Medical Journal News

New England Journal of Medicine, Volume 392, Issue 1, Page 99-101, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, Page 101-102, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, Page 97-99, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, Page 85-89, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, Page 83-84, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, Page 81-82, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, Page 73-79, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, Page 72-72, January 2, 2025.

New England Journal of Medicine, Volume 392, Issue 1, January 2, 2025.

by Jewel Gausman, Richard Adanu, Delia A. B. Bandoh, Neena R Kapoor, Ernest Kenu, Ana Langer, Magdalene A. Odikro, Thomas Pullum, R. Rima Jolivet

Background

Sustainable Development Goal (SDG) Indicator 5.6.2 is the “Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information, and education.” This indicator plays a key role in tracking global progress toward achieving gender equity and empowerment, ensuring its validity is essential. Significant challenges related to the indicator’s calculation have been noted, which have important implications for the indicator’s validity in measuring progress towards meeting the SDG target. Recommendations have been made to revise the scoring of the indicator. This study examines the indicator’s validity by proposing a revision to the indicator’s calculation that addresses these global concerns and comparing the resulting values.

Methods and findings

This is an observational, validation study which used secondary data from the 2022 United Nations Population Fund’s Sexual and Reproductive Health and Rights Country Profiles from 75 countries. To address global recommendations, we proposed making 2 changes to the indicator’s calculation. First, we re-expressed all barriers and enablers to take positive values. Second, we used a weighted additive approach to calculate the total score, rather than the mean of the 13 individual component scores, which assigns equal weight to the substantive domains rather than the components. Our main outcome measures are the indicator values obtained from both scoring approaches examined. We assessed the indicator’s convergent validity by comparing the value obtained using the indicator’s current formula to the proposed formula using the Bland–Altman approach. We examined and interpreted changes in the indicator’s overall score that result from comparing the existing indicator with the proposed alternative. Differences in the total value of the indicator comparing the alternative versus the current formulation range from −7.18 percentage points in Mali to 26.21 percentage points in South Sudan. The majority of countries (n = 47) had an increase in total indicator score as a result of the alternative formula, while 27 countries had a decrease in score. Only 1 country, Sweden, saw no change in score, as it scored 100% of the possible indicator value under both rubrics. The mean difference between the scores produced by the 2 measures is 2.28 suggesting that the 2 methods may produce systematically different results. Under the alternative formulation, the most substantial changes were observed in the scores for “Component 3: Abortion.” The indicator’s current calculation results in 16 countries being assigned a score of zero, for “Component 3: Abortion” which masks important differences in the number of legal barriers present and whether women can be criminally charged for illegal abortion. After re-expressing barriers on a positive scale following the proposed formulation, only 4 countries have a score of zero for Component 3. The main limitation of our methodology is that there is no gold standard for measurement of the phenomenon under study, and thus we are unable to specify with total certainty which indicator performs better.

Conclusions

Our results illustrate underlying challenges with the current indicator formulation that impact its interpretability. The proposed changes could alter the way the current legal landscape governing sexual and reproductive health is understood, thereby pointing to different programmatic and policy priorities that may better support countries in achieving full and equal access to sexual and reproductive health and rights globally.

Are you making a meal over New Year’s resolutions?Absolutely. As the name suggests, Veganuary encourages people to go vegan at the start of every year.Turning over a new leaf?Exactly! And eating more leaves too. The benefits of a plant based diet are well documented.1 It’s good for the planet: plant based foods produce fewer greenhouse gas emissions than animal based foods. And it’s good for human health, reducing the risk of chronic disease, including cardiovascular conditions. Abstinence, you might say, makes the heart grow stronger.I don’t like fadsA vegan diet isn’t a fad. Neither is Veganuary a flash in the pan, as it’s now marking its 10th year. Veganism is now baked into our culture.OK, veggie burgers here I comeSteady on. A study published in the Proceedings of the National Academy of Sciences ranked 24 meat and milk alternatives in terms of nutrition, health, environmental, and cost perspectives.2 It found...

