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Background and Objectives: Current practices and available resources for nutrition therapy in paediatric intensive care units (PICUs) in the Asia Pacific-Middle East region are expected to differ from western countries. Existing guidelines for nutrition management in critically ill children may not be directly applicable in this region. This paper outlines consensus statements developed by the Asia Pacific-Middle East Consensus Working Group on Nutrition Therapy in the Paediatric Critical Care Environment. Challenges and recommendations unique to the region are described.Methods and Study Design: Following a systematic literature search from 2004-2014, consensus statements were developed for key areas of nutrient delivery in the PICU. This review focused on evidence applicable to the Asia Pacific-Middle East region. Quality of evidence and strength of recommendations were rated according to the Grading of Recommendation Assessment, Development and Evaluation approach.Results: Enteral nutrition (EN) is the preferred mode of nutritional support. Feeding algorithms that optimize EN should be encouraged and must include: assessment and monitoring of nutritional status, selection of feeding route, time to initiate and advance EN, management strategies for EN intolerance and indications for using parenteral nutrition (PN). Despite heterogeneity in nutritional status of patients, availability of resources and diversity of cultures, PICUs in the region should consider involvement of dieticians and/or nutritional support teams.Conclusions: Robust evidence for several aspects of optimal nutrition therapy in PICUs is lacking. Nutritional assessment must be implemented to document prevalence and impact of malnutrition. Nutritional support must be given greater priority in PICUs, with particular emphasis in optimizing EN delivery. [ABSTRACT FROM AUTHOR]

Background: Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. Methods: We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Results: Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. Conclusions: With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents. [ABSTRACT FROM AUTHOR]

Background: Kangaroo mother care has been highlighted as an effective intervention package to address high neonatal mortality pertaining to preterm births and low birth weight. However, KMC uptake and service coverage have not progressed well in many countries. The aim of this case study was to understand the institutionalisation processes of facility-based KMC services in three Asian countries (India, Indonesia and the Philippines) and the reasons for the slow uptake of KMC in these countries. Methods: Three main data sources were available: background documents providing insight in the state of implementation of KMC in the three countries; visits to a selection of health facilities to gauge their progress with KMC implementation; and data from interviews and meetings with key stakeholders. Results: The establishment of KMC services at individual facilities began many years before official prioritisation for scale-up. Three major themes were identified: pioneers of facility-based KMC; patterns of KMC knowledge and skills dissemination; and uptake and expansion of KMC services in relation to global trends and national policies. Pioneers of facility-based KMC were introduced to the concept in the 1990s and established the practice in a few individual tertiary or teaching hospitals, without further spread. A training method beneficial to the initial establishment of KMC services in a country was to send institutional health-professional teams to learn abroad, notably in Colombia. Further in-country cascading took place afterwards and still later on KMC was integrated into newborn and obstetric care programs. The patchy uptake and expansion of KMC services took place in three phases aligned with global trends of the time: the pioneer phase with individual champions while the global focus was on child survival (1998-2006); the newborn-care phase (2007-2012); and lastly the current phase where small babies are also included in action plans. Conclusions: This paper illustrates the complexities of implementing a new healthcare intervention. Although preterm care is currently in the limelight, clear and concerted country-led KMC scale-up strategies with associated operational plans and budgets are essential for successful scale-up. [ABSTRACT FROM AUTHOR]

Background: To measure the content of cholesterol-raising diterpenes in coffee sold at the retailer level in Singapore, Indonesia and India and to determine the relationship of coffee consumption with lipid levels in a population-based study in Singapore.Methods: Survey and cross-sectional study in local coffee shops in Singapore, Indonesia and India to measure the diterpene content in coffee, and a population-based study in Singapore to examine the relationship of coffee consumption and blood lipid levels. Interviews and coffee samples (n=27) were collected from coffee shops in Singapore, Indonesia and India. In addition, 3000 men and women who were Chinese, Malay, and Indian residents of Singapore participated in a cross-sectional study.Results and Discussion: The traditional 'sock' method of coffee preparation used in Singapore resulted in cafestol concentrations comparable to European paper drip filtered coffee (mean 0.09±SD 0.064 mg/cup). This amount would result in negligible predicted increases in serum cholesterol and triglyceride concentrations. Similarly low amounts of cafestol were found in Indian 'filter' coffee that used a metal mesh filter (0.05±0.05 mg/cup). Coffee samples from Indonesia using the 'sock' method (0.85±0.41 mg/cup) or a metal mesh filter (0.98 mg/cup) contained higher amounts of cafestol comparable to espresso coffee. Unfiltered coffee from Indonesia contained an amount of cafestol (4.43 mg/cup) similar to Scandinavian boiled, Turkish and French press coffee with substantial predicted increases in serum cholesterol (0.33 mmol/l) and triglycerides (0.20 mmol/l) concentrations for consumption of 5 cups per day. In the Singaporean population, higher coffee consumption was not substantially associated with serum lipid concentrations after adjustment for potential confounders [LDL-cholesterol: 3.07 (95% confidence interval 2.97-3.18) for <1 cup/week versus 3.12 (2.99-3.26) for ≥3 cups/day; p trend 0.12].Conclusions: Based on the low levels of diterpenes found in traditionally prepared coffee consumed in Singapore and India, coffee consumption in these countries does not appear to be a risk factor for elevation of serum cholesterol, whereas samples tested from Indonesia showed mixed results depending on the type of preparation method used. [ABSTRACT FROM AUTHOR]

