Lancet Regional Health-Americas最新文献

{"title":"Impact of phased COVID-19 vaccine rollout on anxiety and depression among US adult population, January 2019–February 2023: a population-based interrupted time series analysis","authors":"","doi":"10.1016/j.lana.2024.100852","DOIUrl":"10.1016/j.lana.2024.100852","url":null,"abstract":"<div><h3>Background</h3><p>Existing research lacks information on the potential impacts of multi-phased coronavirus disease 2019 (COVID-19) vaccine rollouts on population mental health. This study aims to evaluate the impact of various COVID-19 vaccine rollout phases on trends and prevalence of anxiety and depression among US adults at a population level.</p></div><div><h3>Methods</h3><p>We performed a US population-based multi-intervention interrupted time series analysis through Deep Learning and autoregressive integrated moving average (ARIMA) approaches, analyzing 4 waves of US CDC's Behavioral Risk Factor Surveillance System (BRFSS) data (January 2019–February 2023) to assess changes in the weekly prevalence of anxiety and depression following interruptions, including all major COVID-19 vaccine rollout phases from 2020 to early 2023 while considering pandemic-related events.</p></div><div><h3>Findings</h3><p>Among 1,615,643 US adults (1,011,300 [76.4%] aged 18–64 years, 867,826 [51.2%] female, 126,594 [16.9%] Hispanic, 120,380 [11.9%] non-Hispanic Black, 1,191,668 [61.7%] non-Hispanic White, and 113,461 [9.5%] other non-Hispanic people of color), we found that three COVID-19 vaccine rollout phases (ie, prioritization for educational/childcare workers, boosters for all US adults, authorization for young children) were associated with a 0.93 percentage-point (95% CI −1.81 to −0.04, p = 0.041), 1.28 percentage-point (95% CI −2.32 to −0.24, p = 0.017), and 0.89 percentage-point (95% CI −1.56 to −0.22, p = 0.010) reduction, respectively, in anxiety and depression prevalence among the general US adult population despite an upward trend in the prevalence of anxiety and depression from 2019 to early 2023. Among different population groups, Phase 1 was associated with increases in anxiety and depression prevalence among Black/African Americans (2.26 percentage-point, 95% CI 0.24–4.28, p = 0.029), other non-Hispanic people of color (2.68 percentage-point, 95% CI 0.36–5.00, p = 0.024), and lower-income individuals (3.95 percentage-point, 95% CI 2.20–5.71, p &lt; 0.0001).</p></div><div><h3>Interpretation</h3><p>Our findings suggest disparate effects of phased COVID-19 vaccine rollout on mental health across US populations, underlining the need for careful planning in future strategies for phased disease prevention and interventions.</p></div><div><h3>Funding</h3><p>None.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24001790/pdfft?md5=dd0d0b606e523542a83f32d5e2684a7d&pid=1-s2.0-S2667193X24001790-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Healthcare access, quality and financial risk protection among displaced Venezuelan women living in Brazil: a cross-sectional study","authors":"","doi":"10.1016/j.lana.2024.100830","DOIUrl":"10.1016/j.lana.2024.100830","url":null,"abstract":"<div><h3>Background</h3><p>Millions of Venezuelans have been displaced because of deteriorating socio-economic conditions in their country. We examine key domains of universal health coverage among migrant Venezuelan women in Brazil: healthcare access, care quality and financial risk protection.</p></div><div><h3>Methods</h3><p>We collected primary data on 2012 Venezuelan women aged 15–49 who migrated to Brazil between 2018 and 2021, in the cities of Boa Vista and Manaus, along with secondary data for Brazilian women. We used linear regression with entropy balance matching to estimate associations between migrant status and healthcare spending, utilisation and quality indicators.</p></div><div><h3>Findings</h3><p>Our sample had a mean age of 29.5 years (S.D. 8.9), 64% (1286/2011) of mixed ethnicity, 29% (577/2011) white, 4% (71/2011) black, 3% (62/2011) indigenous and 1% (15/2011) other ethnicities. Compared to Brazilian women, migrant women had 9.5 percentage points (pp) (95% CI: 6 pp–13 pp; p &lt; 0.0001) higher catastrophic health expenditure incidence. Migrants were 27 pp (95% CI: 11 pp–43 pp; p = 0.0008) more likely to receive healthcare when sought, but 37 pp (95% CI: −45 pp to −29 pp; p &lt; 0.0001) less likely to have had a pap smear in the last three years. Migrants were as likely as non-migrants to have received pap smear results within three months (95% CI: −9 pp to 22 pp; p = 0.39) and clinically appropriate antenatal consultations (95% CI: −10 pp to 40 pp; p = 0.23).