Press Releases Saturday 9 October 1999
No 7215 Volume 319

Please remember to credit the BMJ as source when publicising an
article and to tell your readers that they can read its full text on the
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the source BMJ article (URL's are given under titles).

(1)IS A ONE CHILD POLICY WORLDWIDE THE
SOLUTION TO HUMAN POPULATION GROWTH?

(2)ENGINEERING PITS BENEATH LONDON
UNDERGROUND TRACKS ARE HELPING TO SAVE
LIVES

(3)EXPECTANT MOTHERS SHOULD KNOW THAT MOST
MIDWIVES WOULD AIM FOR A VAGINAL BIRTH
RATHER THAN A CAESAREAN


 

(1)IS A ONE CHILD POLICY WORLDWIDE THE
SOLUTION TO HUMAN POPULATION GROWTH?

(The two wisdoms: contrasting views on human population
growth)
http://www.bmj.com/cgi/content/full/319/7215/931

(The US Department of Sate is policing the population policy
lockstep)
http://www.bmj.com/cgi/content/full/319/7215/998

This week's BMJ is a theme issue devoted to debating the
implications of an ever growing world population, which is set to
break the six billion mark on 12 October. Commentators
advocate two opposing views on what the future will hold for
demographics. Some deny that the population increase is a
cause for alarm, say Professor Anthony McMichael and
Professor John Guillebaud in their editorial. This line of thinking
argues that, among other things, education, particularly among
women, combined with economic development will bring fertility
levels down; there will be increased agricultural productivity,
boosted by genetically modified foods and global warming will
be adapted to.

The opposing view, they say, is based on the belief that the
population problem needs to be brought under control with
interventionary measures. It is not so confident in science's ability
to double grain production sustainably. It argues that fertility will
not reduce fast enough and some argue that for a transitional
period there must even be a "one child" policy worldwide. It also
advocates that if the developing world is to constrain its fertility
then the developed world must moderate its resource
consumption.

This second view is shared by Dr Maurice King from the
University of Leeds who also argues controversially that the US
Department of State is deliberately supressing dialogue about the
demographic implications of population growth in a bid not to
have to reduce US resource consumption.

King writes in his "education and debate" article that to tackle
the world population problem demographers and the United
Nations must confront the taboo of demographic entrapment
(where a population exceeds its environment, physically and
economically). He also believes that the world's population
should not be left to sort itself out, but instead that there needs to
be intervention.

Contact:

Professor John Guillebaud, Medical Director, Margaret
Pyke Family Planning Centre, London
Email: j.guillebaud{at}lineone.net
Dr Maurice King, Honorary Research
Fellow, University of Leeds, Leeds
Email: mhking{at}iprolink.ch

Other material in this week's BMJ linked to the population issue
includes:-

(Impediments to effective fertility reduction)
http://www.bmj.com/cgi/content/full/319/7215/932

(The population policy pendulum)
http://www.bmj.com/cgi/content/full/319/7215/933

(Human numbers, environment, sustainability and health)
http://www.bmj.com/cgi/content/full/319/7215/977

(World population and health in transition)
http://www.bmj.com/cgi/content/full/319/7215/981

(Paths to lower fertility)
http://www.bmj.com/cgi/content/full/319/7215/985

(Prospects for feeding the world)
http://www.bmj.com/cgi/content/full/319/7215/988

(China's one child family policy)
http://www.bmj.com/cgi/content/full/319/7215/992

(India: looking ahead to one and a half billion people)
http://www.bmj.com/cgi/content/full/319/7215/995
 

(2)ENGINEERING PITS BENEATH LONDON
UNDERGROUND TRACKS ARE HELPING TO SAVE
LIVES

(Effect of station design on death in the London Underground:
Observational study)
http://www.bmj.com/cgi/content/full/319/7215/957

Drainage pits underneath the railway tracks of London
Underground trains greatly reduce the number of deaths from
people falling or jumping in front of trains, claim Mr Tim Coats
and Mr Darren Walter from the Royal London Hospital in this
week's BMJ.

Coats and Walter studied 58 cases of patients falling or jumping
in front of trains during the 15 month period between January
1996 to March 1997. They found that of the 25 patients who
survived, 18 had been involved in an incident at a station with a
pit. and only five had lived after falling or jumping at stations with
no pit (for two patients the existence of a pit was unknown).

The authors say that many attempts have been made to reduce
the number of deaths on the London Underground. Pits were
introduced for engineering reasons and it is purely fortuitous that
they seem to be contributing to an increased chance of survival
for people going under trains, they say. They explain that the pit
increases the clearance between the train and the ground,
probably allowing a casualty to fall away from the train's wheels.

Coats and Walter express concern that the new Jubilee line
trains have less ground clearance, leaving less room for a body
to escape the wheels. They also suggest that, expense aside, the
most effective means of preventing deaths under trains would be
to introduce sliding doors on the platform that open only when
the train has come to a halt.

They conclude that the mechanics of the interaction of the human
body with a train are poorly studied and present rolling stock
and stations are not designed to maximise survival.

Contact:

Mr Tim Coats, Senior Lecturer in Accident and
Emergency, St Bartholomew's and the Royal London School of
Medicine, Royal London Hospital
Email: t.j.coats{at}mds.qmw.ac.uk
 

(3)EXPECTANT MOTHERS SHOULD KNOW THAT MOST
MIDWIVES WOULD AIM FOR A VAGINAL BIRTH
RATHER THAN A CAESAREAN

(Midwives would prefer a vaginal delivery)
http://www.bmj.com/cgi/content/full/319/7215/1008/a

Ninety six per cent of female midwives would opt for a vaginal
delivery as their first choice of giving birth report two
obstetricians in a letter in this week's BMJ. Contrary to recent
reports that 31 per cent of female obstetricians would prefer a
caesarian delivery, the authors report that midwives, who attend
to women and their babies, before, during and after their birth
are better placed to make and informed choice regarding mode
of delivery.

Dr Malcolm Dickson and Dr Mark Willet, both from hospitals in
the Manchester area, argue that obstetricians rarely attend
uncomplicated deliveries and that this may drive some female
obstetricians to opt for an elective caesarian. Midwives,
however are exposed to both traumatic and uncomplicated
deliveries and also deal with women who have had caesarians
post-operatively, write the authors. This, they say, makes the
aware of the difficulties a woman has in nursing her child after a
caesarian section in contrast to women who have normal vaginal
deliveries.

Dickson and Willet conclude that if an expectant mother with an
uncomplicated pregnancy was aware of the fact that most
midwives are strongly in favour of a vaginal delivery then this
might make up her mind to aim for a vaginal birth too.

Contact:

Dr Malcolm Dickson, Specialist Registrar, Department
of Obstetrics and Gynaecology, Wythenshawe Hospital,
Manchester
Email: MalDickson{at}aol.com

(ABC of complementary medicine: Acupuncture) BMJ Volume
319 9 October 1999 pp973-6

Continuing their twelve part series on the ABC of
Complementary Medicine, Dr Andrew Vickers and Dr
Catherine Zollman consider acupuncture this week's BMJ. They
look at the background of the practice of acupuncture; how it
works; its therapeutic scope; safety and regulation of
professional acupuncturists.

Contact:

Dr Catherine Zollman, General Practitioner, Bristol
Email: czollman{at}dial.pipex.com

Or

Dr Andrew Vickers, Integrative Medicine Service, Memorial
Sloan Kettering Cancer Center, New York
Email: ajvrccm{at}gn.apc.org

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