more_vertThis year, the global health community has given top priority ranking on many research and public health fronts to its battle against the spreading Zika virus epidemic. John Maurice reports.
Preference: Statistics, epidemiology and research design
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News briefs
Fungus v Aedes aegypti: battle on
Scientists looking to combat the Zika virus are trying to “weaponise” a fungus called Metarhizium brunneum which has the happy knack of being able to eat mosquito larvae from the inside out, Wired reports. Research published in PLOS Pathogens has shown that the fungus spore sticks to the mosquito larva, then “eats its way through the exoskeleton and starts to grow, fast”. The larva itself helps the process by eating more spores, which work their way through its gut and into its body cavity. The fungus grows, destroying the larva from the inside. “The fungus actually attacks mosquitoes in two ways. One variety of the fungus spore, the conidium, is airborne — it attacks adult mosquitoes. The blastospore, though, does better underwater — that’s the one that attacks the larvae … [and] is so much more virulent than the conidium. Mosquitoes are now developing resistance to pesticides, but it’s harder to resist predators and parasites that are evolving right along with them. Metarhizium brunneum could be a crucial part of the arsenal [against Zika] — as long as it doesn’t spread so widely that it starts killing more than mosquitoes.”
Aussie heads WHO’s Health Emergencies program
Dr Peter Salama, a medical epidemiologist and a University of Melbourne and Harvard University alumnus, has been appointed as the Executive Director of the World Health Organization’s (WHO) new Health Emergencies Program. Dr Salama, 47, has spent the last 18 months as the United Nations Children’s Emergency Fund (UNICEF) Regional Director for Middle East and North Africa and Global Emergency Coordinator for the crises in Syria, Iraq and Yemen. Before that was UNICEF’s Country Representative in Ethiopia and Zimbabwe, as Global Coordinator for Ebola, and as Chief of Global Health. He previously worked at the Centers for Disease Control in the US and with Medecins Sans Frontieres. According to a statement from the WHO: “WHO’s new Health Emergencies Program is designed to deliver rapid, predictable and comprehensive support to countries and communities as they prepare for, face or recover from emergencies caused by any type of hazard to human health, whether disease outbreaks, natural or man-made disasters or conflicts. The development of the new Program is the result of a reform effort, based on recommendations from a range of independent and expert external reports, involving all levels of WHO — country offices, regional offices and headquarters.
[Perspectives] Sari Reisner—making transgender health visible
“Gender diversity exists in every culture and geographic context. It is to be celebrated, not pathologised”, says Sari Reisner, lead author of a paper in The Lancet’s first Series on transgender health. Reisner’s work is helping to advance this agenda. Based in Boston, USA, he enjoys a varied career as Assistant Professor at Harvard Medical School and Boston Children’s Hospital, with a secondary appointment at the Harvard T H Chan School of Public Health, and as Affiliated Research Scientist at The Fenway Institute at Fenway Health.
[Perspectives] GIRES: e-learning for transgender health training
The Gender Identity Research and Education Society (GIRES) was established as a UK-based charity in 1997 by my husband Bernard Reed with the support of transgender activists. We both serve as Trustees. We are the parents of a trans woman who transitioned in a very hostile work environment where she was continuously bullied, causing her to attempt suicide. We helped her to mount a legal challenge against her employer, which she won. The aim of GIRES is to prevent such events happening to other transgender and gender non-conforming people, and to improve their lives.
[Perspectives] Transgender: why should we care?
It was entirely coincidence that I changed employment in 1988 as I was awaiting confirmation from the doctors at Stanford University that I was a worthy candidate for sex reassignment. I had researched and soul-searched for years, struggling with the decision to apply to that programme. I had learned that their entrance criteria were rigorous, and I wanted the validation the programme would give me. I could tell my mother that I had been diagnosed by real doctors, and that there was no doubt my health would benefit from the transition from female to male.
[Editorial] Protocol disparities and research governance
To improve health, research should be reported fully and transparently. If this is not done, it is important to understand why, as discussed today in Correspondence about a trial of neurodevelopmental outcomes after anaesthesia in infancy. Article authors, Andrew Davidson and colleagues, respond to COMPare by explaining that the discrepancies in their reporting were minor errors of omission. Trial registry manager Lisa Askie recommends better updating of outcome details. Meanwhile, the COMPare website states that not only do journals not check for outcome switching, but they routinely permit it.
[Perspectives] Irene Tracey: seeing pain for what it is
Reflecting on the tension between clinicians and scientists that still makes occasional appearances in medical research circles, Professor Irene Tracey speaks dismissively of what she calls “badge-wearing”. This October will see her taking up a post as Head of the Nuffield Department of Clinical Neurosciences at the University of Oxford. The job is one that might traditionally have been expected to go to a clinician; Tracey’s background is in the science of biochemistry and she is already Head of Oxford’s Nuffield Division of Anaesthetics, another job for which the spec might well have read “clinical”.
[Comment] The Lancet Public Health: a new journal and a call for papers
The Lancet’s commitment to improving public health practice and research has long been established. From the publication of seminal studies to the hosting of annual public health conferences (in the UK and China), The Lancet has sought to strengthen the part public health can play in ensuring the right to the highest attainable standard of health for every citizen.
[Comment] Offline: The urgent need to rehumanise science
Over dinner last week, a friend turned to the subject of methods (pitiable, but true). He had just been lecturing about how to make epidemiology more meaningful. The two-by-two table was a wonderful creation, but it may not be well adapted to understanding the hypothetical causes and associative consequences of poverty, war, or climate change. Making connections between seemingly disparate settings and events—in other words, interpreting the complexity of the world—was the chief challenge for the health sciences today, he suggested.
[Comment] Does pay-for-performance in primary care save lives?
People around the world are living longer and a striking and sustained increase in life expectancy has occurred in high-income countries in the past 30 years. A key question for researchers and policy makers is how much of the improvement in mortality and active years of life is due to medical care, and how much to factors such as improved lifestyle and reduced smoking. For coronary heart disease, commonly quoted figures are that around half of the reduction in mortality could be due to improvements in medical care.