Published: 05/02/2004, Volume II4, No. 5891 Page 29

Overseas pilots 'show supervised injection can work'

Medically supervised injecting centres for drug misusers should be considered in preference to the government's proposed heroin prescription clinics, according to researchers from Leeds Centre for Research in Primary Care. The centres, which allow street drugs to be injected in a clinical environment with resuscitation equipment and nursing staff on hand, have already been piloted in Australia, Germany and the Netherlands. Trained staff offer safer injecting advice and help users to move away from intravenous drug use. The researchers say new research from Australia, which shows those attending such centres are more likely to want treatment for their addiction and adopt less risky injection practices.

BMJ 2004;328:100-102 (www. bmj. com)

Survey gives GPs green light to deputise on Saturday mornings

A group of GPs in Surrey found their patients did not care who delivered their medical services on a Saturday morning. As a result, the doctors employed a deputising service. The survey of 125 patients attending Saturday morning surgeries showed that just over 85 per cent felt they needed urgent attention (the rest were using the surgery for convenience).When asked about alternatives, the most popular choice was a deputising service, the least popular a visit to accident and emergency.

BJGP 2004; 54, 47-49 (www. rcgp. org. uk)

'Ethnicity and sex are key determinants of obesity' claim

Ethnic group and sex, rather than social class, hold the key to obesity prevention, according to an analysis of almost 5,700 children by researchers at the Royal Free and University College London. They found that British Afro-Caribbean and Pakistani girls have an increased risk of being obese, and Indian and Pakistani boys are at increased risk of being overweight, compared to children in the general population.However, there were no significant differences in the prevalence of obese and overweight children from different social classes.

Archives of Disease in Childhood 2004; 89: 30-36 (www. adc. bmjjournals. com)

WHO says BMI cut-off points are wrong for Asian populations

Internationally recognised body mass index cut-off points for determining overweight and obesity may be too high for some Asian populations, according to a World Health Organisation expert committee. The experts said the proportion of Asian people with a high risk of type-2 diabetes and cardiovascular disease is substantial at BMIs lower than the existing WHO cut-off point for overweight. The WHO cut-off is traditionally 25kg/m2 for overweight, 25-29.9 kg/m2 for pre-obese and 30kg/m2 for obese. The cut-off point varied for different Asian populations, from 22kg/m2 to 25kg/m2 and for highrisk from 26kg/m2 to 31 kg/m2. Instead of proposing new cut-off points, the committee identified potential public health action points and gave advice on tailoring guidance to populations.

The Lancet 2004; 363: 157-163 (www. thelancet. com)

American prescribing being influenced by negative publicity

Analysis of prescribing data in the US shows that following publication of research last July about the safety of hormone replacement therapy, prescriptions fell. In January to June 2003, prescriptions for the two most popular brands of HRT in the US fell by 66 per cent and 33 per cent compared to 2002. In another study, US researchers looked at the effect on prescribing of publicity about alpha-blocker doxazosin.

Journal of the American Medical Association 2004; 291: 47-53 and 54-62 (www. jama. ama-assn. org)