The Lancet Regional Health: Western Pacific最新文献

{"title":"Efficacy and safety of visepegenatide as an add-on therapy to metformin in patients with type 2 diabetes: a randomised, double-blind, parallel, placebo-controlled, phase 3 study","authors":"Xiaoling Cai ,&nbsp;Linong Ji ,&nbsp;Mingxia Yuan ,&nbsp;Jianhua Ma ,&nbsp;Fang Bian ,&nbsp;Sheli Li ,&nbsp;Wuyan Pang ,&nbsp;Shuang Yan ,&nbsp;Huimin Zhou ,&nbsp;Minghui Hou ,&nbsp;Wenhui Li ,&nbsp;Ying Jia ,&nbsp;Li Liu ,&nbsp;Ke Ding ,&nbsp;Michael Xu","doi":"10.1016/j.lanwpc.2024.101197","DOIUrl":"10.1016/j.lanwpc.2024.101197","url":null,"abstract":"<div><h3>Background</h3><div>Visepegenatide, a once-weekly glucagon-like peptide-1 receptor agonist injection, demonstrated effective glycaemic control and good tolerability without the requirement of dose titration in the two completed phase 2 studies. We aimed to evaluate the efficacy and safety of visepegenatide in Chinese patients with type 2 diabetes mellitus (T2DM) inadequately controlled by metformin monotherapy in this phase 3 clinical study.</div></div><div><h3>Methods</h3><div>This multicentre phase 3 clinical study included a 24-week, randomised, placebo-controlled, double-blind period followed by a 28-week open-label extended treatment period. Patients (N = 620) aged ≥18 and ≤75 years with glycated haemoglobin (HbA_1c) ≥7.0% and ≤10.5% [≥53.0 and ≤91.27 mmol/mol], were randomized in a 1:1 ratio to receive visepegenatide 150-μg or placebo once-weekly subcutaneous injection during the double-blind period. Subsequently, the patients in the placebo group were switched to visepegenatide treatment (placebo→visepegenatide group), and the patients in the visepegenatide group continued the same treatment during the open-label extended treatment period. The primary endpoint was the change in HbA_1c from baseline to week 24.</div></div><div><h3>Findings</h3><div>At week 24, the placebo-adjusted least squares mean (LSM) change of HbA_1c was −0.57% (95% CI −0.71 to −0.43) with visepegenatide (p &lt; 0.001). The proportion of patients achieving HbA_1c &lt; 7.0% and ≤6.5% [&lt;53 and ≤ 48 mmol/mol] was higher in the visepegenatide group versus the placebo group (115 [40.5%] <em>vs</em> 50 [17.9%]; p &lt; 0.001, and 60 [21.1%] <em>vs</em> 17 [6.1%]; p &lt; 0.001). Visepegenatide demonstrated a significant reduction in fasting plasma glucose and 2-h postprandial glucose compared with placebo. Trends in the improvement of these variables were maintained during the open-label extended treatment period. No severe gastrointestinal adverse event or severe hypoglycaemia was reported during the 52-week study period.</div></div><div><h3>Interpretation</h3><div>Once-weekly injection of visepegenatide 150 μg as an add-on treatment to metformin therapy significantly improved glycaemic control and was generally well tolerated in Chinese patients with T2DM who were inadequately controlled with metformin monotherapy.</div></div><div><h3>Funding</h3><div>The study was funded by <span>PegBio Co., Ltd</span>, Suzhou, China.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To what extent could eliminating racial discrimination reduce inequities in mental health and sleep problems among Aboriginal and Torres Strait Islander children? A causal mediation study","authors":"Naomi Priest ,&nbsp;Shuaijun Guo ,&nbsp;Rushani Wijesuriya ,&nbsp;Catherine Chamberlain ,&nbsp;Rosemary Smith ,&nbsp;Sharon Davis ,&nbsp;Janine Mohamed ,&nbsp;Margarita Moreno-Betancur","doi":"10.1016/j.lanwpc.2024.101196","DOIUrl":"10.1016/j.lanwpc.2024.101196","url":null,"abstract":"<div><h3>Background</h3><div>Racism is a fundamental cause of health inequities for Aboriginal and Torres Strait Islander children. We estimated the potential reduction in inequities in Aboriginal and Torres Strait Islander children's mental health and sleep problems if interpersonal racial discrimination was eliminated.