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This paper aims to analyze the levels and trajectories of physical rehabilitation needs across five resource-poor world regions, against global and key country-specific benchmarks. This comparative, secondary cross-region analysis uses data from the Global Burden of Diseases study 2017 [1990–2017], specifically varied metrics of the Years Lived with Disability (YLD) measure from the health conditions likely benefiting from physical rehabilitation. All the resource-poor world regions had significant increases (p < 0.01) in the absolute, relative, and percentage of physical rehabilitation needs [1990–2017]. Nonetheless, The Asia-Pacific region stood out with the greatest YLD Rates (i.e., per population size) in 2017, the greatest growth in YLD Rates since 1990 (38%), and an exponential growth in the rehabilitation-sensitive YLD Rates. The Asia-Pacific region also had the greatest portion of their YLDs coming from rehabilitation-sensitive conditions (72% in 2017), closely followed by the Latin America & Caribbean (67%). Nonetheless, in South Asia and Sub-Saharan Africa, we observed the greatest percent increases in the portion of physical rehabilitation needs among all YLDs, out of lower initial values. An overall growth but differential patterns were observed in the evolution of physical rehabilitation needs across the resource-poor world regions. Asia-Pacific and Latin America & Caribbean regions had over than two-thirds of their non-fatal health loss arising from conditions sensitive to physical rehabilitation, and important growths in rehabilitation need indicators have been observed also for South Asia and Sub-Saharan Africa. The scale-up and strengthening of rehabilitation services and resources should be informed by needs-based data. The needs-based data from this study can inform trans-national developments and the planning of rehabilitation resources, inclusively at the world-region level. [ABSTRACT FROM AUTHOR]

Background In South Asia, women often experience intimate partner violence (IPV) and have limited access to maternal health services (MHS). However, the effects of IPV on antenatal care (ANC) visits remain unclear. This study aimed to examine the impact of IPV of different forms and severities on ANC visits in South Asia. Methods This cross-sectional study used the latest available data from demographic and health surveys conducted in Bangladesh, India, Afghanistan, Nepal, Maldives, and Pakistan. The study sampled 4467 women who had given birth within the past 12 months and were interviewed for IPV. IPV was measured by binary variables indicating the presence of physical violence (PV), categorised into less severe (LSPV) and severe physical violence (SPV), emotional violence (EV), and sexual violence (SV). ANC utilization was measured using binary variables indicating whether respondents had any, at least four, or at least eight ANC visits, as recommended by World Health Organization (WHO). Logistic regressions adjusted for survey weights were used to assess associations between ANC utilization and exposure to IPV during pregnancy and lifetime. Results The prevalence of LSPV, SPV, EV, and SV during pregnancy were 14.5%, 4.4%, 11.6%, and 4.1%. LSPV experience during pregnancy was associated with decreased likelihoods of at least four ANC visits (odds ratio (OR) = 0.55; 95% confidence interval (CI) = 0.40-0.76) and eight ANC visits (OR = 0.53; 95% CI = 0.31-0.90). Results of lifetime exposure to IPV followed similar patterns. Lifetime exposure to LSPV was associated with decreased likelihoods of at least four ANC visits (OR = 0.55; 95% CI = 0.41-0.74) and eight ANC visits (OR = 0.47; 95% CI = 0.29-0.77). Conclusion This study highlights the negativities of LSPV on the frequency of women seeking ANC visits. Policies are necessary to identify women at risk of the often-overlooked LSPV early and provide protective interventions to promote maternal health in South Asia. [ABSTRACT FROM AUTHOR]

