Last week, junior doctors in England's National Health Service (NHS) voted overwhelmingly in favour of strike action for 3 days in December. 27 741 doctors voted in favour of taking strike action whereas only 564 voted against, in a ballot organised by the British Medical Association (BMA). According to Mark Porter, BMA Council chair, “junior doctors have clearly been left with no alternative but to consider strike action due to the Government's continued threat to impose a contract that is unsafe for patients and unfair for doctors”.
The UN observes the International Day of Persons with Disabilities on Dec 3, 2015. This year, three themes are highlighted in the agenda: making cities inclusive for all, improving disability data and statistics, and including those with invisible disabilities in society and development. These themes echo the specific mention of persons with disabilities in five of the Sustainable Development Goals (SDGs): education; economic growth and employment; creation of inclusive, safe, resilient, and sustainable cities; reduction of inequalities; and data collection related to monitoring the SDGs.
At the time of writing, hopes that the devastating west African Ebola outbreak was finally coming to its end were diminished by the recent confirmation of three new cases of the disease in Liberia. The country had previously been declared Ebola free on Sept 3—followed by Sierra Leone on Nov 7 and Guinea on Nov 19. The outbreak, which killed more than 11 000 people and infected at least 28 000, is the largest of its kind and a stark reminder of the fragility of health security in an interdependent world.
After the eight Millennium Development Goals that have shaped progress in the past 15 years, 17 Sustainable Development Goals (SDGs) were adopted by governments at the UN General Assembly in September, 2015. SDG3 explicitly relates to health—to “Ensure healthy lives and promote well-being for all at all ages”. This goal is translated into 13 targets: three relate to reproductive and child health; three to communicable diseases, non-communicable diseases, and addiction; two to environmental health; and one to achieving universal health coverage (UHC).
A voice is heard, but there is no one around who could have spoken. In the popular imagination it's a symptom of insanity, a sign that the hearer is disturbed, distressed, and possibly a danger. We reach for a label: schizophrenia. Around three-quarters of people with this complex and heterogeneous disorder hear voices, but the experience is associated with a wide range of other psychiatric conditions.1 Hearing voices, or auditory verbal hallucinations, is also a part of everyday life for a minority of people who are not patients.
United Nations Resolution 2249, passed on Nov 20, 2015, by the Security Council, argues that Islamic State in Iraq and the Levant (ISIL, Da'esh) “constitutes a global and unprecedented threat to international peace and security”. Is that statement fair? Despite saturation news coverage and the rhetoric of war, ISIL is not (yet) a threat to the security and wellbeing of the entire world. Its effects have been acute and severe but so far geographically localised—to the Middle East, south Asia, north Africa, and, with the recent terrorist bombings in Paris, western Europe.
More Americans are getting health insurance, including coverage for prescription drugs, but high prices may make them inaccessible. Susan Jaffe, The Lancet's Washington correspondent, reports.
Paul Nurse, president of the Royal Society, has called for an overarching body to encompass all the UK's research councils in a long-awaited review released last week. Brian Owens reports.
The British Columbia Centre for Excellence in HIV/AIDS (BC-CfE) opened in Vancouver, BC, Canada, in 1992. At that time, the province had the worst HIV epidemic in Canada, with two new HIV diagnoses and one person dying of AIDS every day. Canada and the world were grappling with the HIV crisis. Fast forward 23 years, and the vision and dedication of current director Julio Montaner, his team, and support from BC politicians past and present, have seen HIV rates in BC plummet from more than 800 new cases per year in the 1990s to their current low of under 250—the lowest rate in Canada.
Evan Wood had not thought much about a career in medicine having studied geography, but an assignment to chart the diffusion of HIV around Vancouver, Canada, got him hooked on clinical epidemiology. Today Wood is Professor of Medicine at the University of British Columbia and a leader of addiction medicine at St Paul's Hospital and the local health authority in Vancouver, where he works to improve systems of care for patients with addictions. As Wood points out, “Addiction science has gotten so far ahead of what the health system actually delivers in terms of care.
