Hot off the presses! Oct 28 Lancet

The Oct 28 issue of the Lancet is now up on Pubget (About Lancet): if you're at a subscribing institution, just click the link in the latest link at the home page. (Note you'll only be able to get all the PDFs in the issue if your institution subscribes to Pubget.)

Latest Articles Include:

• Global funding for infectious diseases: TB or not TB?
  - Lancet 378(9801):1439 (2011)
  
• Cognitive rehabilitation therapy in traumatic brain injury
  - Lancet 378(9801):1440 (2011)
  
• Mental health care—the economic imperative
  - Lancet 378(9801):1440 (2011)
  
• A renewed agenda for global mental health
  - Lancet 378(9801):1441-1442 (2011)
  
• What global protection against women's cancers?
  - Lancet 378(9801):1442-1444 (2011)
  
• Provision of commercial weight management programmes
  - Lancet 378(9801):1444-1445 (2011)
  
• China's progress in neonatal mortality
  - Lancet 378(9801):1446-1447 (2011)
  
• Science to policy: M8 Alliance invites policy makers to step in
  - Lancet 378(9801):1447-1449 (2011)
  
• Time for zero deaths from tuberculosis
  - Lancet 378(9801):1449-1450 (2011)
  
• Offline: Disgrace, mystery, but also wisdom
  - Lancet 378(9801):1451 (2011)
  
• Suicide clusters: the undiscovered country
  - Lancet 378(9801):1452 (2011)
  
• Qatar sets its sights on global scientific domination
  - Lancet 378(9801):1453 (2011)
  
• 2011 Wellcome Trust Book Prize shortlist
  - Lancet 378(9801):1454 (2011)
  
• Steve Wesselingh: the wizard of Oz
  - Lancet 378(9801):1455 (2011)
  
• Kenneth Castro: a public health hero
  - Lancet 378(9801):1456 (2011)
  
• Health effects of financial crisis: omens of a Greek tragedy
  - Lancet 378(9801):1457-1458 (2011)
  
• Increased suicidality amid economic crisis in Greece
  - Lancet 378(9801):1459 (2011)
  
• IMF and European co-workers attack public health in Greece
  - Lancet 378(9801):1459-1460 (2011)
  
• The medium-secure project and criminal justice mental health
  - Lancet 378(9801):1460 (2011)
  
• The medium-secure project and criminal justice mental health – Authors' reply
  - Lancet 378(9801):1460 (2011)
  
• Department of Error
  - Lancet 378(9801):1460 (2011)
  
