Riviste scientifiche

[Editorial] Time's up for sexual harassment in medicine

The Lancet - Sa, 30/06/2018 - 00:00
A career in medicine can be a gruelling endeavour. Long hours, heavy workloads, and high responsibilities make the job physically and emotionally demanding. Yet a report released this month by The National Academies of Sciences, Engineering, and Medicine (NASEM) reveals often under-recognised additional challenges for women: a staggering 58% of female faculty and staff across academia have experienced sexual harassment, and female medical students experience sexual harassment at much higher rates than their peers in science and engineering.

[Editorial] Gender-affirming care needed for transgender children

The Lancet - Sa, 30/06/2018 - 00:00
The number of children and adolescents seeking support for gender dysphoria—the distress caused by incongruence between gender identity and sex assigned at birth—has soared in recent years. On June 18, the first guidelines focusing solely on the care of transgender and gender-diverse children and adolescents were published by the Royal Children's Hospital Gender Service, Melbourne, Australia. Initiated to advocate for legal reform in Australia, where until recently anyone younger than 18 years needed to obtain legal permission to access hormone treatment, the guidelines outline a framework for provision of respectful, gender-affirming care of transgender and gender diverse children and adolescents.

[Comment] The clinical utility of preoperative functional assessment

The Lancet - Sa, 30/06/2018 - 00:00
Nearly 17% of patients undergoing elective surgery have an in-hospital complication, and 0·5% are estimated to die during the admission for surgery.1 With more than 300 million operations occurring per annum, this equates to 50 million complications and 1·5 million deaths annually.2 Preoperative risk assessment is the cornerstone on which subsequent safe surgical care is provided, and functional capacity is entrenched in preoperative cardiovascular assessment. The subjective assessment of functional capacity is a critical decision node in preoperative cardiovascular algorithms,3,4 yet the evidence supporting this practice is limited.

[Comment] The #MeToo movement: an opportunity in public health?

The Lancet - Sa, 30/06/2018 - 00:00
The worldwide #MeToo movement has brought renewed attention to the issue of sexual harassment in the workplace. Such sexual harassment is a form of gender-based violence at work that is an organisational, criminal, and ethical issue. Despite this renewed focus, sexual harassment is rarely considered a public health issue. The #MeToo movement presents an opportunity for the public health community to consider sexual harassment a health issue with implications for disease prevention and health promotion.

[Comment] Intersectionality and why it matters to global health

The Lancet - Sa, 30/06/2018 - 00:00
Leaving no one behind—a cornerstone of the Sustainable Development Goals (SDGs) agenda—represents a shift in thinking and enquiring about and tackling global challenges. However, to achieve the ambitious global health goals laid out in the SDGs, new ways to understand the complex nature of health inequities, especially among the most vulnerable populations around the world, are required.

[Comment] Offline: Migration—the new revolution

The Lancet - Sa, 30/06/2018 - 00:00
40 944 people have migrated to Europe so far in 2018. 960 people have died trying to do so, making migration an immediate European health emergency. Yet the medical and public health communities across Europe remain strangely silent. Why is that? The main destinations for those leaving their homelands have been Italy (16 228), Greece (12 514), and Spain (12 155). Although the political consequences of migration seem to be growing—a new and abrasive anti-immigration regime in Italy, Angela Merkel's precarious coalition in Germany, and continuing fears of free movement of people to Brexit Britain—these figures are actually in decline.

[World Report] Liquid biopsy: still early days for early detection

The Lancet - Sa, 30/06/2018 - 00:00
Excitement about the advances of the non-invasive cancer detection technique are tempered by those who caution there is still far to go. Geoff Watts reports.

[Perspectives] Gout

The Lancet - Sa, 30/06/2018 - 00:00
As he tried to evoke the agonies of his gout-stricken patients in the first century CE, the Greek physician Aretaeus of Cappadocia did not mince his words: “No other pain is more severe than this, not iron screws, nor cords, nor the wound of a dagger, nor burning fire.” Like osteoarthritis, like dental caries, gout is one of many chronic diseases that, in the words of the historians Roy Porter and George Rousseau, “are not in themselves fatal, but incurable, typically debilitating, sometimes crippling and inordinately painful”.

[Perspectives] The blood price

The Lancet - Sa, 30/06/2018 - 00:00
Superstition is rich with stories of infant mortality. In Irish fairy lore, the changeling is a sickly replica of a healthy child: various rites and potions would be prescribed to trick the changeling into revealing its true nature, and drive it out so the human original could be returned. It's a tradition with implications both sinister and benign. On the one hand, changeling beliefs acknowledged the awful likelihood of unspeakable loss. On the other, they codified the abuse of ill and disabled children, encouraged care givers to dissociate from children in poor health, and in extreme cases provided a pattern for selective infanticide.