Hand grip strength (HGS) is an important diagnostic tool for sarcopenia and a reliable predictor for age-related chronic diseases and mortality. Interventions in nutrition have been shown as a low-cost strategy to maintain muscular strength and mass. However, there are limited data on the effect of diet on HGS in Southeast Asian populations. This study aims to investigate the association of diet quality with HGS weakness and asymmetry in a multi-ethnic population in Singapore. This cross-sectional study used data from the Singapore Multi-Ethnic Cohort (n = 1547). Dietary data were collected using a validated semi-quantitative FFQ and summarised as the Dietary Quality Index – International (DQI-I). HGS was calculated as the maximum value of six measurements from both hands. HGS weakness and asymmetry were defined using well-recognised criteria. Multivariable linear regression and logistic regression were utilised for continuous and binary outcomes, respectively, adjusting for age, sex, ethnicity, physical activity and smoking status. It was found that the highest quartile of DQI-I was significantly associated with higher HGS (β = 1·11; 95 % CI 0·41, 1·82; P for trend < 0·001) and lower odds of HGS asymmetry (OR = 0·71; 95 % CI 0·53, 0·94; P for trend = 0·035) and both HGS weakness and asymmetry (OR = 0·50; 95 % CI 0·32, 0·76; P for trend = 0·004). Among the different components of DQI-I, only dietary adequacy was significantly associated with higher HGS (P for trend < 0·001) and lower odds for both HGS weakness and asymmetry (P for trend = 0·006). Our findings support that DQI-I, an indicator of overall diet quality, can be used to provide dietary guidelines for prevention and management of muscle wasting, sarcopenia and frailty. [ABSTRACT FROM AUTHOR]

Introduction: The World Health Organization identified health to be the most important social goal and the 1978 Declaration of Alma Ata placed primary health care central to its attainment and the UN Sustainable Development Goals (SDGs) as the template. The Astana Declaration called on a change of focus in primary care, from treatment of specific diseases to the prevention and inclusion of both scientific and traditional knowledge. Such objectives require public–private partnerships in providing health care, including traditional and complementary medicine systems such as naturopathy that align. However, there is limited understanding of global regulatory frameworks and officially recognized training for naturopathy. Materials and Methods: This descriptive study employs an adapted mixed-methods explanatory framework to examine naturopathy regulation and education. Analysis merges data arising from a descriptive policy analysis of regulation from 36 countries and survey analysis from 65 naturopathic organizations from 29 countries. Results: Four types of workforce regulation were identified within 107 countries where naturopathy was practiced—statutory registration or occupational licensing, coregulation, negative licensing, and voluntary certification. No form of naturopathic regulation was most common. Higher graduate/postgraduate education and access to a broader range of practices were more frequently reported in countries where naturopathy is statutory regulated. Government audits were more frequently reported where naturopathy was statutory regulated or coregulated. Discussion: Naturopathic philosophy and practice align with primary health care goals outlined in the Declaration of Astana. The naturopathic workforce represents an untapped health care resource with a demonstrated track record of translating these aspirational goals into practice. However, naturopathy remains inconsistently regulated globally, serving as a significant barrier to partnering with other health system actors to attain the health-related SDGs. Workforce regulation for the naturopathic profession offers increased standards, reduced risks, integrative health workforce planning, and assistance to countries toward achieving the promise of the Declaration of Astana. [ABSTRACT FROM AUTHOR]

Background and Aim: Despite introducing the hepatitis B virus (HBV) vaccine, the incidence of the Hepatitis B virus globally is still a major health concern. This systematic review and meta-analysis were conducted to provide detailed information on the prevalence of HBV genotypes and subtypes in circulation in Asia. Methods: A systematic search for articles describing the prevalence of HBV genotypes and subtypes in Asia was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Results: Our search returned 207 eligible articles involving 49,279 genotypes and 7457 subtypes representing 28 Asian countries. A meta-analysis was performed on our eligible studies using the Random effect Model. The pooled prevalence of HBV genotypes showed that genotype C (30.9%) (95% CI, 27.5–34.5%; I2 = 97.57%; p < 0.001) was the most common HBV genotype in Asia, followed by genotype B (17.8%) (95% CI, 15.5–20.4%; I2 = 97.26%; p < 0.001) and genotype D (15.4%) (95% CI, 11.8–19.8%). Vietnam had the highest prevalence of genotype B, Lebanon had the highest prevalence of genotypes C, and Jordan had the highest prevalence of genotype D. There was variation in genotypic prevalence with respect to the target genes for HBV genotyping. Reverse dot blot hybridization had the highest estimate of genotypes B and C. HBV subtype C2 (40.0%) (95% CI, 33.3–47.0) is the most prevalent HBV subtype. Conclusion: Evidence from this study reveals that HBV genotypes C and B are the most dominant HBV genotypes in Asia, and HBV subtype C2 is more endemic in Asia. [ABSTRACT FROM AUTHOR]

