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[Perspectives] The medical suffragettes

Sa, 03/02/2018 - 00:00
In January, 1918, the women staff of Endell Street Military Hospital in central London, UK, forgot their ward duties for a few hours as they sang and danced in celebration. That evening the women doctors, nurses, and orderlies donned costumes for a fancy dress party, had a sumptuous dinner, and toasted the Queen before marching through the hospital in a grand procession. It was 10 months before the end of World War 1—and victory for the Allies still hung in the balance—yet the women were intent on celebrating.

[Perspectives] The burning light

Sa, 03/02/2018 - 00:00
“In our life there is a single colour, as on an artist's palette, which provides the meaning of life and art. It is the colour of love”, artist Marc Chagall wrote. While these words encapsulate the strong emotional undercurrent that characterises the work of the Belorussian artist, they also perfectly describe the profound love between Chagall and his first wife Bella, whom he portrayed in many of his canvasses, often flying with him above the roofs of their hometown.

[Obituary] Fotis Kafatos

Sa, 03/02/2018 - 00:00
Biologist, science administrator, and founding President of the European Research Council. He was born in Heraklion, Crete, Greece, on April 16, 1940, and died there on Nov 18, 2017, aged 77 years.

[Correspondence] Can the scientific world positively influence decision makers on planetary health?

Sa, 03/02/2018 - 00:00
The 2017 G7 Health Ministerial Meeting was on Nov 5–6, in Milan, Italy, and for the first time the effect of climate and environmental factors on health was addressed in the agenda of the meeting. As reported in the final Health Ministers communiquè after the meeting (signed by all seven countries),1 the delegation agreed to identify and promote some fundamental adaptation actions. In addition to the novelty of these subjects being in the agenda and in the final meeting documents, we believe the process that led to these outcomes is innovative and interesting.

[Correspondence] The growing problem of loneliness

Sa, 03/02/2018 - 00:00
Imagine a condition that makes a person irritable, depressed, and self-centred, and is associated with a 26% increase in the risk of premature mortality. Imagine too that in industrialised countries around a third of people are affected by this condition, with one person in 12 affected severely, and that these proportions are increasing. Income, education, sex, and ethnicity are not protective, and the condition is contagious. The effects of the condition are not attributable to some peculiarity of the character of a subset of individuals, they are a result of the condition affecting ordinary people.

[Correspondence] Influenza vaccination and prevention of cardiovascular disease mortality

Sa, 03/02/2018 - 00:00
Catharine Paules and Kanta Subbarao presented in their Seminar (Aug 12, 2017, p 697) the clinical features, therapeutic options, and controversies regarding treatment and prevention of seasonal influenza infection.1 Although they acknowledged that influenza can impair different organ systems, little attention was given to cardiovascular consequences. Ischaemic heart disease is the leading cause of death worldwide and influenza vaccination could reduce cardiovascular mortality, particularly in patients with coronary heart disease for whom cardiovascular mortality risk has been reported to be halved by influenza vaccination.

[Correspondence] Influenza vaccination and prevention of cardiovascular disease mortality – Authors' reply

Sa, 03/02/2018 - 00:00
We thank Daniel Caldeira, Joaquim J Ferreira, and João Costa for highlighting the effect of influenza infection on underlying cardiovascular disease and the role of influenza vaccination in potentially mitigating this risk. Although we briefly mentioned that influenza infection could exacerbate underlying cardiovascular disease in our Seminar,1 we were unable to fully expand on this point because of word-count restrictions. In this regard, an epidemiological link between influenza and excess deaths associated with cardiovascular disease was suggested as early as in the 1930s.

[Correspondence] Challenges of measuring the Healthcare Access and Quality Index

Sa, 03/02/2018 - 00:00
We read with interest the GBD 2015 Healthcare Access and Quality study (July 15, 2017, p 231),1 which constructed the Healthcare Access and Quality (HAQ) Index on the basis of risk-standardised cause-specific death rates to facilitate comparisons of personal health-care access and quality for 195 countries and territories from 1990 to 2015. However, we would like to contest some of the findings on the HAQ Index related to chronic kidney disease (CKD).

[Correspondence] Challenges of measuring the Healthcare Access and Quality Index

Sa, 03/02/2018 - 00:00
We read with interest the article by the Global Burden of Disease (GBD) collaborators on the Healthcare Access and Quality (HAQ) Index.1 However, we believe the scaled indicator on measles amenable mortality should be interpreted with caution.