</div></div><div><h3>Methods</h3><div>We drew on cross-sectional data from the Speak Out Against Racism (SOAR; N = 2818) and longitudinal data from the Longitudinal Study of Australian Children (LSAC; N = 8627). The SOAR was completed in 2017 and the LSAC followed children from 2004 to 2014 in the kindergarten cohort and from 2008 to 2018 in the birth cohort. Exposure: Aboriginal and Torres Strait Islander status (Aboriginal and Torres Strait Islander/Anglo-European), a proxy measure of structural racism (SOAR: 10–15 years; LSAC: 4–5 years); Mediator: interpersonal racial discrimination (yes/no) (SOAR: 10–15 years; LSAC: 12–13 years); Outcomes: mental health problems (yes/no) and sleep problems (yes/no) (SOAR: 10–15 years; LSAC: 14–15 years). An interventional effects causal mediation approach was used.</div></div><div><h3>Findings</h3><div>Aboriginal and Torres Strait Islander children had higher prevalence of mental health problems (SOAR: 40.1% versus 13.5%; LSAC: 25.3% versus 7.6%) and sleep problems (SOAR: 28.5% versus 18.4%; LSAC: 14.0% versus 9.9%) than Anglo-European children. Hypothetical interventions eliminating Aboriginal and Torres Strait Islander children's experiences of interpersonal racial discrimination could reduce 42.4% and 48.5% of mental health and sleep inequities in SOAR (equivalent to 11.2% and 4.7% absolute reductions) and 25.6% and 1.6% of mental health and sleep inequities in LSAC (equivalent to 5.5% and 0.1% absolute reductions). Absolute remaining inequities were similar across both studies for both outcomes.</div></div><div><h3>Interpretation</h3><div>Targeted policy interventions that eliminate racial discrimination against Aboriginal and Torres Strait Islander children could have high potential to reduce inequities in mental health and sleep problems. Addressing racism and racial discrimination needs a multi-component and multi-level approach directed by Aboriginal and Torres Strait Islander communities.</div></div><div><h3>Funding</h3><div><span>National Health and Medical Research Council</span> of Australia and <span>Medical Research Future</span> Fund of Australia.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RSV severity in New Zealand 2021 and 2022: applying the WHO severity assessment framework","authors":"David Broderick ,&nbsp;Isabella Cheung ,&nbsp;Janine Paynter ,&nbsp;Jane O'Donnell ,&nbsp;Steffen Albrecht ,&nbsp;Nayyereh Aminisani ,&nbsp;Adrian Trenholme ,&nbsp;Cameron C. Grant ,&nbsp;Sue Huang ,&nbsp;Nikki Turner ,&nbsp;Catherine A. Byrnes ,&nbsp;Peter McIntyre","doi":"10.1016/j.lanwpc.2024.101221","DOIUrl":"10.1016/j.lanwpc.2024.101221","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142446923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of sodium glucose co-transporter 2 inhibitors and glucagon-like peptide 1 receptor agonists on insulin utilisation and costs in Australia: a national retrospective observational cross-sectional study","authors":"Peter S. Hamblin ,&nbsp;Arul Earnest ,&nbsp;Anthony W. Russell ,&nbsp;Stella Talic ,&nbsp;Ella Zomer ,&nbsp;Sophia Zoungas","doi":"10.1016/j.lanwpc.2024.101207","DOIUrl":"10.1016/j.lanwpc.2024.101207","url":null,"abstract":"<div><h3>Background</h3><div>Global insulin requirements for type 2 diabetes were predicted to increase by more than 20% from 2018 to 2030. However, this did not anticipate the rapid increase in use of glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter 2 inhibitors that has occurred over recent years. The current study aims to examine changes in insulin utilisation and costs in Australia from 2003 to 2023.