent need exists to reduce the overuse of injections
and promote injection safety to prevent unnecessary
infections, conclude the authors.

Contact:

Yvan Hutin, Medical Officer, Department of Blood
Safety and Clinical Technology, World Health
Organization, Geneva, Switzerland
Email: hutiny@who.int

(2) TRAINING GPS TO MANAGE OBESITY DOES
NOT AFFECT WEIGHT LOSS

(Improving management of obesity in primary care:
cluster randomised trial)
http://bmj.com/cgi/content/full/327/7423/1085

The usefulness of providing training in obesity
management to general practice teams is questioned by
researchers in this week's BMJ.

Moore and colleagues evaluated the impact of a training
programme intended to improve the management of
obesity. The study involved 44 general practices (22
completed the training and 22 acted as controls) and
843 obese adult patients. Control practices were asked
to provide usual care to their patients.

After 12 months, there was no difference in weight
between those patients attending trained practices and
controls.

Implementation of obesity management was low and did
not achieve improved patient weight loss, say the
authors. Other strategies to manage obesity in primary
care urgently need to be considered and evaluated.
These might include motivated and dedicated obesity
specialists, use of leisure services, and use of the
commercial weight loss sector.

Contact:

Helen Moore, Director of Yorkshire Primary Care
Research Network, Centre for Research in Primary
Care, University of Leeds, UK
Email: h.moore@leeds.ac.uk

(3) ADDRESSING MEDICAL STUDENTS AS
'STUDENT DOCTORS' MAY HELP QUELL
PATIENT FEARS

(Letter: Switch to title of student or trainee doctor may
be helpful)
http://bmj.com/cgi/content/full/327/7423/1110

Simple semantics may help quell patient's fears about
taking part in medical education, according to a letter to
this week's BMJ.

Surprisingly, patients tend to accept a trainee's presence
in a consultation if they are addressed as student doctor
or trainee doctor, as opposed to medical student, writes
Dr Hany George El-Sayeh. This may be because of
fears about being seen by a scruffy, disinterested youth
who may well later report their intimacies in the bar.

He also recommends introducing a "donor card" system
in education, whereby patients attending clinics are
warned in advance of a trainee's potential presence, and
the onus is put on them to opt out of the process.
Currently patients are usually asked (rather
embarrassingly) in clinics if they mind a trainee being
present.

Trainees themselves could counter stereotypes by
making a greater effort to appear interested, smart, and
punctual ± all in line with their new "student doctor"
status, he concludes.

Contact:

Hany George El-Sayeh, Specialist Registrar, Psychiatry,
Leeds Mental Health Teaching NHS Trust, Leeds, UK
Email: hanyelsayeh@doctors.org.uk

(4) AIDS EPIDEMIC SHOULD BE TREATED AS A
DISASTER

(Reframing HIV and AIDS)
http://bmj.com/cgi/content/full/327/7423/1101

In September, the World Health Organization (WHO)
declared the HIV/AIDS epidemic a global health
emergency requiring a rapid scaled-up treatment
response, but researchers in this week's BMJ argue that
governments should go one step further and treat it as a
disaster.

In fact, governments should be encouraged and
rewarded for adopting a disaster response to HIV and
AIDS, they say.

Declaring a state of emergency in a country plagued by
HIV and AIDS could speed up the response. It would
overcome barriers to co-operation and facilitate access
to cheaper drugs. Resources could also be better
co-ordinated, eliminating duplication and ensuring
everyone is working to the same goal.

However, declaring a state of emergency forces the
government to publicly admit that their country is in a
vulnerable condition, which may lead to strained
international trade ties, add the authors.

"We hope, however, that our suggestions will provide a
basis for generating new thinking and a better
co-ordinated, more effective and timely response to the
mounting HIV/AIDS crisis," they conclude.

Contact:

Shevin Jacob, Medical Student, Oregon Health and
Science University, School of Medicine, Portland,
Oregon, USA
Email: sjacob@post.harvard.edu


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)