Human T-cell lymphotropic virus type 1 prevalence estimates are usually based on serological screening of blood donors, pregnant women, and other selected population groups. Previously, data on the global epidemiology of human T-cell lymphotropic virus type 1 infection have been summarized unsystematically and without a focus on general populations. To assess the implications of the virus for healthcare systems it is essential to know its past and present prevalence. The widely cited estimate that 10-20 million people are infected with human T-cell lymphotropic virus type 1 worldwide was calculated from data that are now 25 years old. This estimate may therefore no longer reflect the global epidemiology. The objective of this study was to collate published data that are truly representative of the general population through a systematic review of the literature. Fifty-nine relevant studies were identified and the 17 that met the inclusion criteria were all cross-sectional designs; none reported incidence. The prevalence of human T-cell lymphotropic virus type 1 was highest in the two studies of Japanese islands (36.4%; 95% CI: 29.9-42.8) and lowest in studies from Mongolia, Malaysia and India. In Haiti the prevalence was 3.8% (95% CI: 1.78-5.86); in Africa between 6.6% (95% CI: 4.0-9.9) and 8.5% (95% CI: 6.99-10.10) in Gabon, and 1.05% (95% CI: 0.63-1.47) in Guinea. Only three studies were from West Africa and none were from the South; the only study from India was from the north of the country. We conclude that there is a paucity of general population data from countries in which human T-cell lymphotropic virus type 1 is endemic, and that new studies are required to reevaluate the global burden of infection.
Urgent action is needed to fight the alarming spread of HIV/AIDS that infected 1.3 million people in Southeast Asia last year alone, Malaysia's foreign minister said July 24, 2000. Syed Hamid said the Association of Southeast Asian Nations (ASEAN) should tackle at regional and national level an epidemic that was taking its most drastic toll among the region's youth. "HIV/AIDS not only represents a major public health and social problem but is a serious challenge to development as well," Syed Hamid told the opening ceremony of ASEAN's 33rd annual foreign ministers' meeting. The crisis requires commitment at the "highest political level," he said, warning that HIV/AIDS could become a transnational problem within the 10-member group. Foreign ministers have recommended their leaders discuss the crisis later this year at an informal summit in Singapore and hold a summit on HIV/AIDS in conjunction with the 7th ASEAN Summit in Brunei next year. "I think people recognized the importance and the adverse impacts on our social development," Syed Hamid told reporters later. "I think it is a real issue that we cannot run away from." Among ASEAN members, Thailand, Cambodia, and Myanmar have some of the highest infection rates in Asia of HIV, the virus that causes AIDS.
Australia will fund 23 new HIV-AIDS projects in Southeast Asian countries, the government announced. "Asia is predicted to be the major growth area for human immunodeficiency virus (HIV) infections over the next decade, " Minister for Development Cooperation Gordon Bilney said. "These projects, worth some $4.35 million over three years, will help meet the challenge of preventing the spread of the disease in the region." The projects--in Thailand, Vietnam, the Philippines, Indonesia, Malaysia and Cambodia--emphasize education and prevention activities as well as programs which focus on the care and support of people living with HIV, Bilney said. He also said a variety of Australian and overseas organizations will implement the projects, many of which will feature the significant involvement of communities at risk and people with HIV. "It is in keeping with the fundamental spirit of the aid program that we should seek to share this expertise with our neighbors in the region." Bilney said one Australian success story--the creative "Streetwize comics" (publications in Australia which help street kids and under privileged kids understand HIV/AIDS problems)--will be piloted in Vietnam in conjunction with the Vietnam Youth Federation. He said Vietnamese staff will be trained in the production of a series of bilingual mini-comics on HIV-AIDS prevention for youth. "This project will receive funding of $187,500 over three years," Bilney said. Bilney said the projects would help minimize the individual and social impact of the epidemic in the targeted countries.