In 1981, a group of 17 macaques known as the Silver Spring Monkeys became the most famous research animals in the USA when Alex Pacheco, an undercover college student and animal rights activist, infiltrated the laboratory of psychologist Edward Taub to expose the experiments that took place inside. In his research on neuroplasticity, Taub severed the afferent ganglia to certain limbs while immobilising the limbs that were neurologically intact in an attempt to train the macaques to use the appendages that lacked neural feedback.
Disease Diplomacy by Sara Davies, Adam Kamradt-Scott, and Simon Rushton delves into the high politics of global health security. They trace this new disease diplomacy to the severe acute respiratory syndrome (SARS) epidemic of 2003. Ever since that time, and indeed long before, political leaders took notice of the security and economic effects of new infections spanning national borders.
Major art museums around the world have woken up to the artistic bounty of the longevity dividend, hosting exhibitions of late Rembrandt, Sonia Delaunay, and Edvard Munch. It is increasingly clear that this artistry arises not despite old age, but because of it. This insight is of great importance to clinicians and society alike. By reframing old age in terms of potential rather than problems, it counters those who portray ageing in terms of unmanageable deficit and loss. Creativity also illuminates the complex interplay of growth, loss, and transcendence in later life.
Hearing voices without external stimuli: in the popular imagination, auditory hallucination is most often understood as a symptom of severe mental disorders. Yet voice-hearing is also an important aspect of lived experience, not always satisfactorily addressed by medical diagnosis and treatment. Looking across cultures and historical eras suggests a wide range of possible kinds of voice-hearing experience. The medieval period is of special interest because its thought-world takes for granted the possibility of the supernatural and its theories of medicine and psychology offer powerful explanatory models for hallucinatory experience.
Clinical psychologist who specialised in health behaviours. She was born in Oxford, UK, on Oct 30, 1950, and died from chronic lymphocytic leukaemia in London, UK, on Oct 20, 2015, aged 64 years.
The unprecedented epidemic of Ebola in west Africa has exposed not only response failures of governments, international institutions, and public health agencies, but also the ineffectiveness of using disconnected top-down health messages during public health emergencies. Gilles Guerrier and colleagues' letter (Aug 29, p 851)1 on the need to strengthen scientific journalism in Africa is spot on.
On June 4, 2015, the High Court of Cassation and Justice in Romania made the decision to criminalise the act of public sector physicians receiving any informal payments from patients.1 The decision sparked an intense debate. Although some physicians and patients support physicians' right to be compensated for the services provided, others reject informal payments, mainly because the practice prevents those who cannot pay from accessing health care, and can be embarrassing for the physicians who receive them.
Hearing loss affects more than 10 million people in the UK alone, the majority (92%) of whom experience mild or moderate losses. It has been recognised globally that, “hearing loss continues to be an area in which there is low and highly variable take-up of available interventions and little systematic data for outcomes”.1 Hearing loss is highly prevalent, which makes it costly to society. However, it is also costly to the individual since hearing loss has a substantial effect on interpersonal communication, psychological wellbeing, quality of life, and economic independence.
Autopsy has had a fundamental role in advancing medical knowledge for centuries. Now, medicine is at a junction—should clinicians work together to educate the public and politicians in the valuable role of consented autopsy and, by embracing modern techniques, re-establish it in the 21st century for the benefit of all? Or should the medical profession allow consented autopsy to cease to exist? The situation is serious.
The Lancet Editorial (Aug 8, p 504)1 made reference to an open letter2 that has now been signed by over 600 organisations and individuals, and which specifically states, “We firmly believe and agree with Amnesty International that human beings bought and sold in the sex trade, who are mostly women, must not be criminalized in any jurisdiction and that their human rights must be […] protected to the fullest extent”. However, we vehemently disagree that the wholesale decriminalisation of the sex industry, which effectively decriminalises pimps, brothel owners, and sex buyers, will protect the health and human rights of people engaged in selling sex.