The Lancet Regional Health: Western Pacific最新文献

{"title":"Leveraging managed access with life-cycle reassessment in Asia-Pacific: advancing the learning of health system matters for innovative medicines in oncology","authors":"Yuanshi Jiao , Zonglin Dai , Jiangnan Zhu , Manuel A. Espinoza , Xue Li","doi":"10.1016/j.lanwpc.2025.101769","DOIUrl":"10.1016/j.lanwpc.2025.101769","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101769"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socio-economic inequality underpins inequity in influenza vaccination uptake between public and private secondary schools: an Australian population-based study","authors":"Huong Le ,&nbsp;Christopher C. Blyth ,&nbsp;Clement Schlegel ,&nbsp;Jo-Anne Morgan ,&nbsp;Francis Mitrou ,&nbsp;Ha Nguyen ,&nbsp;Rachel Foong ,&nbsp;Samantha Carlson ,&nbsp;Catherine Hughes ,&nbsp;Bette Liu ,&nbsp;Hannah C. Moore","doi":"10.1016/j.lanwpc.2025.101761","DOIUrl":"10.1016/j.lanwpc.2025.101761","url":null,"abstract":"<div><h3>Background</h3><div>Socio-economic inequality and vaccination inequity have long been critical issues. However, no studies have explored the gap in influenza vaccination uptake between public and private schools. Importantly, the extent to which socio-economic inequality translates into vaccination uptake inequity has not been quantified. We investigate influenza vaccination uptake among school-aged Australian children in 2023, compare uptake between public and private schools, and assess the role of socio-economic inequality in vaccination uptake inequity.</div></div><div><h3>Methods</h3><div>We analysed whole-of-population linked immunisation, census, and administrative data. Multivariable logistic regression was used to identify key uptake predictors, and the Oaxaca-Blinder decomposition was used to identify factors driving uptake inequity between public and private schools.</div></div><div><h3>Findings</h3><div>Of 9.5 million influenza vaccination doses administered, only 0.7 million (7%) were given to school-aged children (5–&lt;18 years), who represent 16% of the population. Coverage among school-aged children was low. Secondary school-aged children had the lowest uptake, with a significant gap between public and private schools. Children in private secondary schools, who demonstrate greater socio-economic advantage, had higher uptake than their public peers (unadjusted OR = 1.47; 95% CI: 1.45–1.57). Two-thirds of the uptake gap is driven by differences in cultural, linguistic, and socio-economic characteristics, with parental education, parental income, and socio-economic characteristics of residential area being the strongest contributors.</div></div><div><h3>Interpretation</h3><div>Addressing socio-economic inequality among parents could reduce vaccination uptake inequity for children. Future influenza vaccination campaigns should consider tailored strategies for specific cultural, linguistic, and socio-economic groups.</div></div><div><h3>Funding</h3><div><span>Wesfarmers Centre of Vaccines and Infectious Diseases</span>; <span>Western Australian’s Future Health Research and Innovation Fund</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101761"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Women's health and female fertility: current evidence and knowledge gaps in the Asia–Pacific region","authors":"Jiaxi Yang ,&nbsp;Wei Wei Pang ,&nbsp;Guoqi Yu ,&nbsp;Juliana Antero ,&nbsp;Ling-Jun Li ,&nbsp;Zhongwei Huang ,&nbsp;Cuilin Zhang","doi":"10.1016/j.lanwpc.2025.101710","DOIUrl":"10.1016/j.lanwpc.2025.101710","url":null,"abstract":"<div><div>In the face of declining global birth rates, women's health status remains a critical yet often overlooked determinant. This review summarises evidence on how various aspects of women's health, including nutrition and lifestyle, socioeconomic status, environmental pollutants, and metabolic and reproductive health are related to birth rates and female fertility. A healthy lifestyle, including a balanced, nutrient-rich diet, regular physical activity, adequate sleep, and mental wellbeing along with optimal metabolic and reproductive health, supports women's health. Meanwhile, broader determinants, such as socioeconomic status and environmental pollutants, also shape women's health and reproductive wellbeing. Collectively, these individual and systemic factors influence female fertility and birth outcomes, and subsequently, population-level birth rates. However, most existing evidence is based on White populations, underscoring the need for more inclusive research, particularly in the Asia–Pacific region. Improving women's health and fertility outcomes requires a holistic approach, with coordinated efforts across research, education, and policy domains.