• Breast and cervical cancer in 187 countries between 1980 and 2010: a systematic analysis
  - Lancet 378(9801):1461-1484 (2011)
  Background Breast and cervical cancer are important causes of mortality in women aged ≥15 years. We undertook annual age-specific assessments of breast and cervical cancer in 187 countries. Methods We systematically collected cancer registry data on mortality and incidence, vital registration, and verbal autopsy data for the period 1980–2010. We modelled the mortality-to-incidence (MI) ratio using a hierarchical model. Vital registration and verbal autopsy were supplemented with incidence multiplied by the MI ratio to yield a comprehensive database of mortality rates. We used Gaussian process regression to develop estimates of mortality with uncertainty by age, sex, country, and year. We used out-of-sample predictive validity to select the final model. Estimates of incidence with uncertainty were also generated with mortality and MI ratios. Findings Global breast cancer incidence increased from 641 000 (95% uncertainty intervals 610 000–750 000) cases in 1980 to 1 643 000 (1 421 000–1 782 000) cases in 2010, an annual rate of increase of 3·1%. Global cervical cancer incidence increased from 378 000 (256 000–489 000) cases per year in 1980 to 454 000 (318 000–620 000) cases per year in 2010—a 0·6% annual rate of increase. Breast cancer killed 425 000 (359 000–453 000) women in 2010, of whom 68 000 (62 000–74 000) were aged 15–49 years in developing countries. Cervical cancer death rates have been decreasing but the disease still killed 200 000 (139 000–276 000) women in 2010, of whom 46 000 (33 000–64 000) were aged 15–49 years in developing countries. We recorded pronounced variation in the trend in breast cancer mortality across regions and countries. Interpretation More policy attention is needed to strengthen established health-system responses to reduce breast and cervical cancer, especially in developing countries. Funding Susan G Komen for the Cure and the Bill & Melinda Gates Foundation.
• Primary care referral to a commercial provider for weight loss treatment versus standard care: a randomised controlled trial
  - Lancet 378(9801):1485-1492 (2011)
  Background The increasing prevalence of overweight and obesity needs effective approaches for weight loss in primary care and community settings. We compared weight loss with standard treatment in primary care with that achieved after referral by the primary care team to a commercial provider in the community. Methods In this parallel group, non-blinded, randomised controlled trial, 772 overweight and obese adults were recruited by primary care practices in Australia, Germany, and the UK. Participants were randomly assigned with a computer-generated simple randomisation sequence to receive either 12 months of standard care as defined by national treatment guidelines, or 12 months of free membership to a commercial programme (Weight Watchers), and followed up for 12 months. The primary outcome was weight change over 12 months. Analysis was by intention to treat (last observation carried forward [LOCF] and baseline observation carried forward [BOCF]) and in the population who completed the 12-month assessment. This trial is registered, number ISRCTN85485463. Findings 377 participants were assigned to the commercial programme, of whom 230 (61%) completed the 12-month assessment; and 395 were assigned to standard care, of whom 214 (54%) completed the 12-month assessment. In all analyses, participants in the commercial programme group lost twice as much weight as did those in the standard care group. Mean weight change at 12 months was −5·06 kg (SE 0·31) for those in the commercial programme versus −2·25 kg (0·21) for those receiving standard care (adjusted difference −2·77 kg, 95% CI −3·50 to −2·03) with LOCF; −4·06 kg (0·31) versus −1·77 kg (0·19; adjusted difference −2·29 kg, −2·99 to −1·58) with BOCF; and −6·65 kg (0·43) versus −3·26 kg (0·33; adjusted difference −3·16 kg, −4·23 to −2·11) for those who completed the 12-month assessment. Participants reported no adverse events related to trial participation. Interpretation Referral by a primary health-care professional to a commercial weight loss programme that provides regular weighing, advice about diet and physical activity, motivation, and group support can offer a clinically useful early intervention for weight management in overweight and obese people that can be delivered at large scale. Funding Weight Watchers International, through a grant to the UK Medical Research Council.
• China's facility-based birth strategy and neonatal mortality: a population-based epidemiological study
  - Lancet 378(9801):1493-1500 (2011)
  Background China's success in improving the quality of and access to obstetric care in hospitals offers an opportunity to examine the effect of a large-scale facility-based strategy on neonatal mortality. We aimed to establish this effect by assessing how the institutional strategy of intrapartum care has affected neonatal mortality and its regional inequalities. Methods We did a population-based epidemiological study of China's National Maternal and Child Mortality Surveillance System from 1996 to 2008. We used data from 116 surveillance sites in China (37 urban districts and 79 rural counties) to examine neonatal mortality by cause, socioeconomic region, and place of birth, with Poisson regression to calculate relative risks. Rural counties were categorised into types 1–4, with type 4 being the least developed. We report attributable risks and preventable fractions for hospital births versus home births. Findings Neonatal mortality decreased by 62% between 1996 and 2008. The rate of neonatal mortality was much lower for hospital births than for home births in all regions, with relative risks (RR) ranging from 0·30 (95% CI 0·22–0·40) in type 2 rural counties, to 0·52 (0·33–0·83) in type 4 counties (p<0·0001). The proportion of neonatal deaths prevented by hospital birth ranged from 70% (95% CI 59·7–77·8) to 48% (16·9–67·3). Babies born in urban hospitals had a low rate of neonatal mortality (5·7 per 1000 livebirths); but those born in hospitals in type 4 rural counties were almost four times more likely to die than were children born in urban hospitals (RR 3·80, 2·53–5·72). Interpretation Other countries can learn from China's substantial progress in reducing neonatal mortality. The major effect of China's facility-based strategy on neonatal mortality is much greater than that reported for community-based interventions. Our findings will provide a great impetus for countries to increase demand for and quality of facility-based intrapartum care. Funding China Medical Board, UNICEF China.
• Bilateral spontaneous anterior dislocation of crystalline lens in an infant
  - Lancet 378(9801):1501 (2011)
  
• Poverty and mental disorders: breaking the cycle in low-income and middle-income countries
  - Lancet 378(9801):1502-1514 (2011)
  Growing international evidence shows that mental ill health and poverty interact in a negative cycle in low-income and middle-income countries. However, little is known about the interventions that are needed to break this cycle. We undertook two systematic reviews to assess the effect of financial poverty alleviation interventions on mental, neurological, and substance misuse disorders and the effect of mental health interventions on individual and family or carer economic status in countries with low and middle incomes. We found that the mental health effect of poverty alleviation interventions was inconclusive, although some conditional cash transfer and asset promotion programmes had mental health benefits. By contrast, mental health interventions were associated with improved economic outcomes in all studies, although the difference was not statistically significant in every study. We recommend several areas for future research, including undertaking of high-quali! ty intervention studies in low-income and middle-income countries, assessment of the macroeconomic consequences of scaling up of mental health care, and assessment of the effect of redistribution and market failures in mental health. This study supports the call to scale up mental health care, not only as a public health and human rights priority, but also as a development priority.
• Child and adolescent mental health worldwide: evidence for action
  - Lancet 378(9801):1515-1525 (2011)
  Mental health problems affect 10–20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability in this age group and their longlasting effects throughout life, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. In this report we review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems. We also discuss barriers to, and approaches for, the implementation of such strategies in low-resource settings. Action is imperative to reduce the burden of mental health problems in future generations and to allow for the full development of vulnerable children and adolescents worldwide.
• A purple rash
  - Lancet 378(9801):1526 (2011)