The Association of Southeast Asian Nations (ASEAN) Mutual Recognition Arrangement (MRA) on medical practitioners' agreement will become a reality in the year 2015. Doctors registered in one ASEAN country will be given reciprocal recognition in another country under this agreement. Rapid and excessive movement of human resources between countries in a short span of time is undesirable and can be destabilizing. The surgical fraternity in the ASEAN countries should plan for a common surgical curriculum, a common examination and an ASEAN Board of Surgery so that standards of future trainees in different countries are comparable. The curriculum should take into consideration the diversity of the countries in socio-economic development. Ideally, it should be based on a public health approach to bring affordable quality surgical care to the masses in an efficient and effective manner.
The question of whether small non-government organizations with comparatively small budgets can make a substantial contribution to sustainable improvement in health care in low- and middle-income countries is crucial to funding global surgical projects. The Royal Australasian College of Surgeons and its Fellows have partnered with local organizations and clinicians to deliver a wide range of projects in South East Asia. These projects have proved sustainable and have increased healthcare capacity in these nations. This provides strong evidence that small non-government organizations such as the Royal Australasian College of Surgeons can make a major contribution to global surgeryI.
Objective: The relationships between awareness, knowledge and attitudes (AKA) and coping mechanisms among people with epilepsy (PWE) have not been well-explored particularly in Asia. This study aimed to: identify preferred coping strategies, correlate between AKA and coping mechanisms and compare coping strategies of PWE with different AKA levels. Methods: A cross-sectional sample of epilepsy outpatients was recruited from the Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu. The participants completed the Malay AKA Epilepsy and the Malay Brief COPE instruments. The data was analysed using non-parametric statistics. Results: Sixty out of 72 patients (response rate = 83.3%) consented
participation (median age = 27.5 years; male = 53.3%; unmarried = 63.3%; Malay = 90.0%; SPM education = 54.2%; unemployed = 35.0%; rural residents = 70.0%). Religion was the most preferred coping strategy (93.3%), followed by Emotional Support (86.7%) and Instrumental Support (81.7%). Awareness was negatively correlated with Instrumental Support (rs = -0.268; p
Study site: Neurology Clinic, Hospital Sultanah Nur Zahirah, Kuala Terengganu.
encountered particularly in mental health issues and to additionally analyze the methodologies used in studies involving HIV/AIDS informal caregivers.
Methods: Four electronic databases; Science Direct, EBSCOhost, Ovid and Springer Link were searched for articles published in the past 10 years (2002 - 2012). Only full-text English articles related to research on care giving of HIV-infected adult patients were selected.
Results: Twenty two out of 293 articles (7.5%) were reviewed, involving 2,765 caregivers in the USA (n=1,610), Africa (n=253), Asia (n=838) and Oceania (n=64) regions. A variety of age categories was involved in care giving with the youngest carer being 12 years old and the oldest, 60 years on average. Females and whites appeared to be dominant and 603 caregivers themselves were HIV positive. The main outcomes measured were care giving burden, challenges and coping. Stress and depression, stigma and discrimination, insufficient support, role overload and extreme poverty were the main challenges experienced in care giving. Both qualitative (n=11) and quantitative (n=9) were the equally preferred types of study. Purposive sampling emerged as the most preferred sampling technique. Various instruments were utilized, but the Beck Depression Inventory (BDI) was the most popular particularly in quantitative studies.
Conclusion: A variety of life aspects were negatively affected in the process of care giving for HIV/AIDS patients and studies of such nature commonly focused on caregivers' psychosocial burden.
The role of science and technology (S&T) in preventing disasters and building resilience to climate change is featured in this paper, drawing primarily on the presentations and discussion of researchers, practitioners and policy makers from 31 institutions in 17 countries during the Workshop on Natural Disasters and Climate Change in Asia, held on 5–7 November 2012 in Bangi, Malaysia. Issues highlighted include advances in climate modelling and weather forecasts, with emphasis on information gaps; hazards and its cascading effects, focusing on current research and approaches; and the potential for land-based mitigation-adaptation strategies. Progress in mobilizing S&T to support disaster prevention and climate resilience is hindered by factors such as absence or lack of research, incomplete and non-existent scientific records, restricted access to data and capacity to innovate and transmit S&T, among others. The establishment of an Asian Network for Climate Science and Technology is proposed to provide and facilitate exchange of information and aid development of research co-ordination projects led by Asian researchers and possibly to act as a one-stop repository of global climate change related research too. The scope of the network would cover climate research with particular relevance to disaster resilience, including scientific capacity, which is all very distinct in Asia.
