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[Correspondence] Obligations in a global health emergency – Authors' reply

Sa, 04/12/2021 - 00:00
We thank Felipe de Carvalho Borges da Fonseca and colleagues, and Kayvan Bozorgmehr and Rosa Jahn for their comments on our Viewpoint.1 We agree with de Carvalho Borges da Fonseca and colleagues about the need for “a more equitable, sustainable, and accountable medical innovation system”. Whether waiving patent rights will meaningfully improve access to COVID-19 vaccines for low-income and middle-income countries (LMICs), particularly in the short term, is an empirical matter. There is wide agreement that intellectual property (IP) for mRNA vaccines is not a primary barrier to vaccinating the world;2,3 vaccine production, distribution, and administration are the rate-limiting steps.

[Correspondence] Enabling physical activity for people living with disabilities

Sa, 04/12/2021 - 00:00
The call for multi-level action for the promotion of participation of people living with disabilities (PLWD) in physical activity by Kathleen Martin Ginis and colleagues1 underscores the lack of structural opportunities for participation. Health-care workers might provide long-term interventions to PLWD in and throughout life-course stages, with an impact on their lives. These interventions might start early in the rehabilitation process, be they congenital, early-onset, acquired, or later-onset disabilities.

[Correspondence] Enabling physical activity for people living with disabilities

Sa, 04/12/2021 - 00:00
Kathleen Martin Ginis and colleagues1 elucidated the significance and challenges of physical activity in people living with disabilities (PLWD). They summarised the difficulty of PLWD in participating in physical activity, despite the absence of serious medical problems. Due to their disability, PLWD are easily isolated from society, which can further reduce their physical activity levels. Social connectedness has been shown to have a positive effect on PLWD participating in social activities.2 Social prescribing is one such approach to resolve individual problems through the establishment of social connection.

[Correspondence] Enabling physical activity for people living with disabilities

Sa, 04/12/2021 - 00:00
We agree with Kathleen Martin Ginis and colleagues1 that theory-based interventions are needed to increase both the quantity and quality of physical activity participation of people living with disabilities (PLWD), and that investing and appropriately resourcing are necessary steps. To date, there has been no considerable progress in physical activity promotion at PLWD level. The distributional effect of broad environmental interventions2 should be given greater emphasis to increase the opportunities of achieving adequate levels of physical activity, thus contributing to increasing social equality for PLWD.

[Correspondence] Enabling physical activity for people living with disabilities – Authors' reply

Sa, 04/12/2021 - 00:00
With interest, we read the Correspondence in response to our recent Series paper,1 all of which raise excellent points regarding the need for greater efforts to advance physical activity participation in children, youth, and adults with disabilities and provide suggestions for doing so.

[Clinical Picture] Fever, abdominal pain, serositis, arthralgia, hearing loss, proteinuria, and a family history: Muckle Wells syndrome

Sa, 04/12/2021 - 00:00
A 53-year-old man presented with a 3-week history of fevers, intermittent abdominal pain, anorexia, arthralgias, fatigue, generalised body swelling, and 6·8 kg of unintentional weight loss.

[Comment] Omicron SARS-CoV-2 variant: a new chapter in the COVID-19 pandemic

Ve, 03/12/2021 - 09:41
On Nov 25, 2021, about 23 months since the first reported case of COVID-19 and after a global estimated 260 million cases and 5·2 million deaths,1 a new SARS-CoV-2 variant of concern (VoC), omicron,2 was reported. Omicron emerged in a COVID-19-weary world in which anger and frustration with the pandemic are rife amid widespread negative impacts on social, mental, and economic wellbeing. Although previous VoCs emerged in a world in which natural immunity from COVID-19 infections was common, this fifth VoC has emerged at a time when vaccine immunity is increasing in the world.

[Obituary] Malcolm Edward Molyneux

Ve, 03/12/2021 - 00:30
Inspirational physician devoted to medicine in Malawi. He was born in Wembo-Nyama, the Democratic Republic of the Congo, on Nov 20, 1943, and died of leukaemia in Liverpool, UK, on Nov 16, 2021, aged 77 years.

[Articles] Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomised, controlled, phase 2 trial

Ve, 03/12/2021 - 00:30
All study vaccines boosted antibody and neutralising responses after ChAd/ChAd initial course and all except one after BNT/BNT, with no safety concerns. Substantial differences in humoral and cellular responses, and vaccine availability will influence policy choices for booster vaccination.

[Comment] An urgent challenge for Europe: from tackling liver diseases to protecting liver health

Gi, 02/12/2021 - 12:00
The liver is an amazing organ. It is the largest solid internal organ and has more than 500 vital functions, such as breaking down toxic substances and waste products, storing energy and vitamins, and producing and regulating hormones. The liver can also regenerate itself if at least 25% of healthy liver remains. Yet, the liver is neglected by individuals, health professionals, governments, policy makers, and international agencies. The Lancet Commission on liver disease in the UK, published in 2014 with annual progress reports, drew attention to the poor provision of services for liver diseases in the UK and made recommendations for improvement.

[Comment] Liver disease: at the heart of public health challenges for Europe in the 21st century

Gi, 02/12/2021 - 12:00
Early civilisations considered the liver the source of the soul before modern medicine and culture elevated the heart to the centre of life.1 Although cardiovascular disease remains the leading cause of death and disability in Europe, liver disease continues to gain importance and is now the second leading cause of years of working life lost in the region.2 Compared with the liver, no other single organ is affected by a range of diseases for which control and prevention are dependent on such a wide array of complex public health policies.