</div></div><div><h3>Methods</h3><div>We conducted a large-scale observational study of national insulin utilisation and expenditure in Australia from 2003 to 2023 using the Australian Pharmaceutical Benefits Scheme. The proportion of insulin-treated people with type 2 diabetes between 2013 and 2023 was estimated using National Diabetes Services Scheme data. Joinpoint models and interrupted time series analysis were used to examine utilisation trends.</div></div><div><h3>Findings</h3><div>Insulin utilisation (units of insulin per person with diabetes) increased by an average of 2.71% per annum (95% CI 1.97, 3.73) from 2003 to 2015, then fell by 2.70% per annum (95% CI −4.55, −1.39) from 2015 to 2023. The proportion of insulin-treated people with type 2 diabetes increased by 1.00% per annum (95% CI 0.81, 1.25) from 2013 to 2020, then fell by 0.66% per annum (95% CI −1.62, −0.04) from 2020 to 2023. A 43% reduction in inflation-adjusted insulin expenditure was observed between 2015 and 2023 due to a combination of reduced utilisation and reduction in the price of insulin glargine.</div></div><div><h3>Interpretation</h3><div>Projected global insulin requirements and costs may be less than previously anticipated if reduced use of insulin in Australia is similarly observed in other countries.</div></div><div><h3>Funding</h3><div>No funding was received for this study.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524002013/pdfft?md5=d8d3afcac05075ed742c8e225f38daee&pid=1-s2.0-S2666606524002013-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142314082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity of colistin resistance mechanism in clonal populations of carbapenem-resistant Klebsiella pneumoniae in Vietnam","authors":"Bui Tien Sy ,&nbsp;Sébastien Boutin ,&nbsp;Le Thi Kieu Linh ,&nbsp;Simone Weikert-Asbeck ,&nbsp;Elias Eger ,&nbsp;Susanne Hauswaldt ,&nbsp;Truong Nhat My ,&nbsp;Nguyen Trong The ,&nbsp;Jan Rupp ,&nbsp;Le Huu Song ,&nbsp;Katharina Schaufler ,&nbsp;Thirumalaisamy P. Velavan ,&nbsp;Dennis Nurjadi","doi":"10.1016/j.lanwpc.2024.101204","DOIUrl":"10.1016/j.lanwpc.2024.101204","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001986/pdfft?md5=e8ac75bc4c923fbb85c602dbfdaa1afc&pid=1-s2.0-S2666606524001986-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142312755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population attributable fractions of depression and anxiety among Aboriginal and Torres Strait Islander peoples: a population-based study","authors":"Subash Thapa ,&nbsp;Kedir Y. Ahmed ,&nbsp;Santosh Giri ,&nbsp;Anayochukwu E. Anyasodor ,&nbsp;M. Mamun Huda ,&nbsp;Peter Gibbs ,&nbsp;Shakeel Mahmood ,&nbsp;Feleke H. Astawesegn ,&nbsp;Jamie Newman ,&nbsp;Allen G. Ross","doi":"10.1016/j.lanwpc.2024.101203","DOIUrl":"10.1016/j.lanwpc.2024.101203","url":null,"abstract":"<div><h3>Background</h3><p>Aboriginal and Torres Strait Islander peoples face an increased risk of common mental disorders, which may be associated with underlying socio-economic challenges, racism, and discrimination. This is the first study to calculate the population attributable fractions (PAFs) for depression and anxiety attributed to potentially modifiable risk factors such as health behaviour, social and cultural characteristics, and past adverse events among Aboriginal and Torres Strait Islander peoples aged ≥15 years.</p></div><div><h3>Methods</h3><p>This cross-sectional study examined the 2018–19 National Aboriginal and Torres Strait Islander Health Survey conducted by the Australian Bureau of Statistics. Logistic regression models were used to compute odds ratios (ORs). PAFs adjusted for communality were calculated using adjusted ORs and prevalence estimates for each risk factor.