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Medical Journal News
Tackling gender disparities in physician suicide: insights from India
The recent systematic review and meta-analysis by Zimmermann and colleagues presents crucial insights into the ongoing gender disparity in physician suicide rates.1 While the overall reduction in suicide among physicians is commendable, the persistently elevated risk in female physicians is a concern that warrants attention.In the Indian context, the challenges faced by female physicians are exacerbated by societal expectations, professional discrimination, and the demanding nature of the medical profession. Psychological stressors, including burnout and depression, are particularly prevalent among female doctors in tertiary care settings in North India.2 These stressors are further compounded by cultural stigmas that hinder help seeking behaviours.2Recent studies underscore the severity of this problem, with nearly 40% of female doctors reporting high stress levels.3 This degree of stress correlates with an increased risk of mental health disorders, including suicidal ideation.To combat this ongoing problem it is essential that healthcare systems implement gender sensitive strategies. One promising...
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FDA proposes limiting the amount of nicotine in cigarettes
The US Food and Drug Administration (FDA) has proposed a rule to restrict the amount of nicotine in cigarettes and other tobacco products to non-addictive levels. If the rule is approved the US would be the first country to do so.1The FDA said that cigarettes and other combustible tobacco products such as cigars and pipe tobacco are the most harmful tobacco products. “Cigarette smoking is the leading cause of preventable diseases and death in the US and is a major driver of chronic diseases nationally. Each year, cigarette smoking alone is estimated to kill nearly half a million people nationally and has been estimated to cost the country more than $600bn (£492bn; €581bn) annually in healthcare costs and lost productivity,” the FDA said.The rule is open for comments until 15 September 2025, after which the agency will decide on future action. That decision will be made under the new administration...
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Out-of-area mental health placements: we must increase resources for severe mental illness and capacity for inpatient care
The Health Services Safety Investigations Body (HSSIB) report1 on out-of-area mental health inpatient placements provides a welcome spotlight on the problem.2 Psychiatrists have, however, repeatedly raised concerns since the Royal College of Psychiatrists set up the Commission on Acute Adult Inpatient Care in 2015, and the Department for Health and Social Care committed to eliminate out-of-area admissions in 2016.3 The HSSIB report highlights several reasons for the failure to achieve this aim, including governance, legal frameworks, and financial arrangements between health and social care services. What is missing, however, is a more fundamental understanding of why the problem has arisen.Much can be attributed to the consequences of the unstated and unevidenced UK mental health policy principles that have held sway for over 20 years: that hospital admission is a failure of least restrictive care by mental health services; that early intervention will prevent the development of most serious mental illness;...
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Vaginal Varix in Pregnancy
New England Journal of Medicine, Ahead of Print.
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Gender-Affirming Surgical Care in Carceral Settings
New England Journal of Medicine, Ahead of Print.
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Ebola and a Decade of Disparities — Forging a Future for Global Health Equity
New England Journal of Medicine, Ahead of Print.
Categories: Medical Journal News
[Editorial] Health in the age of disinformation
Health misinformation (false or misleading data shared unintentionally) and disinformation (deliberately deceptive information) are not new, but the COVID-19 pandemic marked a turning point. The sense of anxiety and urgency, coupled with the rise in the use of social media and politically charged interpretations of the pandemic, fostered the spread of a series of misleading claims about the virus and medical countermeasures. Health misinformation was weaponised as propaganda, exploiting fear, undermining public trust, and hindering collective action in critical moments.
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[Comment] Antibiotics alone versus appendicectomy for uncomplicated appendicitis in children
An international team has set out to answer one of the more vexing questions in paediatric medicine today—namely, are antibiotics alone adequate treatment for acute appendicitis? First, they are to be applauded for this important and unfunded effort. In The Lancet, Shawn D St Peter and colleagues report the results of an international, open-label, multicentre, randomised non-inferiority trial of non-operative treatment with antibiotics alone versus surgical appendicectomy for acute, uncomplicated appendicitis in children—the APPY trial.
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[Comment] Offline: Healing Argentina's wounds
The Haroldo Conti Cultural Centre remains closed. The official explanation from President Javier Milei's Government: “internal restructuring”. This month, thousands of protesters gathered in front of the Escuela de Mecánica de la Armada (ESMA) in Buenos Aires, home to the Cultural Centre, Argentina's National Memory Archive, and, between 1976 and 1983, a Clandestine Centre of Detention, Torture, and Extermination. ESMA was declared a World Heritage Site by UNESCO in 2023. The protesters entitled their vigil, A Memory that Burns (Una memoria que arde).
