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Indian medical journals
1655
replace the 11that exist in south-east England. A joint Royal Free/National Hospital for Neurology and Neurosurgery centre is proposed. The Royal London, Guy’s, Charing Cross or the Hammersmith, and Atkinson Morley’s Hospitals should be the other London-based tertiary centres. Atkinson Morley’s Hospital, however, is likely to be subject to further review in 3 years. 5 tertiary centres for renal services are proposed in London, each of which should include a transplantation service and have a university component. The recommended sites are: Guy’s/St Thomas’s, Royal London, UCH/Middlesex, the Hammersmith (with links to Charing Cross and maintenance of some services at St Mary’s), and St George’s. In addition, 5-7 autonomous tertiary centres should be based in District General Hospitals in counties around London. should not have transplantation or university provision. Plastic surgery and bums services should be centred at the Royal Free, the Royal London, Guy’s/St Thomas’s, St George’s, Charing Cross, and Mount Vernon Hospitals. Specialist services for children (cardiac, neurosciences, nephrology, oncology, and plastics) should each be available in 2 centres (perhaps 3 for neurosciences). The Hospitals for Sick Children (which should link with UCH/Middlesex and Royal Free paediatric services) is recommended as a centre that could offer the full range of tertiary services. Guy’s/St Thomas’s Hospital could become the second major centre, although it faces competition from the Royal Brompton/Chelsea and Westminster for the provision of paediatric cardiac services, and from St George’s linked to the Royal Marsden (Sutton) for cancer services. These
centres
Astrid James 1.
Specialty reviews. 1993. Availabile from Health Publication Unit, Manchester Road, Heywood, Lancaster OL10 2P2, UK. 2. Department of Health. Making London better. 1993. Pp 27. Available from Health Publication Unit, Manchester Road, Heywood, Lancaster OL10 2P2, UK. 3. Report of the inquiry into London’s health services, medical education, and research. London: HM Stationery Office, 1992.
Money for family planning Control of population growth is important for economic and social progress in developing countries but whether the world’s population will reach two, three, or four times its present size before it stabilises will depend very much on the rate of fertility decline in this decade, says a report from Population Action International.1 Surveys indicate that at least 125 million married couples who want family planning do not have satisfactory access to contraceptive information and supplies. Such estimates of unmet demand, the report points out, do not adequately incorporate the growing numbers of sexually active youths or those discouraged from family planning by poor quality of services. At a United Nations sponsored meeting in Amsterdam in 1989 the international community agreed that industrialised countries should allocate 4% of overall foreign aid to population programmes, but in 1991 the average amount given for population assistance was only slightly more than 1 %. Of the twenty countries that were members of the Development Assistance Committee (DAC) of the OECD by 1991, only Norway allocated 4% of economic assistance to population programmes in 1989-91. Finland and the USA reached the high 2% range and Sweden just 2%. Denmark, the Netherlands, Canada, and the UK allocated 1-2%, while Germany, Switzerland, and Japan allocated 0-5-1%. Despite their large aid programmes, France and Italy allocated only 004 and 006%, respectively, to population assistance. The report describes in detail each DAC country’s policy and performance for population assistance. Japan, for instance, has political support for such assistance, but the report points out that the body implementing bilateral aid programmes has been criticised for tying aid too closely to Japanese commercial interests, such as its high-technology products. France recognises its poor performance in population assistance and is said to be developing a new programme, which, however, is expected to focus on public education and demographic research and training rather than family planning assistance. The report calls on donor countries to make a commitment to increase sharply their contributions to make universal access to
family planning achievable in the year 2000. It estimates that if total development assistance were to double in this decade, as it did between 1977 and 1987, the 4% target for donor countries remains adequate for population assistance.
Vivien Choo 1.
Conly SR, Speidel JJ. Global population assistance. A report card on the major donor countries. Washington: Population Action International (1120 19th Street, NW, Suite 550, Washington DC 20036). 1993. Pp 52. $8.
