Press releases Saturday 12 June 2004
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) NO EVIDENCE FOR “TOO POSH TO PUSH” ARGUMENT
(2) STIGMA ATTACHED TO LUNG CANCER CAN
HAVE FAR REACHING CONSEQUENCES
(3) HOME BLOOD
PRESSURE MONITORING IMPROVES CONTROL
(4) MRI SCANS COULD BE ‘ACCEPTABLE ALTERNATIVE’
TO TRADITIONAL BONE SCANS
(1) NO EVIDENCE FOR “TOO POSH TO PUSH” ARGUMENT
(Dr Foster’s case notes: Social
class and elective caesareans in the English NHS)
http://bmj.com/cgi/content/full/328/7453/1399
There is no evidence to support the “too posh to push” argument, according to an analysis of NHS hospital data by Dr Foster in this week’s BMJ.
Over the past two decades, the rising rate of caesarean section delivery has led to concern that many caesareans are unnecessary. Some experts have blamed the rising rate on wealthy women requesting caesareans to avoid pain and problems associated with natural delivery – thus the phrase “too posh to push.”
Researchers examined NHS hospital episode statistics data from 2001-2 and determined the social and economic status of mothers, based on place of residence.
They found that women living in the poorest areas of England were significantly less likely to have an elective caesarean, but otherwise increasing affluence was not associated with having an elective caesarean.
These figures did not include births in private hospitals but, as there are only three private maternity hospitals in England, the relatively small numbers of deliveries involved is unlikely to affect the results, say the authors.
“Our results suggest that it is not so much a case of “too posh to push” within the NHS; it may be more a case of “too proletarian for a caesarean,” they conclude.
Contact:
Ellen Klaus, Dr Foster Ltd, London,
UK
Email: ellen.klaus@drfoster.co.uk
*Dr Foster is an independent organisation that analyses the availability and quality of health care in the United Kingdom and worldwide (www.drfoster.com)
(2) STIGMA ATTACHED TO LUNG CANCER CAN HAVE FAR REACHING
CONSEQUENCES
(Stigma, shame, and blame
experienced by patients with lung cancer: qualitative study)
http://bmj.bmjjournals.com/cgi/reprint/bmj.38111.639734.7C
The stigma attached to patients with lung cancer can have serious consequences on people’s lives, finds new research on bmj.com. Anti-smoking campaigns can often add to this stigma by reinforcing the view that patients are to blame for their disease.
Researchers in Oxford interviewed 45 patients with lung cancer for DIPEx (Personal Experiences of Health and Illness) www.dipex.org
Whether they smoked or not, patients with lung cancer felt particularly stigmatised because the disease is so strongly associated with smoking and because some patients die in an unpleasant way.
Interaction with family, friends, and doctors was often affected as a result, and many patients, particularly those who had stopped smoking years ago or had never smoked, felt unjustly blamed for their illness. One said: “people automatically think you’ve brought it on yourself and it’s a sort of stigma.”
Some patients concealed their illness, which sometimes had serious consequences, such as deterring patients from seeking all the help they needed. Some criticised the media for adding to the stigma, while others maintained that the real culprits were tobacco companies with unscrupulous policies.
A few patients were worried that treatment and research into lung cancer might be adversely affected by the stigma attached to the disease and those who smoke.
Efforts to help people to quit smoking are important, say the authors, but there is a dilemma for anti-smoking campaigns and for clinicians who take seriously their responsibility to deter people from smoking and to encourage smokers to stop.
Those who produce images of “dirty lungs” rightly aim to put young people off tobacco, but such images can upset people with smoking related illness. In contrast, publicity about the Machiavellian role of the global tobacco industry may resonate with young people while avoiding further victim blaming of those with lung cancer and other smoking related diseases, they conclude.
Contact:
Alison Chapple, Senior Research Fellow,
DIPEx Research Group, Department of Primary Health Care, University of Oxford,
UK
Email: alison.chapple@dphpc.ox.ac.uk
(3) HOME BLOOD PRESSURE MONITORING IMPROVES CONTROL
(Blood pressure control by
home monitoring: meta-analysis of randomised trials)
http://bmj.bmjjournals.com/cgi/reprint/bmj.38121.684410.AE
Patients with high blood pressure (hypertension) who monitor their blood pressure at home have better control of their condition, according to a new study available on bmj.com and being presented at the European Society of Hypertension in Paris on 16th June.
Researchers analysed 18 blood pressure monitoring studies involving nearly 3000 people with hypertension. A total of 1359 monitored their blood pressure at home, while 1355 had their blood pressure monitored in the healthcare system.
They found that blood pressure was lower in people who had home blood pressure monitoring than in those who were seen in the healthcare system. A greater proportion of them also achieved blood pressure targets when assessed in the clinic.
Although the reasons for this are not clear, blood pressure monitoring by patients at home is associated with better blood pressure values and improved control of hypertension than usual blood pressure monitoring in the healthcare system, say the authors.
As home blood pressure monitoring is now feasible, acceptable to patients and generally reliable, it could help to involve patients more closely in the management of their own blood pressure and help to manage their hypertension more effectively, they conclude.
Contact:
Francesco Cappuccio, Professor of
Clinical Epidemiology and Primary Care, Department of Community Health Sciences,
St George’s Hospital Medical School, London, UK
Email: f.cappuccio@sghms.ac.uk
(4) MRI SCANS COULD BE ‘ACCEPTABLE ALTERNATIVE’ TO
TRADITIONAL BONE SCANS
(Editorial: Whole body magnetic
resonance imaging)
http://bmj.com/cgi/content/full/328/7453/1387
Magnetic resonance imaging (MRI) could be set to replace traditional bone scans and autopsies, according to an editorial in this week’s BMJ.
Increasing awareness of the hazards of radiation and a worldwide fall in autopsies has prompted a search for a minimally invasive alternative, and MRI provides high quality, three-dimensional images of the inside of the body without using x-rays or other radiation.
Whole body MRI is a valuable addition to clinical examination, say authors Stephen Eustace and Erik Nelson of the National Orthopaedic Hospital in Dublin. It not only improves detection of cancers, it is effective in assessing a corpse, and is useful for body composition research.
The advent of molecular imaging is likely to herald many new scanning applications for whole body sequences, they conclude.
Contact:
Stephen Eustace, Consultant, Department
of Radiology, National Orthopaedic Hospital, Dublin, Ireland
Email: seustace@iol.ie
FOR ACCREDITED JOURNALISTS
Embargoed press releases and articles are available from:
Public Affairs DivisionBMA HouseTavistock
SquareLondon WC1H 9JR
(contact: pressoffice@bma.org.uk)
and from:
the EurekAlert website, run by the American Association for theAdvancement of Science(http://www.eurekalert.org)