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[Articles] Effects, equity, and cost of school-based and community-wide treatment strategies for soil-transmitted helminths in Kenya: a cluster-randomised controlled trial

Ve, 19/04/2019 - 00:30
Community-wide treatment was more effective in reducing hookworm prevalence and intensity than school-based treatment, with little additional benefit of treating every 6 months, and was shown to be remarkably equitable in coverage and effects.

[Comment] UK Public Health Science 2019: a call for abstracts

Gi, 18/04/2019 - 00:30
In the current climate of political uncertainty in the UK and abroad, public health voices that champion equity, sustainability, and the long-term view can struggle to make themselves heard. Generating and implementing evidence that draws on insights from a diversity of research disciplines and that is relevant to policy and practice across societies is more important than ever. We, therefore, welcome abstract submissions for Public Health Science 2019: A National Conference Dedicated to New Research in UK Public Health, to be held in London, UK, on Nov 29, 2019.

[Comment] A turning point for chronic kidney disease in diabetes

Lu, 15/04/2019 - 01:20
The worldwide prevalence of chronic kidney disease is one in seven to one in ten adults.1,2 This pandemic is closely linked to a global diabetes emergency.3 In 2017, 425 million adults had diabetes, with a projection for a 48% increase to 629 million by 2045.3 About half of those with diabetes develop chronic kidney disease.4 Progressive chronic kidney disease eventuates in end-stage kidney disease requiring dialysis or kidney transplantation to sustain life. However, only about 10% of patients survive to end-stage kidney disease because of premature death, predominantly from cardiovascular diseases and infections.

[Articles] Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Lu, 15/04/2019 - 01:20
Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease.

[Editorial] Post-Castro Cuba: new constitution expands health rights

Sa, 13/04/2019 - 00:00
2019 marks the 60th anniversary of the 26th of July Movement, which established Fidel Castro as the leader of the new Cuban Government. Decades later, Cuba is holding fast to its Communist ideology, even after revolutionary icon Fidel Castro's death in 2016 and his brother Raúl stepping down in 2018. Although the grip on power of the so-called historic generation is loosening, the new generation has “demonstrated capacity to uphold the banners of…Revolution and Socialism”, as Raúl Castro noted in 2013.

[Editorial] Best practice in managing postoperative pain

Sa, 13/04/2019 - 00:00
Controlling acute pain after surgery is important not only in the immediate postoperative phase but also to prevent chronic postsurgical pain, which can develop in as many as 10% of patients. A Series of three papers in this week's issue examines postoperative pain management, outlines how and why acute pain can become chronic, what can be done to lessen that risk, and the role of opioids.

[Editorial] Artificial intelligence in global health: a brave new world

Sa, 13/04/2019 - 00:00
Despite decades of progress in global health, many low and middle income countries are not reaching their health Sustainable Development Goals, creating a sense of urgency to prioritise health in resource-strained environments. The use of artificial intelligence (AI) is becoming increasingly attractive to the health-care industry. The accompanying enthusiasm remains awkwardly placed somewhere between aspiration and reality.

[Comment] Optimal postoperative pain management: redefining the role for opioids

Sa, 13/04/2019 - 00:00
Fear of pain is deeply rooted among patients who are about to have surgery.1 Satisfactory perioperative pain management is crucial to assuring a good patient experience, optimising postoperative outcomes, and enhancing functional recovery after surgery.2 Despite decades of research showing the benefits of various new analgesic strategies, many patients endure severe postoperative pain,3 and this holds true across all age groups and continents, even after surgery widely considered to be minor.4 A 2016 study from the USA, which enrolled 799 449 patients, showed that reliance on opioid analgesics as the mainstay for perioperative pain management is still widespread.

[Comment] Guidelines for the diagnosis and treatment of Chagas disease

Sa, 13/04/2019 - 00:00
Chagas disease, caused by the protozoan Trypanosoma cruzi, constitutes a substantial public health concern due to its high morbidity and mortality rates among people typically in low-income populations who often do not have access to timely medical diagnosis and treatment. There are also high economic and social costs generated by the disease. Despite successful and sustained vector control policies and screening of blood and organs for donation, more than 6 million people still live with Chagas disease in the Americas, most of them unaware of their infection.

[Comment] Offline: Facing down the violence of liberal communists

Sa, 13/04/2019 - 00:00
Knife crime. School shootings. Islamophobic and anti-Semitic killings. Sexual violence. Child maltreatment. Gangs. Guns. War. Anthropologist Alain Bertho calls our time the Age of Violence (the title of his 2018 book)—“this is an era conducive to the most varied of murderous follies”. Last week, Britain's Prime Minister and her Home Secretary (Theresa May and Sajid Javid) used a Serious Youth Violence Summit, held at 10 Downing Street, to launch a new approach to violence. What they propose seems to make a great deal of sense.

