Pacific islands

太平洋岛屿
  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    与普通人群相比,土著人的心理健康较差。社会经济差距部分解释了这些差距。然而,人口之间存在差异,法国海外领土研究不足。这项研究调查了新喀里多尼亚和法属波利尼西亚土著人民的心理健康问题的患病率,在考虑相关因素的同时,将其与同行进行描述和比较。
    我们在仅有的3个可获得有关土著身份信息的站点中使用了来自总人口中横断面心理健康调查的数据:Noumea(2006)和\'布什\'(2008)在新喀里多尼亚,法属波利尼西亚(2015-2017)。使用Mini-International神经精神病学访谈筛查了当前的心理健康问题。在多变量分析中,我们考虑了以下因素:性别,年龄,教育水平,婚姻状况,职业活动和月收入。
    总的来说,对2294名参与者进行了分析。在1379名土著参与者中,52.3%的人至少有一个心理健康问题。抑郁症的患病率(18.0%vs11.7%),与非土著参与者相比,土著参与者的酒精使用障碍(16.7%vs11.7%)和自杀风险(22.3%vs16.7%)较高.调整后,土著地位和这些心理健康问题之间的联系并没有持续下去,除了酒精使用障碍。
    我们发现抑郁症的患病率更高,法属波利尼西亚和新喀里多尼亚土著人民的酒精使用障碍和自杀风险。这些差异似乎主要由社会经济差异来解释。未来的研究可以探索土著居民使用和获得医疗保健的情况。
    UNASSIGNED: Indigenous people experience poorer mental health compared to the general population. Socioeconomic gaps partly explain these disparities. However, there is variability between populations and French overseas territories are understudied. This study examines the prevalence of mental health problems among Indigenous people in New Caledonia and French Polynesia, describing and comparing it with that of their counterparts while considering associated factors.
    UNASSIGNED: We used the data from the cross-sectional Mental Health in the General Population survey in the only 3 sites for which information on indigenous status was available: Noumea (2006) and the \'Bush\' (2008) in New Caledonia, and French Polynesia (2015-2017). Current mental health issues were screened using the Mini-International Neuropsychiatric Interview. In multivariable analyses, we considered the following factors: gender, age, education level, marital status, occupational activity and monthly income.
    UNASSIGNED: Overall, 2294 participants were analysed. Among the 1379 indigenous participants, 52.3% had at least one mental health issue. The prevalence of depressive disorder (18.0% vs 11.7%), alcohol use disorder (16.7% vs 11.7%) and suicide risk (22.3% vs 16.7%) were higher among indigenous participants compared to non-indigenous participants. After adjustment, the association between indigenous status and these mental health issues did not persist, except for alcohol use disorder.
    UNASSIGNED: We found higher prevalence of depressive disorder, alcohol use disorder and suicide risk among indigenous people of French Polynesia and New Caledonia compared to their counterparts. These differences seemed largely explained by socioeconomic disparities. Future studies could explore the use of and access to healthcare by indigenous populations.
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  • 文章类型: Journal Article
    我们的报告描述了2019-2020年麻疹流行期间萨摩亚国家医院重症监护病房收治的患者的特征。研究设计是对临床记录的回顾性回顾;年龄范围为2个月至51岁,大多数病例在2-23个月年龄组(71%)。17(24%)的疫苗接种状态未知或未记录。在54名(75%)没有完全接种疫苗的人中,35(65%)没有存活。几乎所有(98%)在入院时出现多种并发症,主要是肺炎(91%)。死亡率为61%,这意味着存活率低,特别是在年轻的婴儿和幼儿中,即使有最佳的护理和管理。
    Our report describes the characteristics of patients admitted to the intensive care unit of the National Hospital of Samoa during the 2019-2020 measles epidemic. The study design was a retrospective review of clinical records; the age range was 2 months to 51 years, with the majority of cases in the 2-23 month age group (71%). Vaccination status was unknown or unrecorded for 17 (24%). Of the 54 (75%) who were not fully vaccinated, 35 (65%) did not survive. Almost all (98%) presented with multiple complications on admission, mostly pneumonia (91%). The mortality rate was 61%, implying a low survival rate particularly among young infants and toddlers, even when optimal care was available and administered.