[Correspondence] Challenges of measuring the Healthcare Access and Quality Index – Authors' reply

Sa, 03/02/2018 - 00:00
Estimating national levels of personal health-care access and quality can inform the understanding of settings in which gains in health care can be achieved. Amenable mortality—deaths that should not occur in the presence of high-quality health care—has been used to approximate country-level personal health-care access and quality for decades.1 Drawing from this scientific approach, the Global Burden of Disease (GBD) collaboration developed the Healthcare Access and Quality (HAQ) Index,2 which aimed to provide a stronger indication of personal health-care quality and access across 195 countries and territories over time.

[Correspondence] Trans people and the myth of homogeneous societies

Sa, 03/02/2018 - 00:00
In their Comment, Arjee Restar and Sari Reisner (Oct 28, 2017, p 1933)1 briefly hint at the diversity in health risk within the transgender (trans) community but then fail to take their recommendations further. For example, among the 60 million refugees worldwide, trans people are particularly at risk of violence and discrimination.2 Yet discrimination based on gender identity and migration status are usually treated separately, as the Comment's omission illustrates.1 Many trans people experience discrimination on multiple grounds, such as refugee status, socioeconomic position, age, and physical and cognative ability, in addition to gender identity, leading to possibly even more negative health consequences than in non-trans people.

[Department of Error] Department of Error

Sa, 03/02/2018 - 00:00
Honigsbaum M. Flawed hero. Lancet 2017; 389: 1874—In this Perspective, the third and fourth sentences in the penultimate paragraph should have read “However, it is in his justification for his action and what he did next that the story becomes fraught. Wadman allows the reader to draw their own conclusions about his fall from grace.” This correction has been made to the online version as of Feb 1, 2018.

[Department of Error] Department of Error

Sa, 03/02/2018 - 00:00
Howlett P, Walder A, Lisk D, et al. Neurological and psychiatric manifestations of post Ebola syndrome in Sierra Leone. Lancet 2017; 389 (suppl): S48—In this Abstract, S Sevalie should have been listed as an author. This correction has been made to the online version as of Feb 1, 2018.

[Correspondence] Turkish Medical Association central council detained for demanding peace

Ve, 02/02/2018 - 11:54
On Jan 24, 2018, the central council of the Turkish Medical Association (TTB) issued a short statement to express its opinion against the ongoing military operations by the Turkish army in northern Syria and to call for an end to the war by demanding peace.1 In its short announcement, TTB underscored the validity of its professional oath and duty to defend human lives.1

[Department of Error] Department of Error

Gi, 01/02/2018 - 00:30
Robinson L. Successful ageing. Lancet 2018; 391: 300. In this Perspectives, the surname of the patient in the second and fifth paragraphs should have been Shuler and the book title should have read Enlightened Aging in the third and fifth paragraphs. This correction has been made to the online version as of Feb 8, 2018.

[Editorial] The health of a president: an unnecessary distraction

Sa, 27/01/2018 - 00:00
The respected New York Times physician-journalist, Lawrence K Altman, often wrote about the personal health of US presidential candidates and other elected leaders in high office. He argued that the medical records of each president should be made publicly available and that the public have a right to know that their president is fit to fulfil the role. Last week, the health of President Donald Trump became the subject of sometimes wild political speculation after the release of his first physical examination results since he took office.

[Editorial] Facial injuries

Sa, 27/01/2018 - 00:00
Patients, surgeons, and other health-care professionals met to discuss life after facial injuries at an event on Jan 22 organised by the Royal Society of Medicine and Saving Faces, the facial surgery research foundation. A large proportion of facial injuries result from interpersonal violence, in which the maxillofacial region is frequently targeted. In domestic violence, damage can be very severe due to extreme violence and protracted uninterrupted attacks. In trauma cases, facial injuries are often a sign of extensive injuries and many patients experience associated head injury.

[Editorial] Institutional and coercive mental health treatment in Europe

Sa, 27/01/2018 - 00:00
Images of people incarcerated, unkempt and kept in chains, mocked, and uncared for dominate the history of psychiatry, particularly from the middle ages to the early 20th century. Locked up for years, and forcibly sedated or sterilised, those with mental ill health were subject to inhumane conditions and removed from society, often under the supervision of doctors. What of now? How have things improved for those with mental illnesses?

[Comment] Offline: Why we must learn to love economists

Sa, 27/01/2018 - 00:00
George Bernard Shaw once remarked that, “If all economists were laid end to end, they'd never reach a conclusion.” Since the global financial crisis of 2007–08, economists have suffered a sharp loss of intellectual confidence. Some critics have rejoiced. Yet the fact remains that economics is the discipline that orders our world. Its locus of influence is the national Treasury. It is finance ministers who have the most decisive say about a country's priorities. For health advocates, we have two choices.

[World Report] Mega-crisis in DR Congo

Sa, 27/01/2018 - 00:00
The UN fears the humanitarian crisis in DR Congo will further deteriorate in 2018, putting in jeopardy the lives of over 13 million people. John Zarocostas reports.