Indian medical journals The future of medical journals in India may well be grim, if discussions at a seminar on improving them, held at the All India Institute of Medical Sciences in New Delhi, are anything to go by. A panel of experts did a spot assessment of 10 Indian medical journals and found only one, The National Medical Journal of India (NMJI), to be of international standard. Concern about the dismal state of medical publishing in India has been voiced before (see Lancet 1992 339: 1589-91). Seminar participants accused international journals of attracting all the best papers from Indian authors and said that the resulting "paper drain" (besides the brain drain, of course) deprives Indian medical journals of material that is rightfully theirs. Dr Richard Smith, editor of the British Medical Journal, disagrees. He pointed out that the best papers should indeed go to international journals because it is good both for the author and for international medical literature. He suggested that to get around the problem, duplicate publication of such papers should be allowed in national journals, with a clear statement of where it was originally published. Dr Samiran Nundy, editor of the NMJI, however, says that if such papers are on topics relevant to, say India, they should originally be submitted to Indian rather than international journals. The NMJI offers Rs 1000 go25) to all accepted papers and a token honorarium to reviewers-"a policy which has been criticised widely", says Nundy. There are other reasons why Indian authors prefer to publish abroad. In job applications, more weight is given to publications in international journals. Until recently, there was an unwritten rule in some universities that a PhD candidate would get their doctorate only after their having been published in international scientific journals. While the perils of ’publish or perish’ have yet to perturb Indian authors, seminar participants also voiced concern about the fact that out of the 350 000 practitioners of western medicine in the country today, only 4% read journals. Dr K. Satyanarayana, an expert on Indian medical journals, argues that this is because journals contain little of practical use and interest for the general practitioners. Perhaps the recent inclusion of doctors in the Consumer Protection Act and the resulting litigations will force doctors in India to read medical journals regularly to keep themselves updated, the seminar participants remarked jokingly.
Bhupesh Mangla
Religious leaders and
health
promotion
An assessment by the Thai Ministry of Public Health, of the efforts of a Buddhist abbot to discourage smoking, indicates the value of the contribution that religious leaders can make to health-promotion activities (MMWR 1993; 42: 367-69). The proportion of persons who had stopped smoking for over a year was higher (p=0-01) in the abbot’s village (25-5%) than in a neighbouring village (16-6%). And in his village his efforts were more commonly cited as an important reason for stopping smoking (80-3%) than were those of health-care workers (72-1%) or family members (62-3%).
In
England then
For many years The Lancet has leavened its readers’ diet of innovation and excellence with diversions under the occasionalheading of "In England Now". It will do so no longer. But contributors will soon have a niche, and readers a heading to seek, in "Diverticulum", a regular monthly page for entertainments not solely from England, but world wide.
replace the 11that exist in south-east England. A joint Royal Free/National Hospital for Neurology and Neurosurgery centre is proposed. The Royal London, Guy’s, Charing Cross or the Hammersmith, and Atkinson Morley’s Hospitals should be the other London-based tertiary centres. Atkinson Morley’s Hospital, however, is likely to be subject to further review in 3 years. 5 tertiary centres for renal services are proposed in London, each of which should include a transplantation service and have a university component. The recommended sites are: Guy’s/St Thomas’s, Royal London, UCH/Middlesex, the Hammersmith (with links to Charing Cross and maintenance of some services at St Mary’s), and St George’s. In addition, 5-7 autonomous tertiary centres should be based in District General Hospitals in counties around London. should not have transplantation or university provision. Plastic surgery and bums services should be centred at the Royal Free, the Royal London, Guy’s/St Thomas’s, St George’s, Charing Cross, and Mount Vernon Hospitals. Specialist services for children (cardiac, neurosciences, nephrology, oncology, and plastics) should each be available in 2 centres (perhaps 3 for neurosciences). The Hospitals for Sick Children (which should link with UCH/Middlesex and Royal Free paediatric services) is recommended as a centre that could offer the full range of tertiary services. Guy’s/St Thomas’s Hospital could become the second major centre, although it faces competition from the Royal Brompton/Chelsea and Westminster for the provision of paediatric cardiac services, and from St George’s linked to the Royal Marsden (Sutton) for cancer services. These
centres
Astrid James 1.
Specialty reviews. 1993. Availabile from Health Publication Unit, Manchester Road, Heywood, Lancaster OL10 2P2, UK. 2. Department of Health. Making London better. 1993. Pp 27. Available from Health Publication Unit, Manchester Road, Heywood, Lancaster OL10 2P2, UK. 3. Report of the inquiry into London’s health services, medical education, and research. London: HM Stationery Office, 1992.