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  • 文章类型: Journal Article
    与以前的疫情类似,2019年冠状病毒病(COVID-19)大流行将对围产期结局产生直接和间接影响,特别是在低收入和中等收入国家。关于怀孕期间严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)感染的直接影响的有限数据显示,肥胖和有并发症的人因COVID-19住院的风险更高。非洲和南亚的年轻年龄组显示COVID-19死亡率增加。太平洋岛国的土著孕妇很可能因糖尿病和肥胖率高而面临COVID-19的严重后果。让孕妇参与研究很重要,特别是在疫苗开发和治疗方面。
    Similar to previous outbreaks, the coronavirus disease 2019 (COVID-19) pandemic will have both direct and indirect effects on perinatal outcomes, especially in low- and middle-income countries. Limited data on the direct impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection during pregnancy shows women who are Black, obese and with co-morbidities are at higher risk of hospitalisation due to COVID-19. Younger age groups in Africa and South Asia have shown increased COVID-19 mortality. Indigenous pregnant women in Pacific Island countries are likely to be high risk for severe outcomes from COVID-19 due to high rates of diabetes and obesity. It is important to involve pregnant women in research, especially with regards to vaccine development and therapeutics.
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  • 文章类型: Journal Article
    背景:乳腺癌是全球和美国(美国)女性中最常见的癌症。其在六个美国附属太平洋岛屿(USAPI)的发病率仍然较少。
    方法:我们使用不同的人群估计值分析了基于人群的癌症登记数据,以计算USAPI中年龄>20岁女性的乳腺癌发病率。计算比率和95%置信区间(CI)以比较USAPI和美国(50个州和哥伦比亚特区)之间的发病率。
    结果:从2007年到2020年,USAPI诊断出1118例新的乳腺癌病例,关岛报告了66.3%(n=741)的病例。USAPI的年龄标准化发病率为每100,000名妇女66.4至68.7,关岛的每100,000名妇女101.1-110.5。与美国相比,USAPI的发病率较低,比率范围为0.38(95%CI:0.36,0.40)至0.39(95%CI:0.37,0.42)。晚期癌症的比例在USAPI(48.7%)明显高于美国(34.0%),特别是在密克罗尼西亚联邦(78.7%)和帕劳(73.1%)。
    结论:USAPI的乳腺癌发病率低于美国;然而,晚期诊断比例更高.低发病率和晚期癌症可能预示着筛查方面的挑战。癌症监测,以及医疗保健服务和资源。扩大获得及时的乳腺癌筛查,诊断,治疗可以降低晚期癌症的比例并提高USAPI的生存率.
    BACKGROUND: Breast cancer is the most common cancer diagnosed among women globally and in the United States (US); however, its incidence in the six US-Affiliated Pacific Islands (USAPI) remains less characterized.
    METHODS: We analyzed data from a population-based cancer registry using different population estimates to calculate incidence rates for breast cancer among women aged >20 years in the USAPI. Rate ratios and 95 % confidence intervals (CI) were calculated to compare incidence rates between the USAPI and the US (50 states and the District of Columbia).
    RESULTS: From 2007-2020, 1118 new cases of breast cancer were diagnosed in the USAPI, with 66.3 % (n = 741) of cases reported in Guam. Age-standardized incidence rates ranged from 66.4 to 68.7 per 100,000 women in USAPI and 101.1-110.5 per 100,000 women in Guam. Compared to the US, incidence rates were lower in USAPI, with rate ratios ranging from 0.38 (95 % CI: 0.36, 0.40) to 0.39 (95 % CI: 0.37, 0.42). The proportion of late-stage cancer was significantly higher in the USAPI (48.7 %) than in the US (34.0 %), particularly in the Federated States of Micronesia (78.7 %) and Palau (73.1 %).
    CONCLUSIONS: Breast cancer incidence rates were lower in the USAPI than in the US; however, late-stage diagnoses were disproportionately higher. Low incidence and late-stage cancers may signal challenges in screening, cancer surveillance, and health care access and resources. Expanding access to timely breast cancer screening, diagnosis, and treatment could reduce the proportion of late-stage cancers and improve survival in the USAPI.