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101710"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indigenous people's perspectives on sharing health data for service delivery purposes: an inquiry using Indigenous methodologies","authors":"Kristie Watego ,&nbsp;Morgan Brodhurst-Hill ,&nbsp;Cherilda Murray ,&nbsp;Clare Mangoyana ,&nbsp;Alynta Emery ,&nbsp;Jayde Woon ,&nbsp;Kara Williams ,&nbsp;Natasha Reid ,&nbsp;Teyl Engstrom ,&nbsp;Carmel Nelson ,&nbsp;Clair Sullivan ,&nbsp;Jenny Setchell","doi":"10.1016/j.lanwpc.2025.101753","DOIUrl":"10.1016/j.lanwpc.2025.101753","url":null,"abstract":"<div><h3>Background</h3><div>With healthcare's accelerating digital transformation and expanding data-sharing capabilities, it is essential to uphold Indigenous Data Sovereignty (IDSov)—which affirms Indigenous ownership and authority over health data relating to Indigenous communities. Indigenous Data Governance (IDGov) provides the mechanisms through which IDSov is enacted, ensuring Indigenous Peoples lead decisions about how data are collected, accessed, and used. Our research investigates a local enactment of IDGov, discussing how custodial stewardship is enacted in data-sharing arrangements between an Aboriginal and Torres Strait Islander community-controlled health organisation and a government birthing facility. The research aimed to understand Aboriginal and Torres Strait Islander service users' and health workers' perspectives on how/whether to share data between services.</div></div><div><h3>Methods</h3><div>Led by a community-controlled organisation, the study used Indigenous methodologies, including ‘yarning’—a traditional knowledge-sharing practice. An Aboriginal researcher conducted yarns with Aboriginal and/or Torres Strait Islander staff and perinatal service users. Collaborative analysis was undertaken using an adapted ‘Thought Ritual’, an Indigenous analytical framework.</div></div><div><h3>Findings</h3><div>Analysis identified four domains: 1) Power and Control in Data Sharing—Data sharing can shift power dynamics, affecting sovereignty and community control, 2) Safety Concerns—Participants cited legal, cultural, and psychosocial risks tied to stigma and systemic racism, 3) Ability to Do My Job—Limited data access can hinder effective service delivery, and 4) Not Everything Should Be Shared—There is a clear preference for consent-based, selective data sharing.</div></div><div><h3>Interpretation</h3><div>Honouring Indigenous perspectives in data-sharing arrangements is an ethical obligation. In perinatal settings, upholding custodial stewardship helps safeguard sovereignty, safety, and equitable outcomes.</div></div><div><h3>Funding</h3><div>Funding was received from the Australian Government through the <span>Medical Research Future Fund</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101753"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Adverse health outcomes among migrant workers and transnational families in the Asia–Pacific: a systematic review and meta-analysis” [The Lancet Regional Health–Western Pacific 2025;64: 101720]","authors":"Rosita Chia-Yin Lin ,&nbsp;Karen Lau ,&nbsp;Kathryn Mackey ,&nbsp;Natasha Roya Matthews ,&nbsp;Maushmi Selvamani ,&nbsp;Beatriz Morais ,&nbsp;Oumnia Bouaddi ,&nbsp;Chaelin Kim ,&nbsp;Azusa Iwamoto ,&nbsp;Masami Fujita ,&nbsp;Ursula Trummer ,&nbsp;Tran Ngoc Dang ,&nbsp;Alena Kamenshchikova ,&nbsp;Cathy Zimmerman ,&nbsp;Sally Hargreaves","doi":"10.1016/j.lanwpc.2025.101774","DOIUrl":"10.1016/j.lanwpc.2025.101774","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101774"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145789939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social determinants of low fertility in Asia: a comparative