Search

Background Objectives Methods Results Discussion Conclusion During the coronavirus pandemic, misinformation was circulated through technology and social media on a large scale. Since people rely on media to keep connected and informed, misinformation can prevent them from staying safe.To examine the quality of information reaching Pakistanis, the effect of information/misinformation on people's perception, and its relationship with risky health behaviours in different demographical groups.A community sample of N= 103 Pakistanis was assessed using a mixed‐method cross‐sectional survey research design to investigate their sources of knowledge/information, perceptions of coronavirus‐related facts, and risky health behaviours.Content analysis of the material that participants read/watched indicated the possible effect of media on people's perception of COVID‐19. Specific demography (e.g., increasing age) and people's tendency to believe misinformation/information may indicate risky health behaviours pertaining to coronavirus infection.Findings showed how the models considered (social cognitive theory, biological warfare conspiracy theory, theory of planned behaviour, protection motivation theory, the health belief model, and biopsychosocial model) may be relevant to examination of the effects of misinformation on different demographic groups.The findings and models need to be verified on larger, more representative samples of Pakistanis using a large‐scale survey based on the insights obtained from this pilot study. [ABSTRACT FROM AUTHOR]

Intertropical Convergence Zone (ITCZ) primarily governs the convective rainfall potential of the summer monsoon in Asia. In the present study, non-parametric trend test with outgoing longwave radiation (OLR) for the summer monsoon period for the last 42 years (1980–2021) have been analyzed for ITCZ zone, representative zones of Hadley circulation and Walker circulation for exploring trend of the deep convection activity. Besides, various climatic variables like temperature (maximum, minimum, mean), precipitation, and cloud cover dataset are used for exploring trend in major rice growing regions of the world. The results indicate that there is a significantly decreasing trend of OLR in ITCZ zone during summer monsoon season. Contrarily, major rice growing regions of the world have witnessed a significantly increasing trend for the temperature parameter among all the zones. Rainfall and cloud cover have shown a typical trend i.e., increasing rainfall but decreasing cloud cover in the Southeast Asian and Maritime Continent rice growing regions. In rice suitable climate assessment, it has been found that the Maritime Continent rice growing region, the Indo-Gangetic Plain and the Southeast Asian rice growing regions have witnessed better rice suitable climates than other rice growing regions during the last 42 years (1980–2021). [ABSTRACT FROM AUTHOR]

Background. The association between economic status and kidney disease is incompletely explored even in countries with higher economy (HE); the situation is complex in lower economies (LE) of South Asia and Southeast Asia (SA and SEA). Methods. Fifteen countries of SA and SEA categorized as HE and LE, represented by the representatives of the national nephrology societies, participated in this questionnaire and interview-based assessment of the impact of economic status on renal care. Results. Average incidence and prevalence of end-stage kidney disease (ESKD) per million population (pmp) are 1.8 times and 3.3 times higher in HE. Hemodialysis is the main renal replacement therapy (RRT) (HE-68%, LE-63%). Funding of dialysis in HE is mainly by state (65%) or insurance bodies (30%); out of pocket expenses (OOPE) are high in LE (41%). Highest cost for hemodialysis is in Brunei and Singapore, and lowest in Myanmar and Nepal. Median number of dialysis machines/1000 ESKD population is 110 in HE and 53 in LE. Average number of machines/dialysis units in HE is 2.7 times higher than LE. The HE countries have 9 times more dialysis centers pmp (median HE-17, LE-02) and 16 times more nephrologist density (median HE-14.8 ppm, LE-0.94 ppm). Dialysis sessions >2/week is frequently followed in HE (84%) and <2/week in LE (64%). "On-demand" hemodialysis (<2 sessions/week) is prevalent in LE. Hemodialysis dropout rates at one year are lower in HE (12.3%; LE 53.4%), death being the major cause (HE-93.6%; LE-43.8%); renal transplants constitute 4% (Brunei) to 39% (Hong Kong) of the RRT in HE. ESKD burden is expected to increase >10% in all the HE countries except Taiwan, 10%–20% in the majority of LE countries. Conclusion. Economic disparity in SA and SEA is reflected by poor dialysis infrastructure and penetration, inadequate manpower, higher OOPE, higher dialysis dropout rates, and lesser renal transplantations in LE countries. Utility of RRT can be improved by state funding and better insurance coverage. [ABSTRACT FROM AUTHOR]