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  • 文章类型: Journal Article
    为了开发一个透明的结构化过程,高效,对低资源生物安全系统的高级别审查(受物理基础设施限制,金融,和人力资源),为了确定并确定未来重点关注的关键领域,然后可能导致干预,由国家量身定制,改善系统。一个关键要求是,所制定的方法在文化上是敏感的,并尊重该国境内的Pasifika人。
    太平洋岛国和领土(PICTs)迫切需要加强动物卫生和生物安全系统,以应对当前和未来的威胁。了解应在何处分配额外资源以最大化利益并确保PICT利益相关者的支持对于采纳所提出的任何建议至关重要。然而,关于审查生物安全系统的文献很少,特别是在需要效率的地方,简单,文化敏感性。通过在国际动物健康发展和支持计划方面有经验的四名新西兰专家之间的初步面对面协商,制定了一个框架。随后,与PICT的某些农业负责人进行了非正式讨论,并包括了他们在以前的系统审查中的经验,以及Pasifika文化专家的一般建议。基本目标包括简单性,局部包容性,和结构化的方法,这可以在相对较短的时间内进行。使用快速证据评估方法来搜索可用的文献(已出版和灰色,搜索词生物安全,系统,太平洋,动物,框架,并在AND/OR组合中使用审查),为生物安全体系审查的其他方法建立证据基础。为审查低资源PICT中的生物安全系统而制定的框架是基于专家启发框架中的要素,世界动物卫生组织的SurF监测评估框架和兽医服务绩效工具。
    开发的框架涉及将利益相关者聚集在一个研讨会环境中,包括绘制PICT生物安全系统和探索组成部分活动的属性等10个步骤。在高层次上了解该系统,使利益相关者能够就解决未来需求的改进提出明智的建议。使用Delphi方法,然后由利益相关者优先考虑建议。
    使用此过程中描述的需求分析的一个显着差异是授权PICT利益相关者确定自己的需求和优先事项,而不是由外部各方开发。
    UNASSIGNED: To develop a structured process for a transparent, efficient, high-level review of a low-resource biosecurity system (limited by physical infrastructure, financial, and human resources), in order to identify and prioritise key areas for future focus which could then lead to interventions, tailored by country, to improve the system. A key requirement was that the approach developed was culturally sensitive and respectful to Pasifika people within the country.
    UNASSIGNED: Animal health and biosecurity systems need to be urgently strengthened by Pacific Island countries and territories (PICTs) if they are to respond to current and future threats. Understanding where additional resources should be allocated to maximise benefit and ensuring buy-in from PICT stakeholders are critical for uptake of any recommendations made. However, there is little available literature on reviewing biosecurity systems, particularly where there is a need for efficiency, simplicity, and cultural sensitivity. A framework was developed through initial in-person consultation between four New Zealand experts who had experience working in international animal health development and support programmes. This was followed by input from informal discussions with selected heads of agriculture in PICTs and included their experiences with previous system reviews, as well as general advice from experts in Pasifika culture. Foundational objectives included simplicity, local inclusivity, and a structured approach, which could be undertaken over a relatively short period of time.A rapid evidence assessment methodology was used to search the available literature (published and grey, search terms biosecurity, system, Pacific, animal, framework, and review used in AND/OR combinations), to establish an evidence base for other methods of biosecurity system review. The developed framework for review of biosecurity systems in low-resource PICTs was based on elements from expert elicitation frameworks, the SurF surveillance evaluation framework and the Performance of Veterinary Services tool from The World Organisation for Animal Health.
    UNASSIGNED: The developed framework involved bringing stakeholders together in a workshop environment and comprised up to 10 steps including mapping the PICT biosecurity system and exploring attributes of component activities. Understanding the system at a high level enables stakeholders to make informed recommendations on improvements to address future needs. Using the Delphi method, recommendations were then prioritised by stakeholders.
    UNASSIGNED: A distinctive difference flowing from the use of the needs analysis described in this process was the empowerment of PICT stakeholders to determine their own needs and priorities, rather than have these developed by external parties.
