Subtype H3N2 Influenza A Viruses: An Unmet Challenge in the Western Pacific

Subtype H3N2 influenza A viruses (A(H3N2)) have been the dominant strain in some countries in the Western Pacific region since the 2009 influenza A(H1N1) pandemic. Vaccination is the most effective way to prevent influenza; however, low vaccine effectiveness has been reported in some influenza seasons, especially for A(H3N2). Antigenic mismatch introduced by egg-adaptation during vaccine production between the vaccine and circulating viral stains is one of the reasons for low vaccine effectiveness. Here we review the extent of this phenomenon, the underlying molecular mechanisms and discuss recent strategies to ameliorate this, including new vaccine platforms that may provide better protection and should be considered to reduce the impact of A(H3N2) in the Western Pacific region.

Western Pacific Teachers’ Perceptions of Implementing Technology in the Classroom

At a Western Pacific Region school district with six public high schools, district administrators implemented an educational technology training program (ETTP) to improve technology integration in the classroom as measured by the Effective Learning Environments Observation Tool, but there was no follow-up to determine how the teachers perceived the ETTP and to identify the experiences of teachers related to instructional technology after taking the district training. This basic qualitative study, guided by the technology acceptance model, addressed this problem in the district by exploring how the teachers perceived the technology professional development program provided by the district and the teachers’ experiences related to instructional technology after taking the district training. The purposeful sample included 13 Western Pacific Region high school teachers who were interviewed via Zoom. Data were analyzed using thematic analysis to create codes, categories, and themes. The participants perceived the ETTP as helpful because they learned new tools and increased their confidence in using technology in their classrooms. Results showed that after completing the ETTP, teachers still needed content-specific technology training and continuous professional development. High school teachers expressed the need for these trainings to continue integrating technology using up-to-date technology tools. Rethinking science professional development is one potential form of social change.

Associations between sociodemographic factors, health spending, disease burden, and life expectancy of older adults (70 + years old) in 22 countries in the Western Pacific Region, 1995–2019: estimates from the Global Burden of Disease (GBD) Study 2019

The needs of the aging populations are putting increasing burden on healthcare particularly in the Western Pacific Region (WPR), which is the home of aging economies such as Hong Kong and Japan alongside rapid increases in older people in low- and middle-income countries (LMICs). However, little is known about the associations between sociodemographic factors, disease burden, and life expectancy in WPR. The current study conducted secondary analysis on the Global Burden of Disease (GBD) estimates of populations aged 70 years and older in WPR countries between 1995 and 2019. Correlation tests, linear mixed regressions and generalized additive mixture models were run to examine the associations of interest. Unsupervised machine learning was conducted to segment the data automatically, at cluster analysis. The sociodemographic development index was found an important factor to the disease burden in terms of Years Lived with Disability (YLD) rate and mortality rate among older adults. YLD rate and mortality rate of non-communicable diseases (NCDs) attributable to different risk groups were significant contributors to higher expectation of Lost Healthy Years (LHE) and shorter life expectancy respectively in the context of rising YLD rate, particularly in LMICs. Three clusters of countries with similar characteristics were identified. NCDs were the most significant contributors to shorter life expectancy within which the time living in poor health did not improve. Better management of NCDs in aging populations should be emphasized in all countries. The country clusters may help in a more regional strategic planning.

Magnitude, Temporal Trends, and Inequalities in the DALYs and YLDs of Nutritional Deficiency among Older Adults in the Western Pacific Region: Findings from the Global Burden of Disease Study 1990–2019

The population in the Western Pacific region is aging rapidly. Nutritional deficiency is prevalent in older adults; however, information regarding nutritional deficiency in this population is scarce. Using the 2019 Global Burden of Disease (GBD) results, the age-standardized disability-adjusted life years (DALYs) and years of healthy life lost due to disability (YLDs) from nutritional deficiency were estimated between 1990 and 2019 for this population. Average annual percentage change (AAPC) was used to assess temporal trends, and linear mixed-effects models were used to examine socioeconomic and sex inequalities. From 1990 to 2019, the age-standardized DALYs of nutritional deficiency in this population decreased from 697.95 to 290.95 per 100,000, and their age-standardized YLDs decreased from 459.03 to 195.65 per 100,000, with the greatest declines seen in South Korea (AAPCs < −5.0). Tonga had the least decline in DALYs (AAPC = −0.8), whereas Fiji experienced an increase in YLDs (AAPC = 0.1). Being female and having a lower sociodemographic index score was significantly associated with higher age-standardized DALYs and YLDs. The magnitude and temporal trends of the nutritional deficiency burden among older adults varied across countries and sex in the region, indicating that health policies on nutritional deficiency among older adults must be crafted to local conditions.

A Review of the Implementation Status of and National Plans on HPV Vaccination in 17 Middle-Income Countries of the WHO Western Pacific Region

The World Health Organization’s Western Pacific Region is responsible for one-fourth of the global cervical cancer burden, and nearly 90% of that burden is concentrated in middle-income countries (MICs). Applying a conceptual model of implementation of population-based interventions, we synthesized the current implementation status of human papillomavirus (HPV) vaccination and national plans that form the basis of its implementation in 17 MICs. We gathered information from a range of governmental documents, published studies, and global databases. For all available national cancer-related plans and immunization plans, we examined the description of HPV vaccination. We found that, as of July 2021, only four countries (24%) had a mature HPV vaccination program with a high first-dose coverage; three (18%) had introduced HPV vaccination, but needed further efforts to scale it up, seven (41%) had not been able to introduce it after conducting demonstration projects, and three (18%) did not have any experience in HPV vaccination. In the national plans, most of the countries recognized the importance of HPV vaccination, but only 10 (59%) provided an implementation strategy on how it would be introduced or scaled up. Countries with a mature program were more likely to have their implementation strategy detailed in their national cancer control plan. Successful implementation of HPV vaccination requires overcoming known challenges and having a clear national plan. Positioning HPV vaccination clearly in the overall national cancer control plan may be key to accelerating its nationwide implementation.

The U.S. Western Pacific Region

This chapter describes the West Pacific region and the major issues facing this marine fisheries ecosystem, and presents some summary statistics related to the 90 indicators of ecosystem-based fisheries management (EBFM) criteria. The U.S. Western Pacific region composes over half (~51%) of the U.S. Exclusive Economic Zone (EEZ), including multiple remote archipelagos, and extends over much of the Western and Central Pacific Ocean basin. The Western Pacific contains the second-highest (among eight regions) number of managed taxa in U.S. waters, including commercially and recreationally important bottomfishes (e.g., emperors, snappers, groupers), pelagic fishes, crustaceans, corals, and coral reef-associated taxa. The U.S. Western Pacific has been affected by above-average natural and human stressors that include the highest frequency and intensity of cyclonic storm activity, intensive fishing, high coastal development, and continually increasing temperatures. Overall, significant EBFM progress has been made in terms of implementing ecosystem-level planning and advancing knowledge of ecosystem principles.