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[Correspondence] Preventable brain injury in term labour

Sa, 04/05/2019 - 00:00
The Editors (Nov 24, 2018, p 2238)1 discuss preventable brain injury in term labour and highlight errors in interpreting, or failing to act on, abnormal cardiotocography results as a major modifiable risk factor. However, they did not mention the limitations of cardiotocography as a test to prevent intrapartum brain injury. In 1968, Benson,2 a pioneer in the development of cardiotocography, stated that cardiotocography is clinically useful at predicting intrapartum brain injury only at the extremes, with a normal trace usually indicating a normal fetus and a pathological trace indicating a fetus needing urgent delivery.

[Correspondence] Social determinants of health: social justice and vested interests

Sa, 04/05/2019 - 00:00
I commend Kumanan Rasanathan (Oct 6, 2018, p 1176)1 for stressing the enduring inertia against efforts to tackle social injustice, despite it killing people on a grand scale. However, this inertia has not existed for a decade, but for more than half a century. In 1984, Marmot2 showed that individuals in the lowest socioeconomic status group were three times more likely to die of cardiovascular diseases than individuals in the highest socioeconomic group. This finding did not preclude the Progression of Early Subclinical Atherosclerosis study3 from investigating subclinical atherosclerosis (imaging, biomarkers, and genetics) in employees of a major bank headquarters in Madrid, Spain.

[Correspondence] A call for academic medicine to remain politically neutral

Sa, 04/05/2019 - 00:00
We question the use of an important medical research paper as a platform for making a political statement. Dehghan and colleagues1 include “occupied Palestinian territory” as one of the 21 participant countries in their study. We presume this is referring to the areas that are described as West Bank and Gaza in official World Bank documents.2

[Clinical Picture] Acute renal and splenic infarctions as the initial manifestations of atrial fibrillation

Sa, 04/05/2019 - 00:00
A 73-year-old man with a history of hypertension and diverticulosis presented to our emergency department with a 1-day history of severe, lower abdominal pain, on his left side, associated with nausea. He did not report any other symptoms: dizziness, chest pain, palpitations, shortness of breath, haematuria, fever, or diarrhoea.

[Comment] Legal determinants of health: facing global health challenges

Me, 01/05/2019 - 00:30
Law is crucial for protecting the health and wellbeing of society. Robust legal systems strive to create a society that is fair. Laws influence every aspect of society and health, from regulating individual lives to stipulating expected behaviours of individuals, states, and corporate entities.

[Comment] Health rights are the bridge between law and health

Me, 01/05/2019 - 00:30
The Lancet–O'Neill Institute Commission on Global Health and Law1 is a welcome attempt to bridge the divide between the health and legal professions.2 The Commission's report1 shows the ubiquity of law and its contribution to health and health care. It is an exhaustive compilation that positions law as a legal determinant of health. The Commission aims to increase health workforce awareness of law by demonstrating the extent to which they already function within legal parameters. The corollary of such an understanding, and we anticipate the ultimate purpose of the Commission, is to promote engagement of the health profession and the global health community in shaping legal determinants of health.

[The Lancet Commissions] The legal determinants of health: harnessing the power of law for global health and sustainable development

Me, 01/05/2019 - 00:30
Health risks in the 21st century are beyond the control of any government in any country. In an era of globalisation, promoting public health and equity requires cooperation and coordination both within and among states. Law can be a powerful tool for advancing global health, yet it remains substantially underutilised and poorly understood. Working in partnership, public health lawyers and health professionals can become champions for evidence-based laws to ensure the public's health and safety.

[Department of Error] Department of Error

Ma, 30/04/2019 - 00:30
Chu DK, Wood RA, French S, et al. Oral immunotherapy for peanut allergy (PACE): a systematic review and meta-analysis of efficacy and safety. Lancet 2019; published online April 25.—In this Article, the URL to the online interactive summary of findings in the third paragraph of the Results section has been corrected. This correction has been made to the online version as of April 29, 2019.

[Review] Iran in transition

Lu, 29/04/2019 - 00:30
Being the second-largest country in the Middle East, Iran has a long history of civilisation during which several dynasties have been overthrown and established and health-related structures have been reorganised. Iran has had the replacement of traditional practices with modern medical treatments, emergence of multiple pioneer scientists and physicians with great contributions to the advancement of science, environmental and ecological changes in addition to large-scale natural disasters, epidemics of multiple communicable diseases, and the shift towards non-communicable diseases in recent decades.

