Asia-Pacific journal of public health
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Asia Pac J Public Health · Oct 2019
Assessing 10-Year Cardiovascular Disease Risk in Malaysians With Type 2 Diabetes Mellitus: Framingham Cardiovascular Versus United Kingdom Prospective Diabetes Study Equations.
In this study, we evaluated the performance of the Framingham cardiovascular disease (CVD) and the United Kingdom Prospective Diabetes Study (UKPDS) risk equations to predict the 10-year CVD risk among type 2 diabetes mellitus (T2DM) patients in Malaysia. T2DM patients (n = 660) were randomly selected, and their 10-year CVD risk was calculated using both the Framingham CVD and UKPDS risk equations. The performance of both equations was analyzed using discrimination and calibration analyses. ⋯ The UKPDS Fatal Stroke demonstrated a good discrimination (aROC curve = 0.841). The Framingham CVD, UKPDS Stroke, and UKPDS Fatal Stroke equations showed good calibration (P = .129 to .710), while the UKPDS CHD and UKPDS Fatal CHD are poorly calibrated (P = .035; P = .036). The UKPDS is a better prediction equation of the 10-year CVD risk among T2DM patients compared with the Framingham CVD equation.
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Asia Pac J Public Health · Apr 2019
Trends in Diabetes Mortality by Gender in Urban and Rural Areas in China From 2003 to 2012: An Age-Period-Cohort Analysis.
We aimed to provide updated estimates for the trends and the effects attributable to age, period, and cohort by gender in urban and rural areas in China. The data were based on the vital registration system in China from 2003 to 2012. The annual percentage change used Joinpoint Regression Analysis. ⋯ The trend analysis of diabetes showed a favorable pattern among urban residents in both genders. Mortality increased with age, and compared with period and cohort effects, age effects were the most important risk factor in diabetes mortality. Although the overall trends in diabetes mortality decelerated, aging and rural-urban differences could still be driving the epidemic underlining a continued need for the priorities for health care programs to focus on predictors in diabetes mortality.
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Asia Pac J Public Health · May 2018
E-cigarette Use and Smoking Cessation Among South Korean Adult Smokers: A Propensity Score-Matching Approach.
Research on the efficacy of e-cigarette use as a smoking cessation tool has yielded inconclusive results. Hence, the objective of this study was to identify the relationship between e-cigarette use and smoking cessation among South Korean adult smokers. This study used data from the sixth Korea National Health and Nutrition Examination Survey (2013-2015) of 2965 adult smokers aged 19 years and older. ⋯ Propensity score matching (PSM) was applied to control selection bias, and sociodemographic and smoking-linked factors were used as covariates in PSM. According to the multiple logistic regression analysis, adult smokers who had not used e-cigarettes were more likely to attempt to quit smoking than those who had used e-cigarettes in the prematching (OR = 1.58; 95% CI = 1.18-2.12) and postmatching (OR = 1.62; 95% CI = 1.08-2.44) samples. Thus, this study suggests that e-cigarette use among South Korean adult smokers was not related to smoking cessation.
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Asia Pac J Public Health · Jul 2017
Twenty Years of Progress on Maternal and Child Health in the Philippines: An Equity Lens.
This article assesses trends and inequalities in maternal and child health in the Philippines between 1993 and 2013, using 6 national household surveys, and also compares the Philippines' performance to 15 other Asia-Pacific countries. Thirteen indicators of child health outcomes and maternal and child health interventions are examined. Two measures of inequality are used: the absolute difference between the poorest and wealthiest quintile, and the concentration index. ⋯ By the first measure of inequality, all indicators show narrowing inequalities. By the second measure, inequality has fallen only for maternal health interventions. Compared with other 15 other developing Asia-Pacific countries, the Philippines performs among the best on the child health outcomes examined and above average on maternal health interventions (except family planning), but only at or below average on child health interventions.
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Asia Pac J Public Health · Nov 2016
The Regional Comprehensive Economic Partnership, Intellectual Property Protection, and Access to Medicines.
The inclusion of elevated standards of intellectual property (IP) protection in the recently negotiated Trans-Pacific Partnership (TPP) agreement has raised serious public health concerns regarding access to medicines. A lesser-known trade agreement under negotiation in the Asia-Pacific region is the Regional Comprehensive Economic Partnership (RCEP). Framed as an attempt to reassert ASEAN's position in response to the United States-led TPP, RCEP includes key players China and India as well as several low- and middle-income countries (LMICs). ⋯ This article identifies TRIPS (Trade Related Aspects of Intellectual Property Rights agreement)-Plus provisions in leaked negotiating texts and examines their implications for LMICs that are not also parties to the TPP: Cambodia, Indonesia, Laos, Myanmar, the Philippines, Thailand, China, and India. We find that higher levels of IP protection delay the market entry of generic medicines, giving rise to increased costs to governments and reduced access to essential medicines. The article concludes that the public health community should recognize risks inherent in trade agreements that promote expansions of IP rights and engage with governments to ensure that public health is adequately and explicitly protected in trade and investment negotiations.