[Perspectives] Tom Hemming Karlsen: hepatologist with a public health message

Gi, 02/12/2021 - 12:00
“The liver is a tough organ. It takes more than one toxin, one injury, one kind of disease to break its resilience”, says Tom Hemming Karlsen, Professor of Internal Medicine at the University of Oslo, Norway. But right now the livers of many Europeans are facing a range of threats, including high alcohol consumption and increasing obesity. The Lancet Liver Commission, organised jointly with the European Association for the Study of the Liver (EASL), makes ten actionable recommendations to protect liver health and prevent liver disease, half of them focused on health policy.

[The Lancet Commissions] The EASL–Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality

Gi, 02/12/2021 - 12:00
Liver diseases have become a major health threat across Europe, and the face of European hepatology is changing due to the cure of viral hepatitis C and the control of chronic viral hepatitis B, the increasingly widespread unhealthy use of alcohol, the epidemic of obesity, and undiagnosed or untreated liver disease in migrant populations. Consequently, Europe is facing a looming syndemic, in which socioeconomic and health inequities combine to adversely affect liver disease prevalence, outcomes, and opportunities to receive care.

[Comment] Tokyo Nutrition for Growth Summit 2021: an opportunity to accelerate the efforts towards achieving the SDGs

Gi, 02/12/2021 - 00:30
Nutrition is fundamental for the health and wellbeing of individuals and a basis for sustainable development and economic growth. Investing in good nutrition is an opportunity to positively impact health, increase individual potential and productivity, and support the economic development of nations. The Government of Japan will host the Tokyo Nutrition for Growth Summit 2021 on Dec 7–8. This is the third Nutrition for Growth Summit following London in 2013 and Rio de Janeiro in 2016. The Tokyo Summit aims to review the current status and challenges in nutrition improvement worldwide and to promote global efforts towards better nutrition.

[Comment] Primary Sjögren's syndrome: new beginning for evidence-based trials

Me, 01/12/2021 - 00:30
Primary Sjögren's syndrome is a heterogeneous disease that impairs quality of life, mainly because of sicca, pain, and fatigue, and 15–90% of patients also have systemic manifestations.1 Most patients, even without systemic manifestations, are willing to try new treatments, including biologics.2 It would be important that primary endpoints for therapeutic trials should include the cardinal primary Sjögren's syndrome symptoms, which are dryness, fatigue, and pain.

[Articles] Safety and efficacy of subcutaneous ianalumab (VAY736) in patients with primary Sjögren's syndrome: a randomised, double-blind, placebo-controlled, phase 2b dose-finding trial

Me, 01/12/2021 - 00:30
The study met its primary objective, showing a dose-related decrease in disease activity as measured by ESSDAI at week 24. Overall, ianalumab was well tolerated and safe, with no increase in infections. To our knowledge, this is the first large, randomised, controlled trial in primary Sjögren's syndrome that met its primary endpoint, and its results mean there is potential for more studies of this mechanism in the future.

[Comment] Nourishing our future: the Lancet Series on adolescent nutrition

Ma, 30/11/2021 - 00:30
Adolescence is a time of phenomenal growth. During adolescence height velocity is second only to the first 2 years of life1,2 and every physiological system is transformed.3 Yet adolescent growth and nutrition have been overlooked in the UN Decade of Action on Nutrition (2016–25). The Sustainable Development Goals for nutrition include no adolescent-specific targets.4 WHO's global action plan for the prevention and control of non-communicable diseases similarly had no clearly specified targets for overweight and obesity in older children or adolescents.

[Comment] A new global policy framework for adolescent nutrition?

Ma, 30/11/2021 - 00:30
This new Lancet series on adolescent nutrition1–3 sets out the challenges and opportunities for addressing healthy adolescent nutrition and development. Adolescence is a time when the multiple faces of malnutrition clearly materialise, as exemplified by overweight adolescents who were stunted children, or obese children with micronutrient deficiencies. This is also a time of extreme plasticity of the body and of changing lifestyles and norms when unhealthy behaviours can be adopted or instead virtuous circles of healthy behaviours can be established.

[Series] Nutrition in adolescent growth and development

Ma, 30/11/2021 - 00:30
During adolescence, growth and development are transformative and have profound consequences on an individual's health in later life, as well as the health of any potential children. The current generation of adolescents is growing up at a time of unprecedented change in food environments, whereby nutritional problems of micronutrient deficiency and food insecurity persist, and overweight and obesity are burgeoning. In a context of pervasive policy neglect, research on nutrition during adolescence specifically has been underinvested, compared with such research in other age groups, which has inhibited the development of adolescent-responsive nutritional policies.

[Series] Food choice in transition: adolescent autonomy, agency, and the food environment

Ma, 30/11/2021 - 00:30
Dietary intake during adolescence sets the foundation for a healthy life, but adolescents are diverse in their dietary patterns and in factors that influence food choice. More evidence to understand the key diet-related issues and the meaning and context of food choices for adolescents is needed to increase the potential for impactful actions. The aim of this second Series paper is to elevate the importance given to adolescent dietary intake and food choice, bringing a developmental perspective to inform policy and programmatic actions to improve diets.