The Lancet Regional Health: Western Pacific最新文献

{"title":"Progress and challenges of confirmatory trials for cancer drugs granted conditional approval in China","authors":"Xingxian Luo , Yang Xu , Xin Du , Xufeng Lv , Si Chen , Yue Yang , Lin Huang , Xiaohong Zhang","doi":"10.1016/j.lanwpc.2024.101238","DOIUrl":"10.1016/j.lanwpc.2024.101238","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101238"},"PeriodicalIF":7.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142654619","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":"Towards an agenda of action and research for making health systems responsive to the needs of people with disabilities","authors":"Thi Vinh Nguyen,&nbsp;Sumit Kane","doi":"10.1016/j.lanwpc.2024.101225","DOIUrl":"10.1016/j.lanwpc.2024.101225","url":null,"abstract":"<div><div>Ensuring health systems responsiveness is crucial for health equity and outcomes of all individuals, particularly disadvantaged groups such as people with disabilities. However, attention to and discussions on health system responsiveness for people with disabilities remains lacking. This viewpoint highlights the pervasive issues within health systems rooted in ableism and proposes an agenda to tackle ableism, aiming to make health systems responsive to the needs of people with disabilities. Their needs are complex and diverse, varying with the disability, its severity, progression, and intersection with other factors. Ableism creates significant obstacles to identifying and addressing their needs and expectations, damages provider–patient interactions, poses multiple challenges in healthcare, and impacts the overall responsiveness of the health system to the populations it is meant to serve. The proposed agenda outlines areas for action and research across six building blocks of health systems as a way forward to enhance the health system's responsiveness to the needs of people with disabilities.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101225"},"PeriodicalIF":7.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535384","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":"Human carcinogen, leisure food, or local specialty: navigating areca nut regulation in China","authors":"Jiayi Jiang,&nbsp;Zexing Zheng","doi":"10.1016/j.lanwpc.2024.101230","DOIUrl":"10.1016/j.lanwpc.2024.101230","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101230"},"PeriodicalIF":7.6,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534970","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":"China's health national adaptation plan for climate change: action framework 2024–2030","authors":"John S. Ji","doi":"10.1016/j.lanwpc.2024.101227","DOIUrl":"10.1016/j.lanwpc.2024.101227","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101227"},"PeriodicalIF":7.6,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534969","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":"Estimating the incidence of dementia in New Zealand: a cohort study applying capture-recapture modelling to routinely collected linked health datasets","authors":"Etuini Ma'u ,&nbsp;Sarah Cullum ,&nbsp;Naaheed Mukadam ,&nbsp;Daniel Davis ,&nbsp;Claudia Rivera-Rodriguez ,&nbsp;Gary Cheung","doi":"10.1016/j.lanwpc.2024.101216","DOIUrl":"10.1016/j.lanwpc.2024.101216","url":null,"abstract":"<div><h3>Background</h3><div>Issues of under-diagnosis and under-coding of dementia in routinely collected health data limit their utility for estimating dementia prevalence and incidence in Aotearoa New Zealand (NZ). Capture-recapture techniques can be used to estimate the number of dementia cases missing from health datasets by modelling the relationships and interactions between linked data sources. The aim of this study was to apply this technique to routinely collected and linked health datasets and more accurately estimate the incidence of dementia in NZ.</div></div><div><h3>Methods</h3><div>All incident cases of dementia in the NZ 60+ population were identified in three linked national health data sets—interRAI, Public hospital discharges, and Pharmacy. Capture-recapture analysis fitted eight loglinear models to the data, with the best fitting model used to estimate the number of cases missing from all three datasets, and thereby estimate the ‘true’ incidence of dementia. Incidence rates were calculated by 5-year age bands, sex and ethnicity.</div></div><div><h3>Findings</h3><div>Modelled estimates indicate 36% of incident cases are not present in any of the datasets. Modelled incidence rates in the 60+ age group were 19.2 (95% CI 17.3–22.0)/1000py, with an incident rate ratio of 1.9 (95% CI 1.9–2.0) per 5-year age band. There was no difference in incidence rates between males and females. Incidence rates in Asian (p &lt; 0.001) but not Māori (p = 0.974) or Pacific peoples (p = 0.110) were significantly lower compared to Europeans, even after inclusion of missing cases.</div></div><div><h3>Interpretation</h3><div>This is the first study to provide estimates of age 60+ dementia incidence in NZ and for the four main ethnic groups and suggests over a third of incident dementia cases are undiagnosed. This highlights the need for better access to dementia assessment and diagnosis so that appropriate supports and interventions can be put in place to improve outcomes for people living with dementia and their families.</div></div><div><h3>Funding</h3><div>Nil.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101216"},"PeriodicalIF":7.