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Press releases Saturday 6 November 2004
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(1) PROBLEM GAMBLING IS A SERIOUS HEALTH ISSUE
(2) IT'S TIME TO ALLOW PEOPLE TO DIE AT HOME WITH DIGNITY
(3) BRITAIN SHOULD
ADOPT UNIVERSAL HEPATITIS B IMMUNISATION
(1) PROBLEM GAMBLING IS A SERIOUS HEALTH ISSUE
(Editorial: Betting your
life on it)
http://bmj.com/cgi/content/full/329/7474/1055
Problem gambling is a health issue that needs to be taken seriously by all within the medical profession, argues a researcher in this week's BMJ.
The United Kingdom is just about to undergo one of the most radical changes of gambling legislation in its history. The new gambling bill will provide the British public with increased opportunities and access to gambling like they have never seen before.
The health and social costs of problem gambling are large on both an individual and societal level and can include extreme moodiness, depression, absenteeism from work, family neglect, and bankruptcy, writes Professor Mark Griffiths of Nottingham Trent University. In Australia, Canada, and New Zealand, problem gambling has increased as a result of liberalisation.
There are also other worrying trends relating to problem gambling. A US study found that a woman whose partner was a problem gambler was 10 times more likely to be a victim of violence from her partner than partners of a non-problem gambler. Another report in 2003 found that child abuse and domestic assaults rose by 42% and 80% respectively with the opening of casinos in South Dakota.
Pathological gambling is very much the "hidden" addiction., says the author. General practitioners routinely ask patients about smoking and drinking but gambling is something that is not generally discussed.
Yet gambling is without doubt a health issue and there is an urgent need to enhance awareness within the medical and health professions about gambling-related problems and to develop effective strategies to prevent and treat problem gambling.
Inevitably, a small minority of people will become casualties of gambling in the United Kingdom, and therefore help should be provided for the problem gamblers, he concludes.
Contact:
Mark Griffiths, Professor of Gambling
Studies, International Gaming Research Unit, Nottingham Trent University,
Nottingham, UK
Email: mark.griffiths@ntu.ac.uk
(2) IT'S TIME TO ALLOW PEOPLE TO DIE AT HOME WITH DIGNITY
(Editorial: Developing primary
palliative care)
http://bmj.com/cgi/content/full/329/7474/1056
People with terminal conditions should be able to die at home with dignity, say researchers in this week's BMJ.
Although 65% of people with cancer want to die at home, only about 30% are successful in doing so. A government committed to choice for patients must improve this figure, write palliative care experts from Edinburgh University.
Developing palliative care services in primary care is essential for realising the expectations of dying people. Primary care professionals have the potential and ability to provide end of life care for most patients, given adequate training and resources. However, until recently, few comprehensive workforce initiatives have been undertaken in primary care that focus on end of life care.
Furthermore, the new general medical services contract has not prioritised palliative care. These changes will greatly affect care for dying people and may increase the number of hospital admissions, they add.
However, one important initiative is gaining momentum within primary care. The Gold Standards Framework is a resource for organising proactive palliative care in the community. It includes a detailed guide to providing holistic, patient centred care and thereby facilitates effective care in the community.
Every person with a progressive illness has a right to palliative care, say the authors. General practitioners and community nurses are trusted by patients and are in a position to provide effective, equitable, and accessible palliative care. This will happen only if they have adequate time and resources and work in a system that encourages such care.
Patients who receive holistic support in the community may be less likely to require expensive admission to hospital and often futile treatments at the end of their lives, they conclude.
Contacts:
Kirsty Boyd, Consultant, Primary
Palliative Care Research Group, Division of Community Health Sciences, University
of Edinburgh, Scotland
Email: kirsty.boyd@ed.ac.uk
Aziz Sheikh, Professor of Primary
Care Research & Development, Division of Community Health Sciences: GP
Section, University of Edinburgh, Scotland
Email: aziz.sheikh@ed.ac.uk
(3) BRITAIN SHOULD ADOPT UNIVERSAL HEPATITIS B IMMUNISATION
(Editorial: Hepatitis B infections)
http://bmj.com/cgi/content/full/329/7474/1059
(Clinical review: Preventing
and treating hepatitis B infection)
http://bmj.com/cgi/content/full/329/7474/1080
z
Britain should adopt universal hepatitis B immunisation, says a senior doctor in this week's BMJ.
The United Kingdom is one of the few developed countries that have not implemented universal immunisation. Because the burden of hepatitis B was low and individual rights were considered paramount, a policy of selective immunisation of high-risk groups, such as health care workers, homosexual men, and drug addicts, has been followed.
However, this approach has failed to provide adequate coverage in Britain and should be replaced by universal immunisation, writes Nicholas Beeching of the Royal Liverpool University Hospital.
The hepatitis B virus causes up to a million deaths worldwide every year. In the United Kingdom, 4,500 acute hepatitis B virus infections, 7,500 new cases of chronic infection, and up to 430 cases of hepatitis B related liver cancer are thought to occur, with estimated NHS costs of up to £375m.
The availability of effective and safe vaccines makes primary prevention of hepatitis B an attractive strategy. Universal immunisation has been adopted by over 150 countries, with evidence of effectiveness lasting more than 10 years in preventing infection, carriage, and liver cancer.
In light of this evidence, it is time that Britain's policy was reviewed, he concludes.
Contact:
Nicholas Beeching, Clinical Lead
and Senior Lecturer, Tropical and Infectious Disease Unit, Royal Liverpool
University Hospital, Liverpool, UK
Email: nicholas.beeching@rlbuht.nhs.uk
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