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[Perspectives] On eugenics, disability, and dignity
The Nazi regime's eugenic determination to “purify” the German “Volk” and society astonishes us to this day with its combination of sheer brutality, careful planning, and public support. The Law for the Prevention of Hereditarily Diseased Offspring introduced on July 14, 1933 mandated the forced sterilisation of individuals with physical and mental disabilities, people who were regarded as so-called “asocial (criminal) elements”, homosexuals, and Roma and Afro-German ethnic minorities. Between 1933 and 1945, it is estimated between 310 000 and 350 000 people belonging to these groups were coercively sterilised and thousands died of medical complications resulting from these procedures.
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[Perspectives] Everything in its right place
At first glance, the title of We Live in Time, a charming and moving comedy-drama from director John Crowley, suggests something abstract and ethereal. Yet it is a statement profoundly rooted in the embodied human experience. We live in time in the sense that the pleasures, pains, and restrictions of our lives are defined not only by our physical surroundings, but by the passage of time itself. Early in the film, this issue becomes particularly pertinent to Almut Brühl (Florence Pugh), a chef whose ovarian cancer has returned, and is at stage 3; how, she wonders, should she spend the next year? Undergoing treatment, which might not work, or simply trying to enjoy her remaining time? What is “the right choice”?
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[Perspectives] The end, and what comes after
In March, 2024, Paul Alexander, the last person in the world living with an iron lung, died. Alexander had contracted poliomyelitis in 1952 when he was 6 years old, and from that point onwards was only able to move his head, neck, and mouth. Iron lungs became a symbol of polio during the epidemic outbreaks of the 1950s, when they were widely used to save the lives of patients with respiratory paralysis during the acute phase of the disease. Iron lungs are now staple exhibition pieces in history of medicine museums, as global polio vaccination efforts have put a stop to major epidemic waves.
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[Obituary] Jimmy Carter
Former US President, humanitarian, and global health champion. Born on Oct 1, 1924, in Plains, GA, USA, he died there on Dec 29, 2024, aged 100 years.
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[Correspondence] Relocation for poverty alleviation: China's path
Poverty eradication by 2030 is the primary objective of the UN Sustainable Development Goals. China is determined to eradicate extreme poverty and uses the relocation of people who are poverty-stricken as a major measure of the targeted poverty alleviation strategy. Wangnian Liang and colleagues discussed the collaboration between Tsinghua University's Vanke School of Public Health and The Lancet aiming to comprehensively evaluate the effectiveness of China's Health and Poverty Alleviation Campaign.
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[Correspondence] Telerehabilitation for chronic knee pain: the PEAK trial
We read with great interest the Article by Rana S Hinman and colleagues,1 which compared the effectiveness of telerehabilitation consultations for chronic knee pain with in-person consultations. However, we have some concerns.
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[Correspondence] Telerehabilitation for chronic knee pain: the PEAK trial
We praise Rana S Hinman and colleagues1 for their comprehensive investigation into the efficacy of telerehabilitation consultations versus in-person consultations for chronic knee pain management. However, although the study offers substantial contributions to the field of rehabilitation medicine, we wish to highlight aspects that could enhance the interpretation of results.
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[Correspondence] Telerehabilitation for chronic knee pain: the PEAK trial
We read with great interest about the PEAK trial,1 which revealed equivalence in clinical outcomes between in-person and remote physiotherapy for patients with chronic knee pain.1 We comment on the significance of the behavioural change intervention of the non-inferiority trial.
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[Correspondence] Telerehabilitation for chronic knee pain: the PEAK trial
We read the Article by Rana S Hinman and colleagues1 with great interest. As highlighted by the study, a substantial reduction in travel time and cost to the clinic is of great benefit to the older population who require financial assistance and have a high physical burden of travel.
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[Correspondence] Telerehabilitation for chronic knee pain: the PEAK trial – Authors' reply
We welcome the interest in our PEAK randomised trial1 and thank the authors for their Correspondence. We agree with Jieliang Shen and colleagues that using social media and email for recruitment might have resulted in a sample more likely to find telerehabilitation acceptable. However, our findings are consistent with an equivalence trial2 in people seeking musculoskeletal health care, which showed that telephone-delivered physiotherapy care was equally as effective as in-person physiotherapy. Nonetheless, future implementation research is needed to confirm our findings in participants seeking health care.
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[Department of Error] Department of Error
GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023; 402: 203–34—In this Article, the map in figure 1 has been updated to correct boundary lines and shading in selected regions. This correction has been made to the online version as of Jan 16, 2025.
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