review of trends in East, Southeast and South Asia","authors":"Wei-Jun Jean Yeung ,&nbsp;Jeofrey Bautista Abalos","doi":"10.1016/j.lanwpc.2025.101724","DOIUrl":"10.1016/j.lanwpc.2025.101724","url":null,"abstract":"<div><div>Asia, home to nearly 60% of the world's population, is central to global demographic change. Fertility trajectories shape population growth, aging, and decline, with implications for labor supply, economic development, family structures, and caregiving. Studying these patterns offers critical insights into the future of population size, structure, and human potential both regionally and globally. This paper addresses gaps in the largely snapshot, country-specific literature by providing a six-decade comparative overview of fertility trends in East, Southeast, and South Asia, with emphasis on their social determinants. Fertility is shaped not only by individual choice or biology but also by broader socioeconomic, cultural, and policy contexts that influence proximate factors of fertility such as union patterns, contraception, postpartum infecundability, and abortion. We identify distinct regional trajectories of fertility decline, examine their underlying drivers, assess the applicability of prevailing theories, and propose an Asymmetric Adaptation Framework to explain Asia's fertility transitions. While socioeconomic development and ideational change have shaped fertility behavior, cultural factors—such as religion, colonial legacies, kinship systems, and family policy—are pivotal in Asia. Certain trends cannot be explained by socioeconomic development alone, reflecting deeper historical and cultural roots. The Asian experience highlights the limits of prevailing Eurocentric, unidirectional theories and underscores the need for regionally grounded explanations that account for the interplay of structural forces, cultural norms, historical contexts, and policy in shaping fertility decline.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101724"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145839285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asia Pacific Heart Rhythm Society (APHRS) scientific statement on stroke prevention strategies in patients with device-detected atrial fibrillation: the 4S-DDAF approach","authors":"Tze-Fan Chao ,&nbsp;Chu-Pak Lau ,&nbsp;Eue-Keun Choi ,&nbsp;Chi-Keong Ching ,&nbsp;Ngai-Yin Chan ,&nbsp;Chung-Lieh Hung ,&nbsp;Boyoung Joung ,&nbsp;Rungroj Krittayaphong ,&nbsp;Hung-Fat Tse ,&nbsp;Gregory Y.H. Lip","doi":"10.1016/j.lanwpc.2025.101770","DOIUrl":"10.1016/j.lanwpc.2025.101770","url":null,"abstract":"<div><div>Device-detected atrial fibrillation (DDAF), including atrial high-rate episodes recorded at a cardiovascular implantable electronic device and subclinical atrial fibrillation detected by insertable cardiac monitor and smart wearables, poses an increasing challenge in stroke prevention. Although oral anticoagulants (OACs) are effective in clinical AF, their benefit-risk balance in DDAF remains uncertain. In response, the Asia Pacific Heart Rhythm Society (APHRS) proposes the 4S-DDAF approach (Strip documentation and longest AF duration, Symptoms, Stroke [ischemic] history, and Score) to guide anticoagulation decisions. This approach integrates electrogram review, symptom assessment, history of ischemic stroke or transient ischemic attack (TIA), and CHA₂DS₂-VASc scoring, emphasizing individualized care. OACs are recommended for patients with AF episodes ≥24 h, prior stroke/TIA, CHA₂DS₂-VASc score ≥4, or vascular disease. In patients not meeting these thresholds, close monitoring and risk factor management are advised. The 4S-DDAF approach provides a practical and evidence-informed strategy for clinical decision-making in the management of DDAF.