The authors report a case of Moyamoya disease in a middle-aged Nepali female. Though the disease is common in other parts of Asia only one case has been reported previously from Nepal. It should be suspected as a rare cause for spontaneous intracerebral hemorrhage in adults. [ABSTRACT FROM AUTHOR]

Aim: There is paucity of data on the epidemiology of end‐stage kidney disease (ESKD) from South Asia and South‐East Asia. The objective of this study was to assess the aetiology, practice patterns and disease burden and growth of ESKD in the region comparing the economies. Methods: The national nephrology societies of the region; responded to the questionnaire; based on latest registries, acceptable community‐based studies and society perceptions. The countries in the region were classified into Group 1 (High|higher‐middle‐income) and Group 2 (lower|lowermiddle income). Student t‐test, Mann‐Whitney U test and Fisher's exact test were used for comparison. Results: Fifteen countries provided the data. The average incidence of ESKD was estimated at 226.7 per million population (pmp), (Group 1 vs. Group 2, 305.8 vs. 167.8 pmp) and average prevalence at 940.8 pmp (Group 1 vs. Group 2, 1306 vs. 321 pmp). Group 1 countries had a higher incidence and prevalence of ESKD. Diabetes, hypertension and chronic glomerulonephritis were most common causes. The mean age in Group 2 was lower by a decade (Group 1 vs. Group 2—59.45 vs 47.7 years). Conclusion: Haemodialysis was the most common kidney replacement therapy in both groups and conservative management of ESKD was the second commonest available treatment option within Group 2. The disease burden was expected to grow >20% in 50% of Group 1 countries and 78% of Group 2 countries along with the parallel growth in haemodialysis and peritoneal dialysis. SUMMARY AT A GLANCE: There are few data on the epidemiology and pattern of practice for end‐stage kidney disease from South Asia and South‐East Asia. This survey covers 15 Asian countries and provide important information on how ESKD patients are managed in this part of the world. [ABSTRACT FROM AUTHOR]

Community-acquired acute kidney injury (CA-AKI) is the dominant form of AKI encountered in developing countries in Asia. Economic disparities, variations in access to health care services, geographic conditions, environmental risk factors, and sociocultural circumstances shape the causes and outcomes of CA-AKI. Infections, drugs, plant and chemical toxins, envenomations, and obstetric complications are common causes of CA-AKI. Previously healthy young individuals who often work outdoors in fields or farms are exposed to a wide variety of work-related or environmental risk factors for CA-AKI. Improving disease definitions, better data, and evolving host-pathogen interactions have changed disease descriptions and presentations over the past 20 years. Among infections, although the incidence of malaria has decreased, the number of cases with dengue and scrub typhus have increased sharply. The recognition of AKI in relation to Plasmodium knowlesi, Plasmodium vivax, scrub typhus, and leptospirosis in areas not traditionally considered at risk, association of infections with the future development of chronic kidney disease, and the role of complement dysregulation in infection-associated AKI are important new findings. Snake-bite-related toxic envenomation continues to be an important cause of AKI in some counties and is a neglected public health problem. On the other hand, significant decreases in the incidence of AKI related to acute diarrheal illness or obstetric causes are signs of hope. Coordinated efforts between administrative stakeholders, society, and health care delivery services at all levels have the potential to propel research and improve outcomes in CA-AKI. [ABSTRACT FROM AUTHOR]

