In the April issue of PLoS Medicine
Some readers might wonder why a general medical journal would publish a paper questioning how lethal execution causes death ; after all it doesn’t really provide insight into any clinical condition and, as we say in the editorial, we are not advocating that anyone tries to come up with a better way of killing people. We’d argue that that execution is a human rights issue and take a similar view to Tony Delamothe in the BMJ who defined their scope as the “clinical, scientific, social, political, and economic factors affecting health”; from this point of view, execution is a legitimate topic for a medical journal.
Another human right is that to medical treatment and in a persuasive essay Gorik Ooms argues that much of the money being poured into this area will be wasted unless the fund also makes a commitment to fund health workers’ salaries.
Another theme of the issue is how to influence behavior. Arguably the most efficient way to improve public health is to influence the behavior of populations by means of large scale public health polices. Albert Lowenfels and colleagues analysed the policies for alcohol control across 30 countries in Europe, Asia, North America, and Australia and found a clear inverse relationship between policy strength and alcohol consumption. In a related perspective article Alison Ritter discusses the pros and cons of the Alcohol Policy Index – the new metric used in this analysis.
Elsewhere in the journal are two revealing articles on the behavior of drug company representatives (drug reps), who influence doctors’ behavior greatly. Using data obtained following litigation that alleged that one drug, gabapentin, was promoted for off-label uses Lisa Bero and colleagues showed the effectiveness of visits by drug reps to doctors in that that despite their short duration, visits were frequently followed by physicians intending to increase their future recommending or prescribing of the drug. In a separate paper, which grew out of conversations between a former drug rep and a physician who researches pharmaceutical marketing, the drug rep reveals the strategies used by reps to manipulate physician prescribing.
Other articles in the issue focus on very specific areas of medicine. Margaret Conner and colleagues suggest that rotavirus is not limited to the intestine of children but that infectious virus is also present in their blood; John Chute and colleagues describe gene expression signatures that can predict radiation exposure ; Frauke Zipp and colleagues describe a new antibody that can distinguish between neuomyelitis optica, a demyelinating disorder, and other neuroinflammatory disorders such as multiple sclerosis. EAE, an animal model of MS, is also discussed in a paper by Harald Neumann and colleagues in which myeloid precursors transduced with TREM2 seemed able to clear much of the cellular debris that is found in the brain of mice with EAE. And an intriguing paper by Ewan Pearson and colleagues suggests that mutations in one gene can have a substantial effect on birthweight – by almost 500g . And lastly, a series of letters discuss the policy forum published in January on XDR-TB; an area of medicine that is already generating a great many papers on all aspects of this emerging disease.