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101770"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Epidemiological characteristics of heatstroke in China, 2010–2023: a longitudinal study based on a national heatstroke surveillance system” [The Lancet Regional Health – Western Pacific 64C (2025) 101722]","authors":"Xiaoye Wang ,&nbsp;Fan Ding ,&nbsp;Xiaoqi Qi ,&nbsp;Ziyi Wang ,&nbsp;Yingxin Pei ,&nbsp;Lijie Zhang ,&nbsp;Jinghuan Ren ,&nbsp;Yeping Wang ,&nbsp;Qing Guo ,&nbsp;Biao Zeng ,&nbsp;Shiyao Xu ,&nbsp;Tian Liu ,&nbsp;Rui Wang ,&nbsp;Zhifeng Wang ,&nbsp;Guoqing Shi","doi":"10.1016/j.lanwpc.2025.101778","DOIUrl":"10.1016/j.lanwpc.2025.101778","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101778"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145736761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence, persistence, and severity of 12-month and 30-day DSM-5 disorders in the World Mental Health Hong Kong Study","authors":"Corine S.M. Wong ,&nbsp;Candi M.C. Leung ,&nbsp;Shiyi Wu ,&nbsp;Francis P. Flores ,&nbsp;Yoona Kim ,&nbsp;Xiao Xiao ,&nbsp;Solomon B.K. Wong ,&nbsp;Wing Chung Chang ,&nbsp;Wai Chi Chan ,&nbsp;Nancy Xiaonan Yu ,&nbsp;Calvin P.W. Cheng ,&nbsp;Albert K.K. Chung ,&nbsp;Edwin H.M. Lee ,&nbsp;Wai Tat Chiu ,&nbsp;William G. Axinn ,&nbsp;Ronald C. Kessler ,&nbsp;Michael Y. Ni","doi":"10.1016/j.lanwpc.2025.101757","DOIUrl":"10.1016/j.lanwpc.2025.101757","url":null,"abstract":"<div><h3>Background</h3><div>The World Mental Health Hong Kong (WMHHK) Study aims to estimate 12-month and 30-day prevalence, persistence, severity, and correlates of DSM-5 anxiety, mood, and externalising disorders in Hong Kong, a densely populated city impacted by consecutive population-level stressors, including social unrest and the COVID-19 pandemic.</div></div><div><h3>Methods</h3><div>Face-to-face interviews, either in-person or video-based online, were conducted from November 2022 to March 2024 with a population-representative sample of 3053 adults aged 18 years and above. Diagnostic assessment utilised the World Mental Health Composite International Diagnostic Interview for DSM-5 (CIDI-5), evaluating ten mental disorders: anxiety (panic disorder, generalised anxiety disorder, post-traumatic stress disorder, obsessive-compulsive and related disorders), mood (major depressive disorder, persistent depressive disorder, bipolar spectrum disorders), and externalising (intermittent explosive disorder, alcohol use disorder, substance use disorder) disorders. Persistence was defined as 12-month prevalence among lifetime cases and 30-day prevalence among 12-month cases. Sociodemographic correlates were analysed using multivariable logistic regression.</div></div><div><h3>Findings</h3><div>Twelve-month and 30-day prevalence of any DSM-5 mental disorder were 10.6% (95% CI: 9.5–11.8) and 7.8% (95% CI: 6.7–8.9), respectively. Twelve-month prevalence was highest for anxiety disorders (8.0%, 95% CI: 7.1–8.9), followed by mood (4.3%, 95% CI: 3.4–5.2) and externalising (1.7%, 95% CI: 0.9–2.4) disorders. Twelve-month persistence among lifetime cases was 49.0%, overall and higher for anxiety (55.6%) than mood (39.0%) or externalising (35.3%) disorders. Younger and middle-aged adults, and who were not currently married, had elevated risks, while lower education was associated with greater disorder severity. Comorbidity was associated with increased persistence and severity across disorders.</div></div><div><h3>Interpretation</h3><div>This study shows a substantial mental health burden in Hong Kong during the post-pandemic period, highlighting the need for tailored public mental health programmes to address urban stressors in this unique context.</div></div><div><h3>Funding</h3><div><span>WYNG Foundation</span>, Hong Kong; <span>State Key Laboratory of Brain and Cognitive Sciences</span>, The <span>University of Hong Kong</span>, Hong Kong Special Administrative Region, China; <span>Hong Kong Jockey Club Charities Trust</span>.</div></div>","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101757"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145615787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From process to publication: the conduct and reporting of co-design in health research in the Western Pacific region","authors":"Yaqoot Fatima ,&nbsp;Michelle Olaithe ,&nbsp;Shannon Edmed ,&nbsp;Bushra Nasir","doi":"10.1016/j.lanwpc.2025.101766","DOIUrl":"10.1016/j.lanwpc.2025.101766","url":null,"abstract":"","PeriodicalId":22792,"journal":{"name":"The Lancet Regional Health: Western Pacific","volume":"65 ","pages":"Article 101766"},"PeriodicalIF":8.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145681863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}