Minerva: July 2003

Soaring caesarean section rates in the United States provide food for thought. The rate in 2001 reached an all time high of 24.4%, while that of women having a vaginal delivery after a previous section dropped to an all time low of 16.5%. An editorial in the Journal of Obstetric, Gynecologic, and Neonatal Nursing (2003;32:283-4) asks whether this situation has arisen because the demand for perfection forces unnecessary intervention, and calls for a return to common sense guided by evidence rather than fear of litigation.

Professional dancers have high rates of injuries that potentially put them out of work. A retrospective cohort study of one troupe of 42 dancers found that the introduction of ‘comprehensive management’ (case management and intervention) reduced the number of new workers compensation cases from 81% to 17%, and the number of days lost from work went down by 60% (American Journal of Sports Medicine 2003;31:365-73). Other high risk occupations might benefit from similar programmes.

The person who interviewed David Lammy, the parliamentary undersecretary of state for health, for Emergency Medicine Journal (2003;20:supplement) makes an interesting observation. Lammy was the youngest member of parliament when he was elected in 2000 and is still only 30. For someone who holds such a powerful position in …