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535383","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":"Rohingya refugee health and well-being in Malaysia: a call for research and action","authors":"Kit-Aun Tan","doi":"10.1016/j.lanwpc.2024.101229","DOIUrl":"10.1016/j.lanwpc.2024.101229","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101229"},"PeriodicalIF":7.6,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142534968","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":"Long Covid is a significant health crisis in China too","authors":"Ziyad Al-Aly","doi":"10.1016/j.lanwpc.2024.101223","DOIUrl":"10.1016/j.lanwpc.2024.101223","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101223"},"PeriodicalIF":7.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142433284","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":"Long COVID facts and findings: a large-scale online survey in 74,075 Chinese participants","authors":"Shijie Qin ,&nbsp;Yanan Zhang ,&nbsp;Yanhua Li ,&nbsp;Ling Huang ,&nbsp;Ting Yang ,&nbsp;Jiahui Si ,&nbsp;Likui Wang ,&nbsp;Xin Zhao ,&nbsp;Xiaopeng Ma ,&nbsp;George F. Gao","doi":"10.1016/j.lanwpc.2024.101218","DOIUrl":"10.1016/j.lanwpc.2024.101218","url":null,"abstract":"<div><h3>Background</h3><div>Research on long COVID in China is limited, particularly in terms of large-sample epidemiological data and the effects of recent SARS-CoV-2 sub-variants. China provides an ideal study environment owing to its large infection base, high vaccine coverage, and stringent pre-pandemic measures.</div></div><div><h3>Methods</h3><div>This retrospective study used an online questionnaire to investigate SARS-CoV-2 infection status and long COVID symptoms among 74,075 Chinese residents over one year. The relationships between baseline characteristics, vaccination status, pathogenic infection, and long COVID were analyzed using multinomial logistic regression, and propensity matching.</div></div><div><h3>Findings</h3><div>Analysis of 68,200 valid responses revealed that the most frequent long COVID symptoms include fatigue (30.53%), memory decline (27.93%), decreased exercise ability (18.29%), and brain fog (16.87%). These symptoms were less prevalent among those infected only once: fatigue (24.85%), memory decline (18.11%), and decreased exercise ability (12.52%), etc. Women were more likely to experience long COVID, with symptoms varying by age group, except for sleep disorders and muscle/joint pain, which were more common in older individuals. Northern China exhibits a higher prevalence of long COVID, potentially linked to temperature gradients. Risk factors included underlying diseases, alcohol consumption, smoking, and the severity of acute infection (OR &gt; 1, FDR &lt; 0.05). Reinfection was associated with milder symptoms but led to a higher incidence and severity of long COVID (OR &gt; 1, FDR &lt; 0.05). Vaccination, particularly multiple boosters, significantly reduced long-term symptoms by 30%–70% (OR &lt; 1, FDR &lt; 0.05). COVID-19 participants also self-reported more bacterial, influenza and mycoplasma infections, and 8%–10% of patients felt SARS-CoV-2-induced chronic diseases.</div></div><div><h3>Interpretation</h3><div>This survey provides valuable insights into long COVID situation among Chinese residents, with 10%–30% (including repeated infection) reporting symptoms. Monitoring at-risk individuals based on identified risk factors is essential for public health efforts.</div></div><div><h3>Funding</h3><div>This study was funded by the <span>China Postdoctoral Science Foundation</span> (2022M723344, 2023M743729), <span>Guangdong Basic and Applied Basic Research Foundation</span> (2023A1515110489), and the <span>Bill &amp; Melinda Gates Foundation</span> (INV-027420).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101218"},"PeriodicalIF":7.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425616","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":"Association of long-term exposure to ozone with cardiovascular mortality and its metabolic mediators: evidence from a nationwide, population-based, prospective cohort study","authors":"Zenglei Zhang ,&nbsp;Chunqi Wang ,&nbsp;Chunying Lin ,&nbsp;Yi Wu ,&nbsp;Jing Wei ,&nbsp;Jiapeng Lu ,&nbsp;Bowang Chen ,&nbsp;Chaoqun Wu ,&nbsp;Xiaoyan Zhang ,&nbsp;Yang Yang ,&nbsp;Jianlan Cui ,&nbsp;Wei Xu ,&nbsp;Lijuan Song ,&nbsp;Hao Yang ,&nbsp;Yan Zhang ,&nbsp;Wenyan He ,&nbsp;Yuan Tian ,&nbsp;Xianliang Zhou ,&nbsp;Xi Li","doi":"10.1016/j.lanwpc.2024.101222","DOIUrl":"10.1016/j.lanwpc.2024.101222","url":null,"abstract":"<div><h3>Background</h3><div>Previous studies about chronic effects of ozone (O₃) on cardiovascular mortality are scarce and inconclusive. We aimed to investigate the association between cardiovascular mortality and a broad range of long-term O₃ exposure levels.</div></div><div><h3>Methods</h3><div>This analysis included 3,206,871 participants aged 35–75 years enrolled in the ChinaHEART study. Participants were recruited from the 31 provinces of the Chinese mainland between January 2015 and December 2020. The five-year average O₃ concentrations before baseline visits were calculated to represent long-term exposure.