</p></div><div><h3>Interpretation</h3><p>Migrant women in Brazil have relatively good healthcare access and quality outcomes. Yet a potential backlog of unmet sexual and reproductive healthcare needs and inadequate financial risk protection require policy attention.</p></div><div><h3>Funding</h3><p>UK <span>Economic and Social Research Council</span> (ES/T00441X/1).</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24001571/pdfft?md5=3e39411067621a588bb6658820d0021f&pid=1-s2.0-S2667193X24001571-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142229860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mass chemotherapy with niclosamide for the control of Taenia solium: population-based safety profile and treatment effectiveness","authors":"","doi":"10.1016/j.lana.2024.100876","DOIUrl":"10.1016/j.lana.2024.100876","url":null,"abstract":"<div><h3>Background</h3><p>Mass drug administration (MDA) with niclosamide (NSM) can be used to control taeniasis, the cause of neurocysticercosis. NSM is 84.3% effective against taeniasis and is considered safe as it is not absorbed from the intestinal tract. However, information on its safety and effectiveness during MDA is limited. We evaluated the effectiveness of NSM and reported adverse events (AEs) during a cysticercosis elimination program in Tumbes, Peru.</p></div><div><h3>Methods</h3><p>Three rounds of NSM at 4-month intervals were offered to 77,397 eligible residents. We revisited all participants in their homes 72 h after each round to collect information regarding AEs. We also collected post-treatment stool samples to diagnose taeniasis after the first round, followed by a second sample at 30 days from those infected to evaluate NSM's effectiveness.</p></div><div><h3>Findings</h3><p>During implementation, 68,751 individuals were administered at least one dose of NSM (mean age 29 years, SD 20; 52% male), and 65,551 (95.3%) were visited post-treatment. 988 (1.5%) reported experiencing at least one AE. Almost all AEs (99.2%) were of mild intensity, with no severe AEs recorded. Of 211 participants diagnosed with taeniasis, 188 provided a follow-up stool sample 30-days after treatment and 141 were cured (treatment effectiveness 75.0%). Older age and higher coproantigen levels were significantly associated with treatment failure.</p></div><div><h3>Interpretation</h3><p>MDA with NSM is safe in <em>Taenia solium</em> endemic settings. However, the effectiveness following one dose is lower than expected, which suggests additional treatment may be necessary to enhance the infection control efforts.</p></div><div><h3>Funding</h3><p>The <span>Bill and Melinda Gates Foundation</span>.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002035/pdfft?md5=5aae0ff9adb1fbfbdaaecd8652189b58&pid=1-s2.0-S2667193X24002035-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental pollution challenges public health surveillance: the case of mercury exposure and intoxication in Brazil","authors":"","doi":"10.1016/j.lana.2024.100880","DOIUrl":"10.1016/j.lana.2024.100880","url":null,"abstract":"<div><p>Pollution, causing millions of deaths annually, disproportionally affects low- and middle-income countries (LMICs). Mercury ranks among the three main chemicals of major public health concern, and even low levels can cause cardiovascular and nervous outcomes, with children and indigenous populations being especially vulnerable. Nearly 80% of all emissions in South America originate from the Amazon. Brazil, the fifth-largest contributor to global mercury emissions, exemplifies the challenges faced by LMICs in effectively monitoring and addressing mercury exposure/intoxication. Despite having powerful tools such as SINAN (a digital platform for compulsory disease reporting), and Community Health Agents, data reveals significant underreporting, especially in the Amazon. Furthermore, SINAN has important delays in its update: for instance, 196 cases of Munduruku Indigenous people in 2019 have only been included in 2023. In this Personal View, we outline insightful recommendations to enhance public health surveillance and implement enduring, effective strategies to monitor, report and address mercury exposure/intoxication, focusing on the Brazilian Amazon. Although these recommendations are tailored to the challenges of this country, they hold potential for adaptation by other Amazonian countries facing similar issues (high mercury emissions and the presence of vulnerable populations, among others).