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National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

L'architecture victorienne est parcourue de contradictions. Technophilie et technophobie coexistent dans la culture architecturale de l'Angleterre de la seconde moitié du XIXe siècle. D'une part, les architectes et les ingénieurs construisent des bâtiments à partir de matériaux innovants comme le fer et le verre et grâce à des procédés issus de la technologie moderne, comme la préfabrication et les biens manufacturés. D'autre part, c'est depuis la culture architecturale que s'élèvent les voix qui condamnent l'industrialisation. Augustus Welby Northmore Pugin et John Ruskin, qui idéalisent le Moyen-Âge, utilisent l'architecture comme point de départ de leur critique du monde moderne et de leur dénonciation des effets désastreux de l'industrialisation sur la société. Comment les architectes victoriens parviennent-ils à composer avec de telles critiques tout en répondant aux besoins des clients de leur époque ? Cet article explore les contradictions de l'architecture victorienne à travers les pratiques architecturales de George Gilbert Scott et E. W. Godwin qui négocient ces demandes contradictoires consistant à utiliser la technologie moderne et à restituer une vision idéale du passé. Les plans que dessine Scott pour le Midland Grand Hotel de St. Pancras soulignent la contradiction architecturale qui réside dans l'utilisation de la technologie la plus récente pour redonner vie au passé. Godwin, quant à lui, adopte une attitude ambiguë face au renouveau architectural en considérant les atouts d'une architecture simple et dénuée de style, en accord avec les réalités de son temps. Les parcours de Scott et de Godwin soulignent la complexité des réponses face aux avantages et aux inconvénients de l'évolution technologique.

L’architecture victorienne est parcourue de contradictions. Technophilie et technophobie coexistent dans la culture architecturale de l’Angleterre de la seconde moitié du xixe siècle. D’une part, les architectes et les ingénieurs construisent des bâtiments à partir de matériaux innovants comme le fer et le verre et grâce à des procédés issus de la technologie moderne, comme la préfabrication et les biens manufacturés. D’autre part, c’est depuis la culture architecturale que s’élèvent les voix qui condamnent l’industrialisation. Augustus Welby Northmore Pugin et John Ruskin, qui idéalisent le Moyen-Âge, utilisent l’architecture comme point de départ de leur critique du monde moderne et de leur dénonciation des effets désastreux de l’industrialisation sur la société. Comment les architectes victoriens parviennent-ils à composer avec de telles critiques tout en répondant aux besoins des clients de leur époque ? Cet article explore les contradictions de l’architecture victorienne à travers les pratiques architecturales de George Gilbert Scott et E. W. Godwin qui négocient ces demandes contradictoires consistant à utiliser la technologie moderne et à restituer une vision idéale du passé. Les plans que dessine Scott pour le Midland Grand Hotel de St. Pancras soulignent la contradiction architecturale qui réside dans l’utilisation de la technologie la plus récente pour redonner vie au passé. Godwin, quant à lui, adopte une attitude ambiguë face au renouveau architectural en considérant les atouts d’une architecture simple et dénuée de style, en accord avec les réalités de son temps. Les parcours de Scott et de Godwin soulignent la complexité des réponses face aux avantages et aux inconvénients de l’évolution technologique.

Over at the George W. Bush Childhood Home museum, a three-bedroom rambler on West Ohio Avenue where the young Bush lived from 1951 to 1955, curators made a point of opening their doors to visitors during the Obama inauguration ceremony -- and promised there would be no televisions to distract those paying their respects.

Re-assembling of Parliament (pg. 71). New Military Service Bill (pg. 71-72). Its Provisions (pg. 72-73). Second Reading Debate (pg. 73-74). Criticism by Mr. Asquith (pg. 74-75). Passed into Law (pg. 75-76). Report of the Irish Convention (pg. 76-77). The Budget (pg. 77-78). Chancellor of the Exchequer's Speech (pg. 78-79). Debate (pg. 79-80). Chancellor's Reply (pg. 80-81). Resignation of General Trenchard (pg. 81-82). Debate (pg. 82-83). Letter of General Maurice to The Times (pg. 83-84). Questions in Parliament (pg. 84-85). Debate on the Maurice Letter (pg. 85-86). Economic Policy (pg. 86-87). Increase of Railway Fares (pg. 87). The Whitsun Recess (pg. 87-88). Conspiracy in Ireland (pg. 88-89). The Ministry of Pensions (pg. 89). The Education Bill (pg. 89-90). Finance Bill in Committee (pg. 90-91). Irish Affairs (pg. 91-92). The Food Situation (pg. 92-93). Work of the Post Office (pg. 93-94). Vote of Credit (pg. 94-95). Control of National Expenditure (pg. 95-96). Finance Bill (Third Reading) (pg. 96-97). The Trade Boards Bill (pg. 97-98). The Imperial War Cabinet (pg. 98-99). Conference of the Labour Party (pg. 99-100). End of the Political Truce (pg. 100-101). National Housing (pg. 101-102). Progress in Food Control (pg. 102-103). Prime Minister's Appeal to Women (pg. 103). National Kitchens (pg. 103-104). Standard Clothing (pg. 104-105). “A Scandalous Trial” (pg. 105).