Background C3 glomerulopathy (C3G) is a heterogeneous disease caused by alternative complement pathway abnormalities without any standardized treatment. An immunosuppressive agent, mycophenolate mofetil (MMF), has been recently shown to be useful in treating C3G, mainly in studies from the west. We report the clinical outcome of 17 Indian C3G patients treated with MMF with or without steroids. Methods The clinical and histology details of the C3G patients treated with MMF for at least 6 months with a follow-up of at least 12 months were retrieved from the medical records of our center. Results The median serum creatinine and proteinuria at presentation were 0.8 mg/dL and 3.7 g/day, respectively, with the majority (88.2%) presenting as nephrotic syndrome. The mean dose of MMF was 1.65 (±0.56) g/day, and the median duration of MMF therapy was 18 months. Two-thirds (64%) of the patients responded to the treatment, with complete remission in 4 (23%) and partial remission in 7 (41%) (median time: 9 months). Three patients progressed to end-stage renal disease (ESRD) on follow-up. Of the three patients, one (33%) had an initial response in proteinuria to MMF but did not respond after a relapse and subsequently progressed to ESRD and two (67%) other patients were nonresponsive to MMF from the start of the therapy. Conclusion Despite a small sample size and lack of a control arm, this study describes the effectiveness of MMF in treating C3G patients from Asia and forms a basis for future randomized trials. [ABSTRACT FROM AUTHOR]

In an Essay, Blake Angell and colleagues discuss ambitious reforms planned to expand coverage of the health system in India. [ABSTRACT FROM AUTHOR]

Background: Evidence supports the integration of prevention and management for tuberculosis (TB) with non-communicable diseases (NCDs). Bi-directional screening for TB and diabetes mellitus (DM) is already implemented in India, a country with a dual burden of TB and NCDs. However, very limited programmatic data are available on the feasibility of adding other NCDs and their risk factors in such screening programme. Objective: To assess the yield, feasibility, and acceptability of a two-stage integrated screening for NCDs and risk factors for NCDs among patients with TB ≥20 years and treated in DOTS centres of two medical colleges in Delhi, between October 2016 and March 2017. Methods: It was a mixed-methods, triangulation study with a quantitative component (cross-sectional study using questionnaires, anthropometric measurements and records review) and a qualitative component (descriptive study using interview data). Results: Amongst 403 patients screened, the prevalence of hypertension was 7% (n = 28) with 20 new cases detected and 8% for DM (n = 32) with 6 new cases diagnosed. The number needed to screen to find a new case was 20 and 63 for hypertension and DM respectively. The most frequent NCD-risk factors were inadequate vegetable (80%) and fruits (72%) intake, alcohol use (34%), use of smokeless tobacco (33%) and smoking (32%). Clustering of four or more risk factors was associated with increasing age and male sex (p<0.05). Both patients and health providers considered the screening relevant and acceptable. However, waiting time and costs involved in blood tests were considered as bothersome by the patients, while health providers perceived increased workload, inadequate medical supplies and inadequate skills and knowledge as key challenges in implementation of the screening. Conclusion: Integrating screening for NCDs and their risk factors in the existing TB programme produces high yield and it is feasible and acceptable by patients and health providers provided the challenges are overcome. [ABSTRACT FROM AUTHOR]

Welcome to this special Journal of Environmental Assessment Policy and Management ( JEAPM) issue on environmental assessment (EA) research in South Asia, which besides this introductory paper includes seven papers contributing to a wider understanding of EA-related practices in the South Asian Region (SAR). Some of the papers are country-specific while others provide useful overviews of a region and/or parts of a region. The collection of papers is a result of a targeted call to researchers taking a special interest on EA issues within SAR. This special issue is timely considering the challenges and rapid growth this part of the world is currently facing. Furthermore, there is a perception that EA-related research in the region is less reported in the academic literature than others. Although this special issue cannot claim to represent all countries in South Asia, it is a step towards narrowing this perceived gap in the literature and in reporting on the emerging trends of EA within the region. It is hoped that this initiative will encourage further SAR EA-related research and publications in the future. [ABSTRACT FROM AUTHOR]