</p></div><div><h3>Findings</h3><p>This study included a weighted sample of 5362 individuals, with a mean age of 40.8 years (SD = ±17.2). Personal income below the national average (PAF = 13.4%; 95% CI: 12.4, 14.5), severed access to Indigenous cultural affiliations (PAF = 12.8%; 95% CI: 11.8, 13.8), central obesity (PAF = 7.2%; 95% CI: 6.4, 8.0), daily smoking (PAF = 5.9%; 95% CI: 5.2, 6.7) and severed access to Indigenous knowledge (PAF = 5.2%; 95% CI: 4.5, 5.8) were associated with 45% of depression cases. Personal income below the national average (PAF = 10.7%; 95% CI: 9.8, 11.7), limited access to Aboriginal Community Controlled Health Services (PAF = 10.6%; 95% CI: 9.7, 11.6), central obesity (PAF = 7.1%; 95% CI: 6.3, 7.9), severed access to Indigenous knowledge (PAF = 5.7%; 95% CI: 4.9, 6.4) and the experience of discrimination in the last 12 months (PAF = 4.7%; 95% CI: 4.0, 5.3) were associated with 39% of anxiety cases.</p></div><div><h3>Interpretation</h3><p>To reduce the burden of depression and anxiety disorder among Aboriginal and Torres Strait Islander peoples, addressing socio-economic and cultural harms that constrain healthy connections to people/kin, their rights, languages, land, and healthy food sources should be a priority.</p></div><div><h3>Funding</h3><p>This work was funded by a grant from the Commonwealth of Australia, represented by the <span>Department of Health and Aged Care</span> (Grant Activity 4-DGEJZ1O/4-CW7UT14).</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001974/pdfft?md5=82eadcb6b95d5a4d1d45efad157772dd&pid=1-s2.0-S2666606524001974-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widening the lens for pandemic preparedness: children must be seen and heard","authors":"Anita J. Campbell ,&nbsp;Fiona M. Russell ,&nbsp;Ben J. Marais ,&nbsp;Philip N. Britton ,&nbsp;Asha C. Bowen ,&nbsp;Christopher C. Blyth ,&nbsp;Katie L. Flanagan ,&nbsp;Ameneh Khatami ,&nbsp;Archana Koirala ,&nbsp;Michelle Mahony ,&nbsp;Linny K. Phuong ,&nbsp;Nan Vasilunas ,&nbsp;Rachel H. Webb ,&nbsp;Phoebe C.M. Williams ,&nbsp;Brendan J. McMullan ,&nbsp;Australian and New Zealand Paediatric Infectious Diseases Society of the Australasian Society of Infectious Diseases","doi":"10.1016/j.lanwpc.2024.101205","DOIUrl":"10.1016/j.lanwpc.2024.101205","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001998/pdfft?md5=e1c72b597b2bf754922005333d8a52c4&pid=1-s2.0-S2666606524001998-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Population-based prevalence of self-reported pediatric diabetes and screening for undiagnosed type 2 diabetes in Chinese children in years 2017–2019, a cross-sectional study","authors":"Wei Wu ,&nbsp;Jian-Wei Zhang ,&nbsp;Yangxi Li ,&nbsp;Ke Huang ,&nbsp;Rui-Min Chen ,&nbsp;Mireguli Maimaiti ,&nbsp;Jing-Si Luo ,&nbsp;Shao-Ke Chen ,&nbsp;Di Wu ,&nbsp;Min Zhu ,&nbsp;Chun-Lin Wang ,&nbsp;Zhe Su ,&nbsp;Yan Liang ,&nbsp;Hui Yao ,&nbsp;Hai-Yan Wei ,&nbsp;Rong-Xiu Zheng ,&nbsp;Hong-Wei Du ,&nbsp;Fei-Hong Luo ,&nbsp;Pin Li ,&nbsp;Ergang Wang ,&nbsp;Jun-Fen Fu","doi":"10.1016/j.lanwpc.2024.101206","DOIUrl":"10.1016/j.lanwpc.2024.101206","url":null,"abstract":"<div><h3>Background</h3><p>The worldwide geographical and temporal variation in the prevalence of diabetes represents a challenge, but also an opportunity for gaining etiological insights. Encompassing the bulk of East Asians, a large and distinct proportion of the world population, China can be a source of valuable epidemiological insights for diabetes, especially in early life, when pathophysiology begins. We carried out a nationwide, epidemiological survey of Prevalence and Risk of Obesity and Diabetes in Youth (PRODY) in China, from 2017 to 2019, to estimate the population-based prevalence of diagnosed pediatric diabetes and screen for undiagnosed pediatric type 2 diabetes (T2D).