Risk prediction of cardiovascular disease in the Asia-Pacific region: The SCORE2 Asia-Pacific model

Background and Aims: To improve upon the estimation of 10-year cardiovascular disease (CVD) event risk for individuals without prior CVD or diabetes mellitus in the Asia-Pacific region by systematic recalibration of the SCORE2 risk algorithm. Methods: The sex-specific and competing risk-adjusted SCORE2 algorithms were systematically recalibrated to reflect CVD incidence observed in four Asia-Pacific risk regions, defined according to country-level World Health Organization age- and sex-standardized CVD mortality rates. Using the same approach as applied for the original SCORE2 models, recalibration to each risk region was completed using expected CVD incidence and risk factor distributions from each region. Results: Risk region-specific CVD incidence was estimated using CVD mortality and incidence data on 8 405 574 individuals (556 421 CVD events). For external validation, data from 9 560 266 individuals without previous CVD or diabetes were analysed in 13 prospective studies from 12 countries (350 550 incident CVD events). The pooled C-index of the SCORE2 Asia-Pacific algorithms in the external validation datasets was. 710 [95% confidence interval (CI). 677-.744]. Cohort-specific C-indices ranged from. 605 (95% CI. 597-.613) to. 840 (95% CI. 771-.909). Estimated CVD risk varied several-fold across Asia-Pacific risk regions. For example, the estimated 10-year CVD risk for a 50-year-old non-smoker, with a systolic blood pressure of 140  mmHg, total cholesterol of 5.5  mmol/L, and high-density lipoprotein cholesterol of 1.3  mmol/L, ranged from 7% for men in low-risk countries to 14% for men in very-high-risk countries, and from 3% for women in low-risk countries to 13% for women in very-high-risk countries. Conclusions: The SCORE2 Asia-Pacific algorithms have been calibrated to estimate 10-year risk of CVD for apparently healthy people in Asia and Oceania, thereby enhancing the identification of individuals at higher risk of developing CVD across the Asia-Pacific region

Governance disclosure on the internet : the case of Australian State Government Departments

This paper examines corporate governance disclosures on the websites of Australian state government departments. The study focuses on the nature and extent of governance information and the ease of finding this information directly on department websites and also in annual reports which are downloadable from websites. Our sample comprises six departments from each of the six states in Australia, giving a sample size of 36 departments. Our findings indicate considerable variability in both the level of disclosure and the accessibility of the information disclosed. The study also highlights a lack of consensus regarding the meaning of governance and what governance comprises, together with the need for a more structured approach to communicating governance information to stakeholders

Regionalização no SUS: uma revisão crítica

Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.O artigo tem por objeto a produção científica sobre o tema da Regionalização da Saúde em periódicos brasileiros indexados no SciELO. Objetivo: Revisar tal produção, trabalhando os resultados como subsídios para gestores na tomada de decisão e também para o processo de análise da produção acadêmica sobre a temática. Método: Busca na base de dados online de artigos no SciELO, utilizando-se 02/06/2016 como corte temporal, ‘regionalização’ e ‘saúde’ como termos pesquisados e todos os índices como ‘abrangência da pesquisa’. Identificou-se 102 referências, cujos resumos foram analisados, chegando-se a 70 artigos que, efetivamente, discutem a regionalização da saúde no Brasil. Encontrou-se 4 artigos em periódicos fora da área da saúde. Análise: Critérios institucionais (periódico, área temática, data da publicação, abrangência, quantidade de autores) e categorias analíticas criadas pelo autor – Tipo 1, envolvendo “Estudos Exploratórios” (26), “Estudos Avaliativos” (6), “Estudos Comparados” (3) e “Relatos de Experiência” (5); Tipo 2, abrangendo “Textos Teóricos-Analíticos” (20) e “Revisões Histórico-Conceituais” (4); Tipo 3, com “Editoriais” (3) e “Resenhas de Livros” (3). Resultados: A regionalização tem repercussão nos periódicos a partir de 2010. Predominam artigos na categoria de Tipo 1.This article is a review of the literature on the regionalization of healthcare, published in Brazilian journals indexed in the SciELO system. Objective: to review the output and the use of the data to support managers in making decisions on the healthcare system, and analyze academic output on the theme. Method: An online search of the SciELO database for articles using ‘regionalization’ and ‘health/healthcare’ as the keywords, and all indices as the ‘scope of the study’. We found a total of 102 references, and after analyzing the abstracts selected 70 articles that effectively discuss regionalization of health/healthcare in Brazil. We also found four articles in non-health related journals. Analysis: the institutional criteria (journal, theme area, date of publication, scope and number of authors), and the analytical criteria created by author - Type 1 - “Exploratory Studies” (26), “Evaluation Studies” (6), “Comparison Studies” (3); and “Reports of Experience” (5), Type 2 - “Theoretical-Analytical” papers (20) and “Historical-Conceptual Reviews” (4), and Type 3 - “Editorials (3) and “Book Reviews” (3). Findings: regionalization has become more important in journals published since 2010. Most of the articles fall in the Type 1 category