Agricultural input and output trade is a powerful engine for agricultural growth. It helps in optimizing farmer's performance and deals with the changing social, environmental and economic conditions. Trade in agricultural inputs arises relatively because of the geographical disparity in the manufacturing of agricultural inputs. This paper discusses the agricultural input-output trade in South Asia. Economic growth of South Asia has been averaging at 6% per year over the last two decades. This study shows that the proportion of the gross domestic product derived from agriculture declined throughout the study period in all the South Asian countries. Also, the employment in agriculture declined from 59.2% in 2000-02 to 47.1% in 2010-12. The availability of better quality inputs would help in increasing the cereals yield across all the South Asian countries. A little improvement is seen in the exportimport of fertilizers, pesticides, insecticides and agricultural machineries during the study period. At the same time, an increasing trend has also been seen in the cereals yield. The agricultural outputs trade enables South Asian countries to manage the balance among food deficit and surplus countries along with balancing the prices of outputs. A policy suggestion would be to establish the most favored nation regulations among South Asian countries to initiate trade exchanges for agricultural inputs other than seeds like fertilizers, insecticides, pesticides and agricultural machinery. [ABSTRACT FROM AUTHOR]

Background: The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism. Aims and Methods: This paper uses the model of the intercultural development continuum and the concept of 'cultural fit' to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism. Results and Conclusions: The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a 'global' approach to how professionalism is embedded in their curricula. [ABSTRACT FROM AUTHOR]

The large-scale Asian summer monsoon circulation has experienced a weakening tendency in recent decades. Using observed data and output from model experiments with the atmospheric component of the NCEP Climate Forecast System, the authors show that a relatively smaller warming in Asia compared to the surrounding regions may be a plausible reason for this change in the monsoon. Although the surface temperature over Asia has increased, the landmass has become a relative 'heat sink' because of the larger warming in other regions of the world. Indeed, over Asia, the vertically integrated tropospheric temperature in the most recent decades is colder than that in the earlier decades, a feature different from the characteristics outside Asia. [ABSTRACT FROM AUTHOR]

Background: The Asian Forum of Chronic Kidney Disease Initiative started in 2007 in Hamamatsu, Japan when delegates from 16 countries joined together to facilitate collaboration in studying chronic kidney disease (CKD) in the Asia–Pacific region. Based on the outcome of the first meeting, the second meeting was organized as a consensus conference to frame the most relevant issues, and develop research recommendations and action plan. Proceedings: The meeting was held on 4 May 2008 as a pre-conference meeting to the 11th Asian Pacific Congress of Nephrology in Kuala Lumpur. This meeting consisted of three sessions: Session I was dedicated to the estimation of glomerular filtration rate and the standardization of serum creatinine measurements. Session II discussed specific considerations in the aetiology of and risk factors for end-stage renal disease in Asia. We concluded that there were regional specific problems that might lead to a very high prevalence of end-stage renal disease. Session III discussed the issue of facilitation of coordination and integration of the CKD initiative between developed and developing countries in the Asia–Pacific region. Conclusion: The following action plans were formulated: (i) validating the existing global estimated glomerular filtration rate equation or creating a new one using serum creatinine standardized by a central laboratory; (ii) establishing a pan-Asian CKD registry to facilitate risk analysis of CKD and its comorbidities; (iii) adapting existing clinical practice guidelines for CKD detection and management to address specific problems in this region; and (iv) working closely with other international professional organizations to promote manpower development and education in different aspects of CKD in developing countries. [ABSTRACT FROM AUTHOR]

Remittances to Asia plunged during the 1997 Asian financial crisis, but the drop was temporary as the flows were increasing once again after just one year. The current crisis, however, is fundamentally different in that even the main remittance-sending countries have been adversely affected. The global nature of this crisis raises several questions such as whether the remittances slowdown will also last for a short time or developing Asia should prepare for a long period of remittance stagnation. This study examines remittances data of several Asian countries to shed light on such questions. The results suggest that while remittance flows to key recipients in the region have slowed down, there has not been a sharp drop. Furthermore, there is no indication that the remittance flows will slow down further, suggesting that the flows should be back on a higher growth path in a few years. It is unlikely, however, to see the same growth rates of the past, given that an important share of that growth during the last two decades was due to better recording of remittances and an increased use of wire transfers on the part of migrants. The study also provides policy options to deal with the future outlook of remittances. [ABSTRACT FROM AUTHOR]