</p></div><div><h3>Methods</h3><p>PRODY was a nation-wide, school population-based, cross-sectional, multicenter survey by questionnaire, fasting urine glucose test and simple oral glucose tolerance test (s-OGTT), among a total number of 193,801 general-population children and adolescents (covered a pediatric population of more than 96.8 million), aged 3–18, from twelve provinces across China. The prevalence of the self-reported pediatric diabetes, the proportion of subtypes, the crude prevalence of undiagnosed T2D and prediabetes in general juvenile population and the main risk factors of type 1 (T1D) and type 2 (T2D) diabetes had been analyzed in the study.</p></div><div><h3>Findings</h3><p>The prevalence of all self-reported pediatric diabetes was estimated at 0.62/1000 (95% CI: 0.51–0.74), with T1D at 0.44/1000 (95% CI: 0.35–0.54) and T2D at 0.18/1000 (95% CI: 0.13–0.25). For undiagnosed T2D, the crude prevalence was almost ten-fold higher, at 1.59/1000, with an estimated extra 28.45/1000 of undiagnosed impaired glucose tolerance (IGT) and 53.74/1000 of undiagnosed impaired fasting glucose (IFG) by s-OGTT screening. Maternal diabetes history is the major risk factors for all subtypes of pediatric diabetes in China.</p></div><div><h3>Interpretation</h3><p>The PRODY study provides the first population-based estimate of the prevalence of pediatric diabetes China and reveals a magnitude of the problem of undiagnosed pediatric T2D. We propose a practical screening strategy by s-OGTT to address this serious gap.</p></div><div><h3>Funding</h3><p>The <span>National Key Research and Development Programme</span> of China, <span>Key R&amp;D Program</span> of Zhejiang, the <span>National Natural Science Foundation of China</span> and the Zhejiang Provincial Key Disciplines of Medicine, Key R&amp;D Program Projects in Zhejiang Province.</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524002001/pdfft?md5=46e372dfe971286fdbc7db3baffd16a1&pid=1-s2.0-S2666606524002001-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic disparities in the incidence and case fatality of subarachnoid haemorrhage: an 18-year nationwide study from New Zealand","authors":"Ilari Rautalin ,&nbsp;Rita V. Krishnamurthi ,&nbsp;Craig S. Anderson ,&nbsp;P. Alan Barber ,&nbsp;Suzanne Barker-Collo ,&nbsp;Derrick Bennett ,&nbsp;Ronald Boet ,&nbsp;Jason A. Correia ,&nbsp;Jeroen Douwes ,&nbsp;Andrew Law ,&nbsp;Balakrishnan Nair ,&nbsp;Amanda G. Thrift ,&nbsp;Braden Te Ao ,&nbsp;Bronwyn Tunnage ,&nbsp;Anna Ranta ,&nbsp;Valery Feigin","doi":"10.1016/j.lanwpc.2024.101199","DOIUrl":"10.1016/j.lanwpc.2024.101199","url":null,"abstract":"<div><h3>Background</h3><p>Although the incidence and case-fatality of subarachnoid haemorrhage (SAH) vary within countries, few countries have reported nationwide rates, especially for multi-ethnic populations. We assessed the nationwide incidence and case-fatality of SAH in New Zealand (NZ) and explored variations by sex, district, ethnicity and time.</p></div><div><h3>Methods</h3><p>We used administrative health data from the national hospital discharge and cause-of-death collections to identify hospitalised and fatal non-hospitalised aneurysmal SAHs in NZ between 2001 and 2018. For validation, we compared these administrative data to those of two prospective Auckland Regional Community Stroke Studies. We subsequently estimated the incidence and case-fatality of SAH and calculated adjusted rate ratios (RR) with 95% confidence intervals to assess differences between sub-populations.