[Obituary] Davida Coady

The Lancet - Sa, 30/06/2018 - 00:00
Public health activist. Born April 15, 1938, in Berkeley, CA, USA, she died of ovarian cancer in Alamo, CA, USA, on May 3, 2018, aged 80 years.

[Correspondence] Author gender in The Lancet journals

The Lancet - Sa, 30/06/2018 - 00:00
Despite substantial advances in recent decades, gender inequality persists in many scientific fields,1 including medicine2,3 and global health. In an upcoming theme issue on women in science, medicine, and global health,4 The Lancet will focus on helping to understand and remove women's disadvantage in these fields. Nevertheless, dedicating a few words to women's representation in The Lancet journals is worthwhile. Here, I present a snapshot of the gender of the authors who publish in The Lancet journals.

[Correspondence] Time's up for journal gender bias

The Lancet - Sa, 30/06/2018 - 00:00
In December, 2017, The Lancet (Dec 2 2017, 2423)1 asserted its commitment to assessing processes and practices in the journal to address inequality and gender bias in global health. The journal called on the community to “create a set of transformative explanations and actions” to address inequities between women and men in science, medicine, and global health and shine light on women and inequalities.

[Correspondence] Gender gap, disparity, and inequality in peer review

The Lancet - Sa, 30/06/2018 - 00:00
In an edition of the New England Journal of Medicine,1 the thanks to the “super reviewers”, caught our eye—ie, reviewers that have reviewed two or more papers. However, when we examined these 282 names, we were surprised that only 52 (18%) are women and 230 (82%) are men. We then looked at 10 years' worth of reviewers (many journals do not list reviewers regularly or uniformly, and therefore gender is difficult to assess). We carried out the first assessment with Excel, but we realised reviewing thousands of names was daunting.

[Correspondence] The Lancet peer reviewers: global pattern and distribution

The Lancet - Sa, 30/06/2018 - 00:00
The Lancet strives to publish a more representative selection1 of scholarly articles, from more diverse sources, when compared with other high impact journals.2 Indeed, The Lancet is the most cited journal by the lay media and is among the world's highest impact general medical journals.3 For these reasons, from the field of medical academia, this journal arguably has the greatest global health influence.

[Correspondence] Lessons from the INTERVAL study

The Lancet - Sa, 30/06/2018 - 00:00
Research on blood donor health is an expanding field, but it faces specific challenges when identifying the health consequences of blood donations. For instance, the healthy donor effect is a type of selection bias inferring that donors are a healthier subset of the general population because of donor selection procedures and self-selection by donors.1 This selection bias might lead to an underestimation of potential harms caused by blood donation, and an overestimation of its health benefits in observational studies or even within a donor population.

[Correspondence] Lessons from the INTERVAL study

The Lancet - Sa, 30/06/2018 - 00:00
The excellent INTERVAL study1 by Emanuele Di Angelantonio and colleagues provides two important insights into recruitment and management of blood donors that should be discussed.

[Correspondence] Lessons from the INTERVAL study – Authors' reply

The Lancet - Sa, 30/06/2018 - 00:00
The INTERVAL study1 randomly assigned 45 263 whole-blood donors to different intervals between donations to assess the effect of varying the frequency of donation on donor health and blood supply. Reducing the inter-donation intervals used in the UK to those used in blood services in the USA or western Europe led to a substantial increase in the amount of blood collected over the 2-year study period. For instance, reducing the inter-donation interval from 12 weeks to 8 weeks in men led to an increase in blood supply of 33% (an average of 1·7 units per donor).

[Articles] Assessment of functional capacity before major non-cardiac surgery: an international, prospective cohort study

The Lancet - Sa, 30/06/2018 - 00:00
Subjectively assessed functional capacity should not be used for preoperative risk evaluation. Clinicians could instead consider a measure such as DASI for cardiac risk assessment.

[Clinical Picture] Antiphospholipid syndrome causing reversible internal carotid artery thrombosis

The Lancet - Sa, 30/06/2018 - 00:00
A 51-year-old man presented to the emergency department with a 2-day history of cognitive decline. He was admitted to the neurology department for an assessment where he was found to be confused and disorientated, and his attention, concentration, and memory were affected. He scored 12 on the Glasgow Coma Scale.

Cimon the robot blasts off to the International Space Station

New Scientist - Ve, 29/06/2018 - 16:36
A second-hand SpaceX rocket has just launched a spherical robot to the International Space Station, where it will assist astronauts in a variety of tasks
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