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  • 文章类型: Journal Article
    与美国相比,美国附属太平洋岛屿(USAPI)的宫颈癌发病率和死亡率较高,筛查覆盖率较低。这可能是因为经济,地理,卫生保健服务,以及生活在这些资源有限的妇女的文化障碍,孤立的地区。最新的美国和世界卫生组织宫颈癌筛查指南建议将原发性人乳头瘤病毒(HPV)检测作为一种筛查选择或首选筛查方式。基于原发性HPV筛查的策略提供了优于USAPI中当前筛查方法的几个优点。然而,在美国,这种较新的筛查方式的采用进展缓慢,尚未纳入USAPI筛查计划.美国疾病控制和预防中心及其合作伙伴于2019年启动了太平洋抗宫颈癌(PACe)项目,以评估其可行性。可接受性,关岛和雅普基于HPV检测的主要策略的成本效益,密克罗尼西亚联邦。本报告概述了PACe项目,并概述了我们在实施原发性HPV检测作为一种新的宫颈癌筛查策略(包括在Yap中进行自我采样的选择)时采取的方法。包括四个核心组成部分:(1)社区参与和教育,(2)医疗和实验室能力建设,(3)卫生信息和系统改进,(4)建模和成本效益分析。PACe项目为USAPI提供了系统实施和资源适当技术的示例,对美国和太平洋地区从未筛查和筛查不足的人群有更广泛的影响,因为他们在获得宫颈癌筛查服务方面面临类似的障碍。
    The U.S.-affiliated Pacific Islands (USAPI) have higher cervical cancer incidence and mortality rates and lower screening coverage compared with the United States. This is likely because of economic, geographical, health care delivery, and cultural barriers for women living in these resource-constrained, isolated regions. The most recent U.S. and World Health Organization cervical cancer screening guidelines recommended primary human papillomavirus (HPV) testing as one screening option or the preferred screening modality. Primary HPV screening-based strategies offer several advantages over current screening methods in the USAPI. However, adoption of this newer screening modality has been slow in the United States and not yet incorporated into USAPI screening programs. The U.S. Centers for Disease Control and Prevention and partners initiated the Pacific Against Cervical Cancer (PACe) project in 2019 to evaluate the feasibility, acceptability, and cost-effectiveness of primary HPV testing-based strategies in Guam and in Yap, Federated States of Micronesia. This report provides an overview of the PACe project and outlines the approaches we took in implementing primary HPV testing as a new cervical cancer screening strategy (including the option of self-sampling in Yap), encompassing four core components: (1) community engagement and education, (2) medical and laboratory capacity building, (3) health information and system improvement, and (4) modeling and cost-effectiveness analysis. The PACe project provides examples of systematic implementation and resource appropriate technologies to the USAPI, with broader implications for never screened and under-screened populations in the United States and Pacific as they face similar barriers to accessing cervical cancer screening services.
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  • 文章类型: Journal Article
    空气质量(AQ)显著影响人类健康,受自然现象和人类活动的影响。2021年,人们对AQ健康影响的认识提高,促使世界卫生组织(WHO)指南进行了修订。倡导更严格的污染标准。然而,对AQ的研究主要集中在高收入国家和人口稠密的城市,忽视低收入和中等收入国家,特别是太平洋岛国,领土,和国家(PICTS)。本系统综述汇编了PICTS中有关AQ研究的现有同行评审文献,以评估当前的知识状况并强调需要进一步调查。系统的文献检索从包括WebofScience在内的数据库中获得了40篇论文,Scopus,和Embase。在26个图片中,只有6个(夏威夷,斐济,巴布亚新几内亚,新喀里多尼亚,马绍尔群岛共和国,和太平洋)已经接受了与AQ相关的研究,其中4个考虑世界卫生组织(世卫组织)参数,26个考虑非世卫组织参数。分析显示,AQ参数通常超过2021年世卫组织PM2.5、PM10、SO2和CO指南,引起地区政府的关注。研究主要集中在城市,农业,农村,和开阔的海洋区域,其中15个基于主要数据,14个基于主要和次要来源。研究兴趣和资金来源决定了使用的方法,主要关注环境风险而不是社会风险,经济,和技术影响。尽管有些论文涉及健康影响,这方面需要进一步努力。这项审查强调了迫切需要在PICTS中进行AQ监测工作,以生成空间和时间上可比的数据。通过呈现AQ知识的当前状态,这项工作为协调区域监测奠定了基础,并为国家政策制定提供了信息。
    Air quality (AQ) significantly impacts human health, influenced by both natural phenomena and human activities. In 2021, heightened awareness of AQ\'s health impacts prompted the revision of the World Health Organization (WHO) guidelines, advocating for stricter pollution standards. However, research on AQ has predominantly focused on high-income countries and densely populated cities, neglecting low- and middle-income countries, particularly Pacific Island Countries, Territories, and States (PICTS). This systematic review compiles existing peer-reviewed literature on AQ research in PICTS to assess the current state of knowledge and emphasize the need for further investigation. A systematic literature search yielded 40 papers from databases including Web of Science, Scopus, and Embase. Among the 26 PICTS, only 6 (Hawai\'i, Fiji, Papua New Guinea, New Caledonia, Republic of Marshall Islands, and Pacific) have been subject to AQ-related research, with 4 considering the World Health Organization (WHO) parameters and 26 addressing non-WHO parameters. Analysis reveals AQ parameters often exceed 2021 WHO guidelines for PM2.5, PM10, SO2, and CO, raising concerns among regional governments. Studies primarily focused on urban, agricultural, rural, and open ocean areas, with 15 based on primary data and 14 on both primary and secondary sources. Research interests and funding sources dictated the methods used, with a predominant focus on environmental risks over social, economic, and technological impacts. Although some papers addressed health implications, further efforts are needed in this area. This review underscores the urgent need for ongoing AQ monitoring efforts in PICTS to generate spatially and temporally comparable data. By presenting the current state of AQ knowledge, this work lays the foundation for coordinated regional monitoring and informs national policy development.