India signed a Free Trade Agreement with ASEAN on 13th August, 2009. In this paper we analyze one aspect of the possible impacts of the FTA: that on India's Balance of Trade. It is found that the impact of the agreement on India's balance of trade is expected to be negative. India's imports will rise significantly, however there will be no commensurate rise in India's export to these countries except to Indonesia. [ABSTRACT FROM AUTHOR]

Untreated or partially treated wastewater, which is a negative externality of urban water use, is widely used for irrigation in water scarce regions in several countries including India. While the nutrients contained in the wastewater is considered as beneficial to agriculture, the contaminants present in it pose environmental and health risks. This paper examines the morbidity status, its determinants as well as the cost of illness for households living in the areas irrigated with wastewater in comparison with those using normal quality water. Primary data collected from six villages irrigated with wastewater along Musi River which is fed with wastewater and one control village where normal quality water is used for irrigation has been used for the analysis. It is seen that higher rates of morbidity exist in the wastewater irrigated villages when compared to the control village. Specifically, adult and female morbidity rates are significantly higher than child and male morbidity rates. From the logit analysis it is seen that exposure to wastewater and engagement in activities based on it places the households in higher risk groups to report morbidity. Small and marginal farmers incur higher economic cost of illness. However, it has been difficult to ascertain the cause and effect relationship as most of the households have reported more common illnesses like fever, head ache, skin itching, stomach ailments, etc. The study points out the need for a comprehensive risk assessment and adoption of risk management measures including setting standards for treatment and discharge of wastewater and regulations on the type of uses etc. to prevent unplanned use of untreated or partially treated wastewater while taking into account local conditions. [Copyright &y& Elsevier]

There are divergent explanations but common empirical themes in the study of rural entrepreneurship in South and Southeast Asia. Most studies are based on empirical data collection in one country and present their data within an analytical framework that is specific to the particular Asian sub-region concerned. Studies on the entrepreneurial class in South Asia tend to focus on the structural aspects of entrepreneurial behaviour, while studies on the entrepreneurial class in Southeast Asia tend to focus on the cultural aspects of their behaviour. By comparing the findings of field-work among Hindu, Muslim, and Chinese rural capitalists in India, Indonesia, and Malaysia, this paper argues that there is sufficient common ground in the type of empirical subject studied for a unified, comparative framework to be developed which will give us a better understanding into the emergence of the entrepreneurial class in both South and Southeast Asia. [ABSTRACT FROM AUTHOR]

Modern Singapore has been a focus of contact between the three cultural blocs of China, India, and Indonesia, and between Orient and Occident. Asian migrants came as laborers, artisans, and entrepreneurs; the much smaller European migrant group introduced western economic and administrative institutions. Subsequent modernization and development, necessitating improved coordination and development of all resources, has been hampered by substantial cultural divergences relating to economic and social practice and attitude. Contrasting cultural patterns are commonly identified with ethnic differences and can most readily be analyzed on this basis; the ethnic data utilized in this paper serve to highlight significant cultural differences which are only gradually breaking down despite sustained locational contiguity and the unifying force of political independence within, and subsequently outside the Federation of Malaysia. [ABSTRACT FROM AUTHOR]

Dietary intake during pregnancy plays a vital role in determining the health of both mother and baby. Maternal undernutrition affects a large proportion of women in low and lower middle income countries (LLMIC) likely influencing high maternal, infant, and child mortality in these countries. Mobile health (mHealth) interventions have been proposed as effective solutions to improve maternal and neonatal health. This paper reviews the literature to evaluate the effectiveness of mHealth interventions on improving dietary/nutrients intake of pregnant women in LLMIC. Eight electronic databases were searched from inception up to April 2018, including the MEDLINE, EMBASE, CINAHL, Cochrane, Web of Science, Scopus, Global Index Medicus, and Maternity and Infant Care. Using Covidence, two reviewers assessed articles for inclusion, assessed study quality and extracted data. Only studies published in English language were included. Data were summarised narratively. In total, 6,778 were identified of which four were included, with three randomised controlled trials and one prepost experimental study. Studies were conducted in India (n = 2), Indonesia (n = 1), and Kenya (n = 1). All articles evaluated the use of nutrient supplements; iron supplements (n = 1), vitamin supplements (composition not mentioned; n = 1), or calcium supplements (n = 1). This review suggests that mHealth interventions can be used to improve intake of micronutrient supplementation and nutritional status of pregnant women in LLMIC. Further studies are needed to address the limited evidence base related to mHealth nutrition interventions targeting dietary intakes of pregnant women in LLMIC. [ABSTRACT FROM AUTHOR]

The human tragedy caused by the Sumatra-Andaman earthquake (momentmagnitude 9.3) on 26 December 2004 and its companion Nias earthquake(moment magnitude 8.7) on 28 March 2005 is difficult to comprehend.These earthquakes, the largest in 40 years, have also left seismologistssearching for the words and tools to describe the enormity of thegeological processes involved. Four papers in this issue discuss aspectsof a rupture process of surprising complexity, the first such event totest the sensitivity and range of many new technologies. A surprisingfeature of the earthquake is that after the initial rapid rupture,subsequent slip of the plate interface occurred with decreasing speedtoward the north. [ABSTRACT FROM AUTHOR]

Abstract: Asia’s largest biofuels producers are currently Indonesia, Malaysia, the Philippines, Thailand, China and India. This paper first examines the current status of biofuels in these countries, including the national development targets, strategies, incentives and policies. It then identifies the fundamental driving forces behind the development and promotion of these industries and considers their economic, social and environmental impacts. [Copyright &y& Elsevier]