Long-acting injectable regimens for HIV treatment have been developed which are less frequent, more discreet, and more desirable for some people living with HIV (PLHIV) and may help reduce stigma-related barriers to HIV treatment. However, there is little information on the relationship between reported stigma and preference for these newer treatments. We characterized anticipated, experienced, and internalized HIV stigma and examined the associations with treatment preferences among an international sample of PLHIV. Data came from the international, web-based, cross-sectional study called "Positive Perspectives" conducted among PLHIV aged ≥ 18 years in 25 geographic locations during 2019 (n = 2389). Descriptive analyses were stratified among East Asian (n = 230) vs. non-Asian (n = 2159) participants. Results showed that prevalence of anticipated stigma was significantly higher among East Asian than non-Asian participants (72.2%[166/230] vs. 63.8%[1377/2159], p = 0.011). A significantly higher percentage of East Asian (68.7%[158/230]) than non-Asian participants (43.3%[935/2159] indicated that someone finding their HIV pills would cause them much "stress or anxiety" (p < 0.001). Actions taken by some PLHIV to prevent unwanted disclosure included restricting who they shared their HIV status with, hiding their HIV pills, or even skipping a dose altogether because of privacy concerns. Overall, 50.0%[115/230] East Asian participants believed HIV would reduce their lifespan and 43.0%[99/230] no longer planned for their old age because of HIV. Anticipated stigma was strongly associated with receptivity to non-daily regimens. Concerted efforts to reduce stigma and deliver flexible treatment options that address the unmet treatment needs of PLHIV, including confidentiality concerns, may improve their health-related quality of life. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the research trends on salivary oxidative stress associated with dental caries and to perform bibliometric approaches for existing publications on this association. A search was performed using the Web of Science Core Collection, without any restriction of language or publication year. The number of periodicals with the most published articles in this theme, most published authors and keywords were mapped; other metrics were also evaluated such as the countries that have more research on the subject and the period in which there were more publications on the subject. During the knowledge mapping, the most frequent experimental designs were analyzed, type of saliva collection, stage of caries disease, evaluated oxidative parameters were retrieved and analyzed from each manuscript. Between the 43 selected articles, the Journal of Clinical Pediatric Dentistry was the periodical appearing the most with 4 published articles. The authors who published the most were Celec, P., Tothova, L., Hegde, A.M., Shetty, S., Antoniali, C., and Pessan, JP with three articles each, and a total of 180 keywords representing the evolution of the theme. India and Asia were found to be the country and continent with most publications, respectively. Most articles collected non-stimulated total saliva, with total antioxidant capacity being the parameter most often evaluated. The type of study that appeared the most was cross-sectional studies, and articles published in the period of 2017–2022 were the most frequent. Studies show that dental caries can be associated to the changes in salivary oxidative biochemistry with an increase in lipid peroxidation, a biomarker of oxidative damage, and an increase in antioxidant capacity in chronic caries, in response to cariogenic challenge. Some studies evidence the reduction of lipid peroxidation after treatment of the carious lesion. Our findings reveal worldwide research trends, as well as a clearer knowledge of the evolution and future scenarios of this issue, also showing the mechanisms associating dental caries with changes in salivary oxidative biochemical parameters are not clear. [ABSTRACT FROM AUTHOR]

There has been growing interest in the social-emotional development of children. However, the social-emotional development of children in Asia remains a knowledge gap. This systematic review identifies and summarizes existing studies on children's social-emotional development in Asia. We conducted a systematic review using the Guidelines for Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We reviewed 45 studies that met the inclusion criteria, and they were from 12 Asian countries, primarily the East Asia region (China and Hong Kong). Most of the studies were cross-sectional in design (n = 28, 62.2%). Six themes emerged, including (a) social-emotional development (overall) (n = 24, 53.3%); (b) social competence (n = 7, 15.6%); (c) emotional development (n = 5, 11.1%); (d) social-emotional learning (n = 3, 6.7%); (e) problem behavior (n = 3, 6.7%); (f) self-regulation (n = 2, 4.4%); and (g) both social-emotional learning and problem behavior (n = 1, 2.2%). The findings highlighted the paucity of studies, the need for examining more diverse variables in a similar population, and the low quality of intervention studies in social-emotional research in Asia. Research gaps indicate the need for more social-emotional and ethnocultural studies in other Asian regions. Parent and teacher knowledge of children's social-emotional functioning should be examined more closely in future research. [ABSTRACT FROM AUTHOR]