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  • 文章类型: Journal Article
    我们使用超保守元件(UCE)基因组数据来研究系统发育,年龄,和harmochirine跳跃蜘蛛的生物地理历史,包括物种丰富的哈布罗纳特斯属的一组,其非凡的求爱使其成为行为研究的焦点,性选择,和多样化。我们从43个哈莫奇林分类群和4个外群中恢复了1947个UCE基因座,产生193个UCE的核心数据集,占用率至少为50%。关联的可能性和ASTRAL分析证实了哈莫奇林分为两个主要分支,这里指定了哈莫奇利塔和佩伦尼塔。大多数是非洲或欧亚大陆,但明显的例外是包含美洲的Habronattus和Pellenattus以及太平洋岛屿的Havaika和Hivanua的pellenites进化枝。使用DEC模型的生物地理学分析有利于将进化枝的祖先从欧亚大陆分散到美洲,Havaika的祖先分散到夏威夷,Hivanua的祖先分散到马克萨斯群岛。对占用率为85%的32个基因座的发散时间分析,根据化石和岛屿时代校准,大约在4到6百万年前向美洲扩散。Habronattus的爆炸性辐射可能仅开始于大约4mya。系统发育阐明了性特征的进化(例如,在Pellenes中,终末变位被扩大了,随后没有丢失)和分类学。Habronattus被证实为单系。Pellenatus被提升到属的地位,13个物种作为新的组合进入其中。BianorstepposusLogunov,1991年被转移到锡比亚诺,和布拉瓦伊诺斯韦索沃斯卡,1999年移交给Neaetha。提出了蜘蛛UCE的分子时钟速率估计,并讨论了其告知先验分布的实用性。
    We use ultraconserved elements (UCE) and Sanger data to study the phylogeny, age, and biogeographical history of harmochirine jumping spiders, a group that includes the species-rich genus Habronattus, whose remarkable courtship has made it the focus of studies of behaviour, sexual selection, and diversification. We recovered 1947 UCE loci from 43 harmochirine taxa and 4 outgroups, yielding a core dataset of 193 UCEs with at least 50 % occupancy. Concatenated likelihood and ASTRAL analyses confirmed the separation of harmochirines into two major clades, here designated the infratribes Harmochirita and Pellenita. Most are African or Eurasian with the notable exception of a clade of pellenites containing Habronattus and Pellenattus of the Americas and Havaika and Hivanua of the Pacific Islands. Biogeographical analysis using the DEC model favours a dispersal of the clade\'s ancestor from Eurasia to the Americas, from which Havaika\'s ancestor dispersed to Hawaii and Hivanua\'s ancestor to the Marquesas Islands. Divergence time analysis on 32 loci with 85 % occupancy, calibrated by fossils and island age, dates the dispersal to the Americas at approximately 4 to 6 million years ago. The explosive radiation of Habronattus perhaps began only about 4 mya. The phylogeny clarifies both the evolution of sexual traits (e.g., the terminal apophyses was enlarged in Pellenes and not subsequently lost) and the taxonomy. Habronattus is confirmed as monophyletic. Pellenattus is raised to the status of genus, and 13 species moved into it as new combinations. Bianor stepposus Logunov, 1991 is transferred to Sibianor, and Pellenes bulawayoensis Wesołowska, 1999 is transferred to Neaetha. A molecular clock rate estimate for spider UCEs is presented and its utility to inform prior distributions is discussed.
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