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All you need to read in the other general journals

BMJ 2011; 343 doi: (Published 19 October 2011) Cite this as: BMJ 2011;343:d6657

Training package improves response to domestic violence

Primary care services are often the first port of call for women experiencing domestic violence. The response can be patchy, so researchers designed an intensive package of training and support for primary care practices in the UK, in an attempt to improve case finding and encourage referral to advocacy services.

In a cluster randomised controlled trial, practices that received the package referred substantially more women than control practices to local advocacy services (223 v 12 referrals in one year; adjusted rate ratio 22.1, 95% CI 11.5 to 42.4). The package also improved case finding and recording of domestic violence (641 v 236 records of domestic violence in one year; 3.1 (2.2 to 4.3). Twenty four practices in two UK cities were trained. The 24 control practices were promised training at the end of the trial.

Although the training was fairly brief (two sessions of two hours with an expert from the local advocacy service), it was backed up by regular support, a fast track referral pathway, electronic prompts, a practice champion, and regular feedback to the clinical team. The response looks promising, says a linked comment (doi:10.1016/S0140-6736(11)61386-X), although absolute rates of referral remained low—just 0.3% of the 70 000 women in trained practices, and 0.02% of women in control practices.

Did this intervention protect women, reduce violence, or improve health and wellbeing? We don’t yet know, and these questions will be difficult and expensive to answer, says the comment. Local commissioners may reasonably decide not to wait.

Barrett’s oesophagus looks more benign than we thought

OpenUrlCrossRefPubMedWeb of Science

Danish researchers have called for a re-evaluation of surveillance guidelines for adults with Barrett’s oesophagus. A population based study capturing the entire population of Denmark (5.4 million) suggests that only one in 860 adults …

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