</p></div><div><h3>Findings</h3><p>Over 78,187,500 cumulative person-years, we identified 5371 SAHs (95% sensitivity and 85% positive predictive values) resulting in an annual age-standardised nationwide incidence of 8.2/100,000. In total, 2452 (46%) patients died within 30 days after SAH. Compared to European/others, Māori had greater incidence (RR = 2.23 (2.08–2.39)) and case-fatality (RR = 1.14 (1.06–1.22)), whereas SAH incidence was also greater in Pacific peoples (RR = 1.40 (1.24–1.59)) but lesser in Asians (RR = 0.79 (0.71–0.89)). By domicile, age-standardised SAH incidence varied between 6.3–11.5/100,000 person-years and case fatality between 40 and 57%. Between 2001 and 2018, the SAH incidence of NZ decreased by 34% and the case fatality by 12%.</p></div><div><h3>Interpretation</h3><p>Since the incidence and case-fatality of SAH varies considerably between regions and ethnic groups, caution is advised when generalising findings from focused geographical locations for public health planning, especially in multi-ethnic populations.</p></div><div><h3>Funding</h3><p><span>NZ Health Research Council</span>.</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666606524001937/pdfft?md5=d4ac945cee1c70af791b843a3afb10cc&pid=1-s2.0-S2666606524001937-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathways to healthy ageing in Vanuatu: a qualitative evaluation of national policy priorities","authors":"Anna Palagyi ,&nbsp;Thomas Gadsden ,&nbsp;Jenny Stephens ,&nbsp;Myriam Abel ,&nbsp;Lindah Peter ,&nbsp;Siwon Lee ,&nbsp;Tsogzolmaa Bayandorj ,&nbsp;Christopher Bates ,&nbsp;Sébastien Libert","doi":"10.1016/j.lanwpc.2024.101178","DOIUrl":"10.1016/j.lanwpc.2024.101178","url":null,"abstract":"<div><h3>Background</h3><p>The Pacific Island country of Vanuatu is at the early stages of demographic ageing. The government is yet to develop a strategic approach to optimize the health and wellbeing of older indigenous Vanuatu residents (ni-Vanuatu).</p></div><div><h3>Methods</h3><p>Using policy mapping and semi-structured interviews with 42 ni-Vanuatu, this research aimed to explore the current policy context surrounding ageing in Vanuatu and the priorities of older adults to inform preliminary steps to develop a national response to healthy ageing. Analyses were grounded in the World Health Organization's <em>Regional Action Plan on Healthy Ageing in the Western Pacific</em>.</p></div><div><h3>Findings</h3><p>While the national policy context exhibited an indirect commitment to creating an environment conducive to healthy ageing, explicit policy commitments and monitoring indicators were lacking. Older persons reported numerous obstacles to healthy ageing, including financial insecurity, physical and psychological barriers to participation, and lack of community support.</p></div><div><h3>Interpretation</h3><p>Findings highlighted the need for policymakers and stakeholders to focus preliminary strategic efforts on select components of the Regional Action Plan: evidence generation, advocacy/awareness, financing, community engagement and coordination, and family-centred empowerment. To ensure acceptability and sustainability, it is vital that these leverage existing strengths of traditional community values and the prevailing role of faith and religion in the lives of older ni-Vanuatu.</p></div><div><h3>Funding</h3><p>This project was funded and supported by the <span>World Health Organization</span> (WHO) Regional Office for the Western Pacific (WPRO). Outcomes reflect the deliberations of authors and research partners.</p></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":null,"pages":null},"PeriodicalIF":7.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266660652400172X/pdfft?md5=594c5d9e802c360cb869e2f98a1383d3&pid=1-s2.0-S266660652400172X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142243182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}