Influenza A and B viruses cause significant human disease worldwide through regular outbreaks and epidemics of seasonal influenza, and occasional pandemics when a novel influenza A virus emerges. Whereas Australia and New Zealand have well-established systems for community and laboratory-based surveillance of influenza, most other countries of the Pacific are only beginning to develop such systems with the support of various global and regional agencies and networks. Here we describe the role of the World Health Organization Global Influenza Surveillance Network and other organizations in laboratory-based influenza surveillance in the region and review some of the available data on seasonal and pandemic influenza in the developed and developing countries of the Pacific. The particular features of the Pacific Island countries and territories as small dispersed island communities, together with the greater susceptibility of indigenous people to the severe effects of influenza, highlight the importance of developing local laboratory-based surveillance systems. Such systems will improve the understanding, detection and control of seasonal influenza while also providing early warning of the emergence of potential pandemic viruses.
Disease Outbreaks ; Humans ; Influenza, Human/epidemiology ; Influenza, Human/virology ; Pacific Islands/epidemiology ; Population Surveillance ; Seasons ; World Health Organization.

Purpose: We aimed to describe our technique for and experience with elective endovascular aneurysm repair using EndoAnchors under local anesthesia. Materials and Methods: We included seven patients with abdominal aortic aneurysms who underwent endovascular aneurysm repair using EndoAnchors with a standard regimen consisting of local anesthesia, intravenous sedation, and analgesia. The procedural and follow-up details were retrospectively reviewed. Results: Six out of seven infrarenal abdominal aortic aneurysms were successfully treated with endovascular aneurysm repair using primary EndoAnchors under local anesthesia. One patient was converted to general anesthesia due to acute aneurysm thrombosis independent of EndoAnchor deployment during the procedure. Remifentanyl infusions of up to 3.2 mg/min, morphine doses up to 6 mg (median, 0.5 mg), and midazolam doses of up to 4 mg (mean, 1.4 mg) were used. The mean theater time was 83 minutes (range, 60–130 minutes). Two patients were discharged on day 0, and the mean hospital stay was one day. All patients were alive between 484 and 1,128 days post-procedure, with no aneurysm-specific reintervention. Conclusion The combination of local anesthesia, intravenous sedation, and analgesia is a viable strategy for timely and effective endovascular aneurysm repair using EndoAnchors. This technique may allow endovascular repair of more ruptured aneurysms using EndoAnchors with potential survival benefits.

BACKGROUND: Individual health behavior is related to environmental and social structures. To promote physical activity (PA) effectively, it is necessary to consider structural influences. Previous research has shown the relevance of the built environment. However, sex/gender differences have yet not been considered. The aim of this systematic review was to identify built environmental determinants of PA by taking sex/gender into account. METHODS: A systematic literature search was carried out using six electronic databases (PubMed, CINAHL, SportDiscus, PsycInfo, Scopus, Web of Knowledge) to identify studies analyzing the effect of changes in the built environment on PA, taking sex/gender into account. To be included, studies had to be based on quantitative data and a longitudinal study design. Changes in the built environment had to be objectively assessed. The methodological quality of the studies was examined using the QualSyst tool for examining risk of bias. RESULTS: In total, 36 studies published since 2000 were included in this review. The data synthesis revealed that the majority of reviewed studies found the built environment to be a determinant of PA behavior for both, males and females, in a similar way. Creating a new infrastructure for walking, cycling, and public transportation showed a positive effect on PA behavior. Findings were most consistent for the availability of public transport, which was positively associated with overall PA and walking. The improvement of walking and cycling infrastructure had no effect on the overall level of PA, but it attracted more users and had a positive effect on active transportation. In women, the availability of public transport, safe cycling lanes, housing density, and the distance to daily destinations proved to be more relevant with regard to their PA behavior. In men, street network characteristics and road environment, such as intersection connectivity, local road density, and the presence of dead-end roads, were more important determinants of PA. CONCLUSION This review sheds light on the relevance of the built environment on PA. By focusing on sex/gender differences, a new aspect was addressed that should be further analyzed in future research and considered by urban planners and other practitioners.
Built Environment ; Exercise ; Female ; Humans ; Longitudinal Studies ; Male ; Sex Factors