Systems perspectives are fundamental in driving technological improvements and yield-enhancing strategies that improve agricultural productivity. These can resolve farmerʼs problems and are important pathways for sustaining food and nutritional security for human welfare in Asia. The essential determinants of this objective are the capacity to efficiently manage the natural resource base (land, crops, animals, and water) to resolve constraints to farming systems, and notably the integration of multiple research and development (R&D) issues through all levels of formal and non-formal learning systems. Both formal and informal education systems are important, with the former relating more to universities and colleges, and the latter to the intermediate level. Graduates from this level have the primary responsibility of introducing improved technologies and change to farmers, mainly along production and disciplinary pathways.The traditional research–extension–farmer model for technology delivery is no longer acceptable, due to “top down” extension functions and prescriptions, ineffectiveness to cope with the dynamics of production systems, complex interactions within the natural resources, effects of climate change and globalisation. There are also reservations on the technical capacity and skills of extension agents, constraints identification, methods for technology diffusion and dissemination, and innovative use of beneficial technological improvements that can directly respond to the needs of small farmers, and impact on subsistence agriculture. Agricultural education and systems perspectives are therefore an overriding compelling necessity which transcends prevailing limitations to waning agriculture and rural growth. Their wider recognition and applications provides an important means to maximise efficiency in the potential use; of the natural resources, increase engagement and investments in agriculture, promote ways to become more self-reliant in the development of crucial new technologies and intensification. These together can meet the challenges of the future and overcome the legacy of continuing poverty, food and nutritional insecurity. Asian farming systems, with their diversity of crops and animals, traditional methods, multiple crop-animal interactions, numerous problems of farmers present increasingly complex issues of natural resource management (NRM) and the environment. Many if not all of these can only be resolved by interdisciplinary R&D, which overcomes a major weakness of many R&D programmes presently and in the past. Improved education and training is a powerful and important driver of community-based participation aimed at enhancing sustainable food security, poverty reduction and social equity in which the empowerment of women in activities that support organising themselves is also an important pathway to enhance self-reliance and their contribution to agriculture. A vision for the future in which improved agricultural education in a systems context can provide the pathway to directly benefit the revitalisation of agriculture and agricultural development is proposed with a three-pronged strategy as follows:
Define policy for the development of appropriate curricular for formal agricultural education that provides strong multi-disciplinary orientation and improved understanding of the natural resources (land, crops, animals and water) and their interactions
Organise formal degree education and specialisation at the university level that reflects strong training in understanding of agricultural systems; systems perspectives, methodologies and their application, and
Define non-formal education and training needs that can be intensified at different levels, including the trainin of trainers as agents of change.
In agricultural systems, animals play a very important multifunctional role for developing communities
throughout the world. This is reflected in the generation of value-added products like meat, milk and eggs for food security; socio-economic benefits like increased income, security and survival, and an infinite variety of services such as the supply of draught power and dung for soil fertility. However, and despite this importance, the situation is awesome since the projected total meat and milk consumption levels in 2020 are far in excess of anticipated supply, and projections of both meat and milk will have to be doubled by 2050 to meet human requirements. Strategies for productivity growth from animals are therefore urgent, and are discussed in the context of the scenario of waning agriculture, extreme poverty and hunger, food crisis, the current contributions from the components of the animal industries, prevailing constraints, opportunities and strategies for improved production. Current trends suggest that the non-ruminant pig and poultry industries will continue to contribute the major share of meat and all of egg production to meet projected human needs. With ruminants by comparison, overall meat production continues to come mainly from the slaughter of numbers. Strategic opportunities exist for maximising productivity in improved production systems. These include targeting rainfed areas, development of small farms, integrated crop-animal systems, intensive application of productivity-enhancing technologies, promoting intensive use of crop residues and expanding the R&D frontiers with interdisciplinarity and farming
systems perspectives. The issues, together with increased investments and institutional commitment, provide for expanded animal production systems and productivity which can forcefully impact on improved human welfare in Asia in the immediate tomorrow.