[Correspondence] The 2019 UN high-level meeting on universal health coverage

Sa, 27/04/2019 - 00:30
In their discussion of universal health coverage (UHC), the Editors (Jan 5, p 1)1 rightly state that “simply convening a UN high-level meeting is not enough” to achieve UHC. The Civil Society Engagement Mechanism for UHC2030 (CSEM) strongly agrees and is concerned that, without a radically different approach, the meeting will be a business-as-usual global health event. We are concerned that speakers at the high-level meeting on UHC on Sept 23, 2019, will declare support for UHC and leaving no one behind, but will not be held to account for their contradictory policies and actions.

[Editorial] Measles eradication: a goal within reach, slipping away

Sa, 27/04/2019 - 00:00
Prior to the introduction of the measles, mumps and rubella vaccine (MMR) in 1963, an estimated 3 to 4 million people in the USA contracted measles annually. As of April 22, 626 children in the USA have become infected with the virus so far in 2019. This fact has led to urgent Congressional hearings, understandably alarmed national news coverage, and the introduction of legislation to address the outbreak. Measles was declared eliminated in the USA in 2000, but the resurgence of the disease and its continued prominence globally are causes for great concern.

[Editorial] Paediatric practice in a modern era

Sa, 27/04/2019 - 00:00
Imagine you are a clinician and you have just finished a ward round involving a complex paediatric patient. It is a Thursday afternoon. Watching the television later, you discover the whole case—including your name and personal details—is the lead item on the evening news. Within another 24 h, not only is the issue a matter of international debate, but US President Trump and the Pope are also embroiled in the case.

[Editorial] Mining: protect the rights of local communities

Sa, 27/04/2019 - 00:00
In March, 2016, Sikhosiphi “Bazooka” Rhadebe, who had been protesting against a titanium mine in the Xolobeni region of South Africa, received eight shots to the head in his home. Three years later, the perpetrators have not been identified. Rhadebe's death was in no way an isolated incident, as was reported in a joint report published April 16 by the Centre for Environmental Rights, groundWork, Earthjustice, and Human Rights Watch, which finds that those who dare protest against mining activities in South Africa face harassment, intimidation, or violence.

[Comment] Gender mainstreaming within WHO: not without equity and human rights

Sa, 27/04/2019 - 00:00
Addressing gender inequalities through an equity and human rights lens is central to the leave no one behind pledge of the Sustainable Development Goals and is at the heart of WHO's normative responsibility. 1,2

[Comment] Gambling control: in support of a public health response to gambling

Sa, 27/04/2019 - 00:00
Gambling has been identified as a threat to health,1 but responses, including policy and industry-funded corporate social responsibility initiatives, continue to focus on individual gamblers rather than, as is increasingly accepted for other health threats, challenging the companies that profit from this misery. There is a need to rapidly move away from this individual–level narrative and address the wider corporate determinants of health in relation to gambling. At the same time, there is a need to limit the ability of industry to prevent the implementation of effective measures.

[Comment] Offline: Japan—rich nation, big questions

Sa, 27/04/2019 - 00:00
Unusual as it might seem in a post-everything world, Japan is welcoming (and pondering the meaning of) a new imperial era. The Reiwa period begins on May 1, 2019, with the accession of Crown Prince Naruhito as the country's 126th Emperor. There is some uncertainty about the meaning of Reiwa, but the official translation is “beautiful harmony”. The end of Emperor Akihito's Heisei period is a useful moment to reflect on Japan's future. Japan is a “great power”—a member of the G7 and G20, and the world's third largest economy.

[World Report] Alemtuzumab to be restricted pending review, says EMA

Sa, 27/04/2019 - 00:00
Reports of stroke in patients having taken alemtuzumab for multiple sclerosis prompt a safety review by the European Medicines Agency. Becky McCall reports.

[World Report] Doctors arrested in US crackdown on illegal opioids

Sa, 27/04/2019 - 00:00
The multiagency operation hit five states and led to the arrest of 60 people. Perpetrators face up to 50 years' prison sentence if found guilty. Susan Jaffe reports.

[World Report] RTS,S malaria vaccine pilots in three African countries

Sa, 27/04/2019 - 00:00
The vaccine is to be rolled out in Ghana, Kenya, and Malawi, 2 years after the announcement of the programme. Paul Adepoju reports.

[World Report] US FDA rules manufacturers to stop selling mesh devices

Sa, 27/04/2019 - 00:00
The US Food and Drug Administration has said that there isn't sufficient safety and efficacy evidence to support the device being distributed in the USA. Ed Holt reports.