A consultant psychiatrist has been struck off the UK medical register after a tribunal found that he had engaged in “scaremongering” over coronavirus vaccines in an online video.Daniel Armstrong accused governments, health authorities, and drug companies of mounting a “monumental cover-up operation” to hide vaccine harms in his video, entitled Navigating the Truth-Deception Duality Brought to you by Dr Daniel Armstrong MBChB. The video was reported to the General Medical Council (GMC) by an anonymous email.“I am using my doctor title, my registration under the GMC in the UK, to bring you this message about what the truth is, but also highlight the deception,” said Armstrong in his video. “You’ve a doctor here, he’s got his licence on the line—given it up. Don’t take any more of the injections. These guys are evil.”The European Convention on Human Rights guarantees the right to free speech, and case law has upheld the...

Pilot medical apprenticeship programmes in England, which were being trialled as a new route into the profession, have been paused by the government.Peninsula Medical School in Plymouth, one of the universities in the pilot scheme, has been told not to recruit for the course—due to start in September 2025—pending a review of doctor apprenticeships, which were intended to widen access to medical careers. The arm’s length agency Skills England told course leaders at the medical school that it would review and “discuss areas where funding for level 7 apprenticeships will be restricted, and a decision will follow in due course.”Laura Bowater, head of the Peninsula Medical School, described the government’s move as “disappointing.” She told The BMJ that the change was part of the government’s cooling towards level 7 apprenticeships, which include medicine.Anglia Ruskin University has 25 medical apprentices on its course, which started in September 2024. The University of...

Davis and colleagues highlight the critical need for clearer and more accessible information about medicines for patients.1 As an anaesthetist, I often encounter challenges in communicating the risks and benefits of perioperative drugs, particularly as we cannot always predict every medication that might be required during an operation.A key example is sugammadex, a neuromuscular blockade reversal agent that can reduce the efficacy of hormonal contraceptives by binding to steroidal molecules, thus increasing the risk of unintended pregnancy. Patients must be advised to use alternative contraceptive measures for up to seven days after its administration. Such vital information is often overlooked, however, creating a potential gap in patient understanding. This emphasises the need for accessible drug information that can be easily conveyed in time critical scenarios.The unpredictability of anaesthetic practice further complicates the consent process. It is often not possible to foresee every medication that might be given during surgery, such...

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

New England Journal of Medicine, Ahead of Print.

Preliminary laboratory findings suggest that a mystery illness in the Democratic Republic of the Congo is a combination of common and seasonal viral respiratory infections and malaria, the World Health Organization (WHO) has said.1WHO described the previously undiagnosed disease as “acute respiratory infections complicated by malaria,” which had led to an increase in severe infections and death when compounded by acute malnutrition.A broad surveillance case definition was established in absence of a diagnosis, which included patients who presented with fever, cough, body weakness, and runny nose. Other signs and symptoms may include chills, headache, difficulty breathing, malnutrition, and body aches.From 24 October to 16 December a total of 891 cases and 48 deaths from the Panzi health zone in the Kwango province met the case definition. More cases occurred in females (58%), especially adults (66%). The disease disproportionately affected children under 5 years old, who made up 47% of all...

The last major hospital in northern Gaza is now out of commission after a raid by Israeli forces left its surgical unit, medical store, and laboratory “burnt and severely damaged.” Staff and critically ill patients have been forced to leave, and the hospital’s director, Hussam Abu Safiya, has been detained.The World Health Organization (WHO) said that it was “appalled” by the raid, which “put the last major health facility in North Gaza out of service,” and was “deeply concerned” for the patients moved to a hospital that cannot care for them, as well as for Abu Safiya. “Kamal Adwan is now empty,” said WHO. “Some people were reportedly stripped and forced to walk toward southern Gaza.”Since early October WHO has confirmed at least 50 attacks on healthcare that took place on or around the hospital. It said, “Attacks on the hospitals and on health workers have occurred almost daily. This...

Davis and colleagues share their concern about the lack of accessible information on both the magnitude and nature of the benefits of new drugs.1 Without such information, it is impossible for patients, or clinicians, to balance the benefits against the adverse effects of the medicine and so arrive at an informed choice.I have been an independent adviser for the UK medicines regulator, the Medicines and Healthcare Products Regulatory Agency, for 40 years and have for many years urged the agency to explore ways of filling this astonishing gap. Almost insurmountable problems exist in two forms: current information for patients is almost entirely with the manufacturers, who would have to be persuaded to invest in the initiative, and many of the clinical rating scales used in the pivotal clinical trials cannot readily be translated into language that means much to patients. These are huge problems, but as the article points out,...