</div></div><div><h3>Findings</h3><div>Over a median follow-up period of 4.7 (interquartile range: 3.7−6.2) years, 35,553 (1.1%) participants died from cardiovascular diseases (CVD). Following multivariable adjustment, nonlinear relationships were identified between O₃ concentrations and CVD and ischemic heart disease (IHD) mortality, with inflection points at 85.44 and 88.15 μg/m³, respectively. Above these points, a 10.0 μg/m³ increase in the O₃ level was associated with a 13.9% (hazard ratio [HR]: 1.139, 95% confidence interval [CI]: 1.096−1.184) and 25.0% (HR: 1.250, 95% CI: 1.151−1.357) greater risk of CVD and IHD mortality, respectively. Conversely, O₃ exposure exhibited a linear relationship with ischemic stroke mortality. Moreover, the metabolic factors explained more than half of the association between O₃ exposure and CVD mortality.</div></div><div><h3>Interpretation</h3><div>Substantial influences of long-term O₃ exposure on CVD mortality were identified, with notable mediation proportions attributed to metabolic factors. These findings could facilitate the air quality standard revisions and risk reduction strategy making in the future.</div></div><div><h3>Funding</h3><div>This study was supported by the <span>CAMS</span> Innovation Fund for Medical Science (2021-1-I2M-011), the <span>CAMS</span> Innovation Fund for Medical Science (CIFMS, 2022-I2M-C&amp;T-A-010), the <span>National High Level Hospital Clinical Research</span> Funding (2022-GSP-GG-4), the <span>Ministry of Finance of China</span> and <span>National Health Commission</span> of China, the 111 Project from the <span>Ministry of Education of China</span> (B16005).</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101222"},"PeriodicalIF":7.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425617","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":"Non-optimal temperature-attributable mortality and morbidity burden by cause, age and sex under climate and population change scenarios: a nationwide modelling study in Japan","authors":"Lei Yuan ,&nbsp;Lina Madaniyazi ,&nbsp;Ana M. Vicedo-Cabrera ,&nbsp;Chris Fook Sheng Ng ,&nbsp;Kazutaka Oka ,&nbsp;Paul L.C. Chua ,&nbsp;Kayo Ueda ,&nbsp;Aurelio Tobias ,&nbsp;Yasushi Honda ,&nbsp;Masahiro Hashizume","doi":"10.1016/j.lanwpc.2024.101214","DOIUrl":"10.1016/j.lanwpc.2024.101214","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Future temperature effects on mortality and morbidity may differ. However, studies comparing projected future temperature-attributable mortality and morbidity in the same setting are limited. Moreover, these studies did not consider future population change, human adaptation, and the variations in subpopulation susceptibility. Thus, we simultaneously projected the temperature-related mortality and morbidity by cause, age, and sex under population change, and human adaptation scenarios in Japan, a super-ageing society.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We used daily mean temperatures, mortality, and emergency ambulance dispatch (a sensitive indicator for morbidity) in 47 prefectures of Japan from 2015 to 2019 as the reference for future projections. Future mortality and morbidity were generated at prefecture level using four shared socioeconomic pathway (SSP) scenarios considering population changes. We calculated future temperature-related mortality and morbidity by combining baseline values with future temperatures and existing temperature risk functions by cause (all-cause, circulatory, respiratory), age (&lt;65 years, ≥65 years), and sex under various climate change and SSP scenarios (SSP1-2.6, SSP2-4.5, SSP3-7.0, and SSP5-8.5). Full human adaptation was simulated based on empirical evidence using a fixed percentile of minimum mortality or morbidity temperature (MMT), while no adaptation was simulated with a fixed absolute MMT.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;A future temporal decline in mortality burden attributable to non-optimal temperatures was observed, driven by greater cold-related deaths than heat-related deaths. In contrast, temperature-related morbidity increased over time, which was primarily driven by heat. In the 2050s and 2090s, under a moderate scenario, there are 83.69 (95% empirical confidence interval [eCI] 38.32–124.97) and 77.31 (95% eCI 36.84–114.47) all-cause deaths per 100,000 population, while there are 345.07 (95% eCI 258.31–438.66) and 379.62 (95% eCI 271.45–509.05) all-cause morbidity associated with non-optimal temperatures. These trends were largely consistent across causes, age, and sex groups. Future heat-attributable health burden is projected to increase substantially, with spatiotemporal variations and is particularly pronounced among individuals ≥65 y and males. Full human adaptation could yield a decreasing temperature-attributable mortality and morbidity in line with a decreasing population.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interpretation&lt;/h3&gt;&lt;div&gt;Our findings could support the development of targeted mitigation and adaptation strategies to address future heat-related impacts effectively. This includes improved healthcare allocations for ambulance dispatch and hospital preventive measures during heat periods, particularly custom-tailored to address specific health outcomes and vulnerable subpopulations.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Funding&lt;/h3&gt;&lt;div&gt;&lt;span&gt;Japan Science and Technology Agency&lt;/","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"52 ","pages":"Article 101214"},"PeriodicalIF":7.6,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142425614","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}