Summary: Asia, the largest continent in the world, is heterogeneous in the ethnic, socioeconomic, and developmental status of its populations. A vast majority of it is poor with no adequate access to modern health care, making an accurate estimation of the nature and extent of acute kidney injury (AKI) difficult. Community-acquired AKI in otherwise healthy individuals is common, and the population developing AKI is younger compared with its counterparts in Europe or North America. The etiologic spectrum varies in different geographic regions of Asia depending on environmental, cultural, and socioeconomic factors. Some of the etiologic factors include AKI in relation to infectious diseases, intravascular hemolysis caused by glucose 6-phosphate dehydrogenase deficiency, poisonings caused by industrial chemicals or copper sulphate, animal venoms, natural medicines, heat stroke, and after complications of pregnancy. Preventive opportunities are missed because of failure to recognize the risk factors and early signs of AKI. Patients often present late for treatment, leading to multi-organ involvement and increased mortality. The exact etiologic diagnosis cannot be established in many instances because of a lack of appropriate laboratory support. Modern methods of renal replacement therapy are not universally available; and intermittent peritoneal dialysis is still widely practiced in many areas. [Copyright &y& Elsevier]

The authors reflect on the emerging threats from chronic diseases in Asia particularly in China and India which has shown major health and poverty implications and significant challenge for the government. They evaluate that many of the chronic diseases are avoidable with the cost-effective interventions and controls. They assess that the creation of epidemiologic and clinical interventions to monitor the evolution of the chronic diseases can have global scientific benefits.

This paper analyses the possible response from Asian developing countries (ADC) to the proposal for the formation of an international legal entity called World Environmental Organisation (WEO). WEO has found mention in various forums. We conceive of a WEO based on the principle of internalisation of global external effects (Whalley and Zissimos, 2000), not the adoption of standards, as was the case in efforts like Agenda 21. Consonant with this, we focus on the twin issues of demarcation of property rights and side payments in order to facilitate Coasian deals°. [ABSTRACT FROM AUTHOR]

Examines the role of the U.S. in Asia. Dynamics of political processes; Improvement of the relationship between India and the U.S.; Influence of policy makers on professional lobbyists.

Examines characteristic patterns of domestic resource mobilization, investments and foreign capital inflows in developing Asia. Emerging issues in resource mobilization; Impact of high levels of investments and savings; Differences in patterns of resource mobilization among low-income and high-income Asian countries; Development challenges; Role of external resources.

Examines the monsoon energetics in the Asian region. Difficulty associated with monsoon forecasting; Factors which have contributed to the deterioration of monsoon forecasts; Advantages of the kinetic energies of the rotational and divergent motions; Logical extension of the zonally symmetric monsoon to a full three dimensions; Details on the maintenance of a monsoon systems; Methodology and results of the study.

The present study, first of its kind, has analyzed the land cover and investigated the spatial patterns of deforestation and forest fragmentation in South Asian region since the 1930's. This region comprises of eight countries: India, Bangladesh, Bhutan, Nepal, Pakistan, Afghanistan, Sri Lanka and Maldives. In South Asia, agricultural land is predominant constituting 43% of the total geographical area followed by barren land (19.99%) and forests (14.72%). The long-term change analysis using the classified maps of 1930 and 2014 indicated a loss of 29.62% of the forest cover. Higher annual net deforestation rates were observed in the period from 1930–1975 (0.68%) followed by 1975–1985 (0.23%), 1985–1995 (0.12%), 1995–2005 (0.06%) and 2005–2014 (0.04%) for the region. Forest fragmentation had significant spatio-temporal variation across the South Asian countries. In 1930, 88.91% of the South Asian forest was classified as large core forest, 8.18% as edge forest and 1.18% as perforated forest. The large core forest category has decreased significantly in area over last eight decades. The results of the present study are expected to serve as a reference for the evaluation of globally agreed Aichi biodiversity target 5 for South Asian countries. This study will be a valuable basis for developing management strategies and restoration programs as it tracks the spatial changes in deforestation and forest fragmentation. [ABSTRACT FROM AUTHOR]

Cancer registries help to establish and maintain cancer incidence reporting systems, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.