Money for family planning Control of population growth is important for economic and social progress in developing countries but whether the world’s population will reach two, three, or four times its present size before it stabilises will depend very much on the rate of fertility decline in this decade, says a report from Population Action International.1 Surveys indicate that at least 125 million married couples who want family planning do not have satisfactory access to contraceptive information and supplies. Such estimates of unmet demand, the report points out, do not adequately incorporate the growing numbers of sexually active youths or those discouraged from family planning by poor quality of services. At a United Nations sponsored meeting in Amsterdam in 1989 the international community agreed that industrialised countries should allocate 4% of overall foreign aid to population programmes, but in 1991 the average amount given for population assistance was only slightly more than 1 %. Of the twenty countries that were members of the Development Assistance Committee (DAC) of the OECD by 1991, only Norway allocated 4% of economic assistance to population programmes in 1989-91. Finland and the USA reached the high 2% range and Sweden just 2%. Denmark, the Netherlands, Canada, and the UK allocated 1-2%, while Germany, Switzerland, and Japan allocated 0-5-1%. Despite their large aid programmes, France and Italy allocated only 004 and 006%, respectively, to population assistance. The report describes in detail each DAC country’s policy and performance for population assistance. Japan, for instance, has political support for such assistance, but the report points out that the body implementing bilateral aid programmes has been criticised for tying aid too closely to Japanese commercial interests, such as its high-technology products. France recognises its poor performance in population assistance and is said to be developing a new programme, which, however, is expected to focus on public education and demographic research and training rather than family planning assistance. The report calls on donor countries to make a commitment to increase sharply their contributions to make universal access to
family planning achievable in the year 2000. It estimates that if total development assistance were to double in this decade, as it did between 1977 and 1987, the 4% target for donor countries remains adequate for population assistance.
Vivien Choo 1.
Conly SR, Speidel JJ. Global population assistance. A report card on the major donor countries. Washington: Population Action International (1120 19th Street, NW, Suite 550, Washington DC 20036). 1993. Pp 52. $8.
Indian medical journals The future of medical journals in India may well be grim, if discussions at a seminar on improving them, held at the All India Institute of Medical Sciences in New Delhi, are anything to go by. A panel of experts did a spot assessment of 10 Indian medical journals and found only one, The National Medical Journal of India (NMJI), to be of international standard. Concern about the dismal state of medical publishing in India has been voiced before (see Lancet 1992 339: 1589-91). Seminar participants accused international journals of attracting all the best papers from Indian authors and said that the resulting "paper drain" (besides the brain drain, of course) deprives Indian medical journals of material that is rightfully theirs. Dr Richard Smith, editor of the British Medical Journal, disagrees. He pointed out that the best papers should indeed go to international journals because it is good both for the author and for international medical literature. He suggested that to get around the problem, duplicate publication of such papers should be allowed in national journals, with a clear statement of where it was originally published. Dr Samiran Nundy, editor of the NMJI, however, says that if such papers are on topics relevant to, say India, they should originally be submitted to Indian rather than international journals. The NMJI offers Rs 1000 go25) to all accepted papers and a token honorarium to reviewers-"a policy which has been criticised widely", says Nundy. There are other reasons why Indian authors prefer to publish abroad. In job applications, more weight is given to publications in international journals. Until recently, there was an unwritten rule in some universities that a PhD candidate would get their doctorate only after their having been published in international scientific journals. While the perils of ’publish or perish’ have yet to perturb Indian authors, seminar participants also voiced concern about the fact that out of the 350 000 practitioners of western medicine in the country today, only 4% read journals. Dr K. Satyanarayana, an expert on Indian medical journals, argues that this is because journals contain little of practical use and interest for the general practitioners. Perhaps the recent inclusion of doctors in the Consumer Protection Act and the resulting litigations will force doctors in India to read medical journals regularly to keep themselves updated, the seminar participants remarked jokingly.
Bhupesh Mangla
Religious leaders and
health
promotion
An assessment by the Thai Ministry of Public Health, of the efforts of a Buddhist abbot to discourage smoking, indicates the value of the contribution that religious leaders can make to health-promotion activities (MMWR 1993; 42: 367-69). The proportion of persons who had stopped smoking for over a year was higher (p=0-01) in the abbot’s village (25-5%) than in a neighbouring village (16-6%). And in his village his efforts were more commonly cited as an important reason for stopping smoking (80-3%) than were those of health-care workers (72-1%) or family members (62-3%).
In
England then
For many years The Lancet has leavened its readers’ diet of innovation and excellence with diversions under the occasionalheading of "In England Now". It will do so no longer. But contributors will soon have a niche, and readers a heading to seek, in "Diverticulum", a regular monthly page for entertainments not solely from England, but world wide.