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Press releases Saturday 26 February 2005
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(1) IS CAESAREAN SECTION LINKED TO POSTNATAL DEPRESSION?
(2) BRANDING PRACTICES IN RURAL INDIA SHOULD BE BANNED
(3) CONCERNS OVER
THE FUTURE OF CHILDREN'S HEALTH CARE IN BRITISH GENERAL PRACTICE
(1) IS CAESAREAN SECTION LINKED TO POSTNATAL DEPRESSION?
Online First
(Operative delivery and postnatal depression: a cohort study)
http://bmj.bmjjournals.com/cgi/rapidpdf/bmj.38376.603426.D3
Elective caesarean section does not protect women from postnatal depression, according to a study published on bmj.com today. Furthermore, neither emergency caesarean section nor assisted vaginal delivery (use of forceps or vacuum extraction) is associated with an increased risk of postnatal depression.
These findings challenge the theory that women at risk of postnatal depression should be managed differently, and should also help women make informed decisions about childbirth.
Over 14,000 pregnant women completed a questionnaire eight weeks after giving birth to a single infant at full term. Postnatal depression was also assessed using a recognised scale.
There was no evidence that elective caesarean section altered the odds of postnatal depression compared with planned vaginal delivery.
Among planned vaginal deliveries there was similarly little evidence of a difference between women who had an operative delivery and those who had spontaneous vaginal delivery.
There is no reason for women with a history of depression or those at high risk of depression to be managed differently with regard to mode of delivery, say the authors. Even if emergency caesarean section or assisted vaginal delivery is required, women can be reassured that there is no reason to believe that they are more likely to experience postnatal depression.
Contact:
Deirdre Murphy, Professor of Obstetrics
and Gynaecology, Division of Maternal and Child Health Sciences, University
of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland
Email: d.j.murphy@dundee.ac.uk
(2) BRANDING PRACTICES IN RURAL INDIA SHOULD BE BANNED
(Letter: Branding treatment
of children in rural India should be banned)
http://bmj.com/cgi/content/full/330/7489/481
The superstitious practice known as 'branding treatment' in rural India should be banned, urge researchers in this week's BMJ.
Branding or inflicting burns over the body as a remedy for illnesses such as pneumonia, jaundice, and convulsions, is a harmful practice prevalent in rural India. Children and young babies are worst affected by this superstitious practice, which causes serious ill health and delays in seeking proper medical care.
Researchers investigated this practice after noting that many young children attending a rural health centre had scars from branding over their chest.
Off 144 children under 5 years, 20 had been branded for either pneumonia or convulsions, and eight had been branded to protect against pneumonia. All of them belonged to Hindu families, illiterate parents, and families in lower socioeconomic groups.
In-depth interviews with the parents of branded children and villagers revealed that all 28 children had been branded by a native healer in a nearby village.
The people believed that the evil potion comes out through the branding sites, curing the disease. Most of the parents interviewed were also branded in their childhood, and there was a tendency for this practice to be followed through generations.
Inflicting burns over normal children is a non-scientific painful procedure and is unacceptable, say the authors. Stringent laws should be enforced to ban this harmful practice.
Contact:
Bethou Adhisivam, Senior Resident,
Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education
and Research, Pondicherry, India
Email: adhisivam1975@yahoo.co.uk
(3) CONCERNS OVER THE FUTURE OF CHILDREN'S HEALTH CARE IN BRITISH GENERAL PRACTICE
(Editorial: Primary Care
for children in the 21st century)
http://bmj.com/cgi/content/full/330/7489/430
The British model of general practice is rightly admired, but there are several causes for concern regarding the future of children's health care in general practice, argues an editorial in this week's BMJ.
For instance, new out of hours arrangements may encourage parents to bypass primary care and seek emergency care in hospitals, while general practitioners have yet to take on a major role in managing chronic disorders, many of which persist into adult life, writes Professor David Hall.
Health promotion for teenagers is also problematic because of concerns about the privacy and confidentiality offered by their local general practice, despite many practices having sought to reassure young people by establishing special teenage clinics.
He believes that the new contract does not encourage general practitioners to focus on children's care. It offers additional remuneration based on a points system, but child health surveillance gets just six points. In contrast, cervical screening can get 22 points, mental health work 41 points, diabetes 99, and heart disease 121.
This structure may encourage general practitioners to focus on and develop special interests in adult health and chronic disease, he says.
General practice is at a crossroads. To maintain their place as the main providers of health care for children and young people, general practitioners will need appropriate training and remuneration for providing a practice based quality child health service for the 21st century and opportunities to develop special interests in various aspects of child and adolescent health, he concludes.
Contact:
David Hall, Professor of Community
Paediatrics, Institute of General Practice and Primary Care, Northern General
Hospital, Sheffield, UK
Email: d.hall@sheffield.ac.uk
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