</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002072/pdfft?md5=c3e8459fdf6cd02d6dc9764de17b53bb&pid=1-s2.0-S2667193X24002072-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Venous thromboembolism prevention program implementation in a community oncology practice: a cohort study","authors":"","doi":"10.1016/j.lana.2024.100866","DOIUrl":"10.1016/j.lana.2024.100866","url":null,"abstract":"<div><h3>Background</h3><p>While national guidelines recommend Venous Thromboembolism (VTE) risk assessment in cancer outpatients and consideration of pharmacologic prophylaxis in high-risk patients, prophylaxis rates are low in community oncology practices. A successful model for guideline implementation (the Vermont Model, VM) is validated in an academic tertiary oncology setting. We undertook an implementation study to determine the success of this model in a multi-site community oncology practice. The study objectives were to: 1) adapt the VM to the community practice setting; 2) implement the adapted VM into practice; and 3) evaluate clinical and implementation outcomes.</p></div><div><h3>Methods</h3><p>The study was carried out in three phases: (1) Pre-implementation, a multidisciplinary team addressed the need to adapt the VM to the local context including electronic medical record (EMR) optimisation and clinician education; (2) implementation of the strategies adapted to the local context, informed by VM and adapted based on stakeholder feedback; (3) prospective evaluation of clinical and implementation outcomes at six months after implementation.</p></div><div><h3>Findings</h3><p>Following creation of a comprehensive initiation roadmap for the adaptation of VM program to the community practice, 302 cancer outpatients initiating new treatment met inclusion criteria over a 6 month implementation period. VTE risk education was provided to 100% of patients, and 98% (296) of patients received a VTE risk assessment. Of 52 patients (18%) who scored as high risk based on a modified Khorana (Protecht) score, 14 (27%) initiated prophylaxis. Barriers to program adaptation included EMR optimization challenges and practice-level responsibility assignment, time constraints, concern about potential drug interactions, and financial &amp; insurance issues.</p></div><div><h3>Interpretation</h3><p>Implementation of a multidisciplinary VTE prevention model in the community-based oncology setting successfully increased VTE education and risk assessment rates. AC prophylaxis rates were modestly increased, highlighting the need to understand and address barriers to anticoagulant prophylaxis prescribing in this setting.</p></div><div><h3>Funding</h3><p>Northern New England Clinical Oncology Society Research Funding Program.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24001935/pdfft?md5=d3206742b6cc98a6f5792bb988967117&pid=1-s2.0-S2667193X24001935-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142096403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sports betting scandals highlight knowledge gaps for gambling harm","authors":"","doi":"10.1016/j.lana.2024.100879","DOIUrl":"10.1016/j.lana.2024.100879","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002060/pdfft?md5=afb0db3ce57b9e84558578892c19efb4&pid=1-s2.0-S2667193X24002060-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142089721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A surveillance study of cancer incidence and mortality among young adults in Costa Rica","authors":"","doi":"10.1016/j.lana.2024.100872","DOIUrl":"10.1016/j.lana.2024.100872","url":null,"abstract":"<div><h3>Background</h3><p>There has been an increase in certain cancers among young adults (YA) aged 20–39, particularly in Latin America. This is the first study to examine cancer incidence and mortality in YA in Costa Rica, focusing on sex-specific patterns.