[World Report] International outrage over Brunei's discriminatory laws

Sa, 13/04/2019 - 00:00
The egregious laws would disproportionately affect LGBT communities and women, experts say. Sharmila Devi reports.

[World Report] Health debate rising around the upcoming Indian election

Sa, 13/04/2019 - 00:00
The BJP will be promoting its Ayushman Bharat scheme further, while the main party in opposition decries an insurance-based model. Patralekha Chatterjee reports from New Delhi and Haryana.

[World Report] Italy calls on retired doctors to fill health worker gap

Sa, 13/04/2019 - 00:00
Experts say that the shortfall of doctors has been fuelled by poorly conceived policies for health worker recruitment dating back 10 years. Marta Paterlini reports.

[Perspectives] Digital health care for older adults

Sa, 13/04/2019 - 00:00
Leila is an 86-year-old woman with type 2 diabetes and high blood pressure. She lives alone, and, as a result of a recent heart attack, her family doctor and cardiologist want to see her more frequently. She has some moderate arthritis involving her knees and hips and poor vision, but she is committed to maintaining her independence.

[Perspectives] Writing the body

Sa, 13/04/2019 - 00:00
What is the thing called you? When I was admitted to hospital with abdominal pain in my twenties, I asked the doctor giving me an ultrasound to show me around my own interior. Bladder, uterus, appendix: so this was me, after all this time, although I didn't feel nearly so naked examining my guts on a screen as I did a day later, when a surgeon came to look at the stitches where he'd sealed me up after an appendectomy. Our bodies are as personal as you can get, but they're also alien and unknown, the inner self inaccessible as another planet, at least under normal circumstances.

[Perspectives] Ramani Moonesinghe: anaesthetist with a perioperative vision

Sa, 13/04/2019 - 00:00
“I am a clinical academic who strives to improve perioperative care”, states the opening sentence of anaesthetist Professor Suneetha Ramani Moonesinghe's CV. And strive she does if the number of research groups and advisory bodies that she variously directs or belongs to is a relevant metric. “There are lots of people in academic medicine who are personally ambitious and driven”, says Viki Mitchell, one of Moonesinghe's fellow anaesthetists at London's University College Hospital (UCH) and its Divisional Clinical Director for Anaesthesia and Perioperative Medicine.

[Perspectives] Disease X and other unknowns

Sa, 13/04/2019 - 00:00
On Feb 26, 2003, Carlo Urbani, an infectious diseases specialist in WHO's country office in Vietnam, was called to the French Hospital in Hanoi to examine a grievously ill Chinese-American businessman. Johnny Chen had been admitted with severe breathing difficulties shortly after stepping off a flight from Hong Kong and was being nursed in intensive care, where x-rays revealed ominous shadows on his lungs. Fearing Chen had a virulent form of avian influenza, Urbani convinced the Vietnamese authorities to quarantine the hospital and made staff wear high-filter masks and double gowns.

[Perspectives] Closure or retribution?

Sa, 13/04/2019 - 00:00
In a shared house in downstate Illinois, Andy (an intense performance by Tim Hopper), a man in his forties, sits on a sofa trying to express his feelings of anger and low self-esteem to Fred (a creepy Francis Guinan), an elderly man who uses a wheelchair. But he is constantly interrupted by the arrival of other people and phone calls. What seems to be a comical situation is instead the wrong-footed opening of Bruce Norris's incendiary play Downstate, directed by Pam MacKinnon in a co-production with Steppenwolf Theatre at the National Theatre, London, UK.

[Obituary] William Carter Jenkins

Sa, 13/04/2019 - 00:00
Epidemiologist and whistleblower on notorious Tuskegee study. Born July 26, 1945, in Mount Pleasant, SC, USA, he died of complications of sarcoidosis on Feb 17, 2019, in Charleston, SC, USA, aged 73 years.

[Correspondence] Indigenous Australian children and the impact of adoption legislation in New South Wales

Sa, 13/04/2019 - 00:00
Despite widespread opposition from the community, during the final days of 2018, the Parliament of New South Wales (Australia) passed legislation imposing an arbitrary 24 months for children in out-of-home care to be reunited with their families, before adoption can become permanent. The new laws enable a 2 year limit on the creation of permanent arrangements for a child, guardianship orders that can be arranged without parental consent, amendments to the application process of family restoration, and removal of parental consent for adoption on permanent orders.