have become unwieldly monsters hijacked by the financially
motivated.
A forthcoming international conference on HIV and AIDS
is a case in point. Registering participants are limited to one
abstract. Submission of the abstract requires the payment of
the registration fee (445). Abstracts must be submitted by
February 1. The deadline for notification of abstract
acceptance is April 15. If the abstract is not accepted at this
stage then only 50% of the fee is returnable. Telephone
cancellations are not acceptable. Cancellation after May 1
leads to complete loss of registration fee. Why has this
approach been taken? First, to increase the quality of
abstracts by limiting to one per registration and discouraging
poor quality submissions? Registrants, or those with a copy
of the doubtless substantial abstract book(s), will be able to
overall
decide the
quality. Second, to discourage
submissions from poorly funded groups? Clearly there are
many people who will only obtain funding on the basis of an
accepted abstract. This is especially true of workers in the
developing world. Third, to maximise income? Although
conferences must make some profit if anyone is going to go
to the trouble of organising them, the financial motive seems
to overwhelm the scientific purpose of the event. What is
true is that this will prove to be an enormous and well
attended conference and it is likely that the costs involved
(registration, travel, accommodation) will massively exceed
the resources that are available biannually to many nations
in Africa in their attempts to prevent and manage HIV
disease.
N French
Medical Research Council, Research Programme on AIDS
Virus Research Institute, PO Box 49, Entebbe, Uganda
in
Uganda,
Birth dates and admission to medical school
SIR--Boddi and colleagues have claimed in Nature’ that, in a
group of 957 medical students in Florence, Italy, a
significant excess was born during April to June. They
interpreted the result in terms of "the importance of the
seasons in the early development of the child", and hoped
that "someone in the Southern Hemisphere will now analyse
similar data, in order to confirm (or to confute) the ’spring
advantage"’. Here I report being unable to confirm the effect
they find, even in another and much larger European
sample.
We have collected extensive data on the selection of
British medical students, studying those applying for
admission in October, 1981,z 1986,’ and 1991.4 Season of
birth did not differ between successful and unsuccessful
applicants in any of the three cohorts (=0-931, 2-641,
0-939, respectively); the table shows data for all applicants.
Nor did cohorts differ in season of birth (B=5-533), and the
cohorts were therefore combined. The proportions of
applicants in each season were compared with the
proportion born during the same seaons in 1974,5 and show
a highly significant difference from the expected numbers
(X2=24’068, p<0-001). However, size of the effect is much
smaller than-and the pattern is entirely different fromthat reported by Boddi’s group,’ with fewer students born in
April to June, and the greatest numbers born in October
to
December. In Britain, schooling usually begins
in September. The reported advantage for those born
during autumn and winter is perhaps explained by a
child born in autumn having spent a greater proportion of its
total life in education than has a child born during the
summer.
1
Bennett JR. Altruism and Scientific
congress. Lancet
1996; 347:
377-78.
Mental health research in Japan
SIR-Takei
p 523)’ is right to disclose the very low
mental care research in Japan. Japanese funding
for the health sciences has put heavy emphasis on "hard"
medicine-such as development of medical instruments
(endoscopy, computed tomography, and so on) and
pharmaceuticals2-largely because their efficacy is easy to
judge and their commercial prospects are biggest. Mental
health has been generally neglected in Japanese society
because the issue is kept out of the public eye.3 Since most
psychiatric patients are confined to psychiatric units and do
not commit any crimes, the public rarely gives thought to
them and no organisation (governmental or otherwise) feels
a burning need to support such studies.
The financial situation of health research is even worse
than portrayed because institutional overheads almost halve
the amounts. In return for this charge, the institutions
should support research by providing secretarial assistance,
for example, but in practice hardly any support is available.2
Moreover, there is a risk of fraud in clinical trials because
busy clinicians tend to rely on industry manpower to fill in
case-report forms. In mental health research informed
spending
(Feb 24,
This failure to replicate was originally sent to Nature, who
declined to publish, with no reason given. That rejection
must raise concerns about the probity of scientific publishing
since, presumably, if an effect is interesting or important
enough to publish in the first instance, then at least one
refutation must also be of interest.
on
I C McManus
Imperial College of Science, Technology and Medicine, Paterson Centre for Mental
Health, London W2 1PD, UK
1
2
3
4
5
Boddi V, Brizzi E, Conti A, Gensini GF. Birth dates in Florence.
Nature 1996; 379: 394.
McManus IC, Richards P. An audit of admission to medical school: 1.
Acceptances and rejects. BMJ 1984; 289: 1201-04.
McManus IC, Richards P, Maitlis SL. Prospective study of the
disadvantage of people from ethnic minority groups applying
to medical schools in the United Kingdom. BMJ 1989; 298:
723-26.
McManus IC, Richards P, Winder BC, Sproston KA, Styles V.
Medical school applicants from ethnic minorities: identifying if and
when they are disadvantaged. BMJ 1995; 310: 496-500.
OPCS. Birth Statistics: review of the Registrar General on births and
patterns of family building in England and Wales, 1974. London:
HM Stationery Office, 1977: 17.
may be ignored.
restructuring of health-research funding in Japan is
urgently needed, especially for studies in mental health.
consent
A
Kyoko Imamura
4-3-10-102
1
2
3
Kamiyoga, Setagaya-ku, Tokyo 158, Japan
Takei N. Funding of research in mental health care in Japan. Lancet
1996; 347: 523-24.
Imamura K. A critical look at research in Japan. Lancet 1993; 342:
279-82.
Imamura K. Mental health in Japan. Lancet 1995; 346: 509-10.
1120
Table: Season of birth of medical school applicants and
entrants