</p></div><div><h3>Methods</h3><p>Invasive cancer cases (excluding non-melanoma skin cancer) in YA from 2006 to 2015 were obtained from the Costa Rican National Registry of Tumors. Utilising SEER∗Stat software, age-standardized incidence rates (IRs) and incidence rate ratios (IRRs) were calculated. Trends and annual percent changes (APCs) in IRs were estimated using the Joinpoint regression analysis program. Cancer deaths from 2000 to 2021 were obtained from the Costa Rican National Institute of Statistics and Census. Age-standardised mortality rates were calculated using STATA®17.</p></div><div><h3>Findings</h3><p>YA comprised 10.7% of all invasive cancer cases diagnosed from 2006 to 2015. The age-standardized incidence rate (ASIR) of invasive cancer in YA was 50.9/100,000 person-years. The ASIR was twofold higher for females compared to males (IRR = 2.03, 95% CI:1.94, 2.13). This difference increased with age, peaking in the 35–39-year age group (IRR = 2.84, 95% CI:2.62, 3.10). Thyroid, breast, and cervical cancer were the most common in females. Testicular cancer was the most common in males. Leading causes of cancer-related deaths included cervical and breast cancer in females and stomach and brain/nervous system cancer in males.</p></div><div><h3>Interpretation</h3><p>The study highlights sex-specific patterns in cancer incidence and mortality among YA in Costa Rica to increase understanding and improve cancer outcomes in this age group.</p></div><div><h3>Funding</h3><p>This study was funded by the <span>Intramural Research Program</span> of the <span>National Cancer Institute</span>.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24001996/pdfft?md5=50ebab2883e4bb97bd74a7ae5c524134&pid=1-s2.0-S2667193X24001996-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142083120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociohistorical justice: a corrective framework to mend the modern harms of medical history","authors":"","doi":"10.1016/j.lana.2024.100874","DOIUrl":"10.1016/j.lana.2024.100874","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002011/pdfft?md5=050c9283fc3a018904d27e6e485396c9&pid=1-s2.0-S2667193X24002011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our environment, our health, our challenge: perspectives from a Southern Brazil tragedy","authors":"","doi":"10.1016/j.lana.2024.100878","DOIUrl":"10.1016/j.lana.2024.100878","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X24002059/pdfft?md5=aaad5d3cc59cfc1ab2061e5e34f58b0c&pid=1-s2.0-S2667193X24002059-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A scoping review of end-of-life discussions and palliative care: implications for neurological intensive care among Latinos in the U.S.","authors":"","doi":"10.1016/j.lana.2024.100873","DOIUrl":"10.1016/j.lana.2024.100873","url":null,"abstract":"<div><p>Goals of care (Goals-of-care) discussions and palliative care (PC) are crucial to providing comprehensive healthcare, particularly for acute neurological conditions requiring admission to a neurological intensive care unit. We identified gaps in the literature and describe insight for future research on end-of-life discussions and PC for U.S. Latinos with acute neurological conditions. We searched 10 databases including peer-reviewed abstracts and manuscripts of hospitalized U.S. Latinos with acute neurological and non-neurological conditions. We included 44 of 3231 publications and identified various themes: PC utilization, pre-established advanced directives in Goals-of-care discussions, Goals-of-care discussion outcomes, tracheostomy or percutaneous gastrostomy tube placement rates among hospitalized Latinos. Our review highlights that Latinos appear to have lower palliative care utilization compared with non-Latino Whites and may be less likely to have pre-established advanced directives, more likely to have gastrostomy or tracheostomy placement and less likely to have do-not-resuscitate status.</p></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":null,"pages":null},"PeriodicalIF":7.0,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667193X2400200X/pdfft?md5=08f8d85c1d015dccfb682f58937c86f1&pid=1-s2.0-S2667193X2400200X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142049153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}