Background: Migration-flows pose the risk of poliovirus reintroduction from endemic countries to Greece. This study aims to evaluate serologic-immunity/vaccination against poliomyelitis in newly-arriving migrant children. Methods: Demographic-immunisation data and blood-serum were obtained from migrants 1-14years-old, referred to a hospital-clinic in Athens-Greece within three months from arrival. Immunity to polioviruses-1-3 was determined by serum-neutralizing-antibodies(WHO guidelines). Titers ≥ 1:8 were considered positive. Results: From 9/2010 to 9/2013, 274 children(150 refugees/124 immigrants), mean age 7.1years-old, were enrolled. Only 57(20.8%) of them presented with vaccination-records. Children originated mainly from Asia(n = 198), Eastern Europe(n = 28), Middle East(n = 24) and Africa(n = 24) with 160(58.4%) from polio-endemic-countries(Afghanistan-112(40.8%), Pakistan-24(8.8%) and India-24(8.8%)). Seropositivity against polio-1-2&3 was 84.3%, 86.1% and 74.5%, respectively. Immigrants, had higher seroprotective rates against polioviruses-1-2&3 than refugees(polio-1:p = 0.002;polio-2:p = 0.004,polio-3:p < 0.001). Seronegativity to 1PVs-2PVs and all three polio serotypes was found in 37(13.5%),12 (4.4%), and 30 children(10.9%) respectively. Increasing number of vaccine-doses, and younger-age, were positively-associated with seropositivity. Discussion: A remarkable fraction of newly-arrived migrant-children were seronegative to one or more polioviruses. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this study was to examine and compare decision‐making preferences on end‐of‐life care for older people in Japan, the Hong Kong SAR and South Korea. Background: Cultural values and beliefs influence decision‐making on end‐of‐life care. Design: A cross‐sectional design was adopted. Methods: Community‐dwelling people aged ≥65 with additional requirements were recruited in 2016–2017 in the three regions. Their decision‐making preferences on end‐of‐life care were assessed using Pang et al.'s questionnaire. These preferences and their sociodemographic and personal experience variables were compared and analysed using univariate and multiple logistic regressions. The STROBE checklist was followed. Results: This study involved 415 participants. In all three regions, the most preferred decision maker and person with whom to discuss end‐of‐life care issues was a family member. Participants in the Hong Kong SAR were less likely to select a family member as their preferred decision maker than those in Japan (adjusted odds ratio = 0.129). Koreans were less likely to discuss end‐of‐life care issues with medical professionals than people in Japan (adjusted odds ratio = 0.278). More than 70% of the participants in each region indicated that they would not prefer to leave an advance directive to decide their end‐of‐life care. Conclusion: Older Asians prefer to make their own decisions after consulting others. Family members play an important role in helping older people plan their preferred end‐of‐life care arrangements, even acting as decision makers when older people become incapable of deciding for themselves. Relevance to clinical practice: Sufficient information should be provided to older people and their families for the older people to determine their preferred care. Helping families to understand and support the planned care and advance directives is a strategy for maximising family compliance with the care. Continuous efforts should be made to promote advance care planning and advance directives. [ABSTRACT FROM AUTHOR]

Evidence suggests that within the context of collectivistic minority groups, familial pride may function largely as a family-based emotion. We examined whether emotions derived from achieving on behalf of ones' family were associated with positive psychological functioning in Asian American college students. The sample for this cross-sectional design included 219 Asian Americans (M = 19.4, SD = 2.0, 66% women) at a minority serving university in Southern California. Participants completed a self-report survey assessing familial cultural values, depression, self-esteem, family-responsive joy, and the recently articulated construct of familial pride. Along with other familial cultural values (i.e., support, obligation, respect, and family as referent), factor-analytic results supported the use of the novel familial pride measure in this sample. Path analyses revealed familial pride was uniquely associated with lower depressive symptoms, higher self-esteem, and higher family responsive joy. In addition to assessing commonly conceptualized familial cultural values, researchers should seek to understand how the emotional correlates of familial pride are related to psychosocial functioning in Asian American adolescents and emerging adults. Practices aimed at fostering these experiences are likely to promote adaptive development for this population. Highlights: Familial pride is related to family values but functions uniquely in its impact. Familial pride is associated to lower depression, higher self-esteem, and higher joy. Pride is beneficial when embedded within family context for Asian American youth. [ABSTRACT FROM AUTHOR]

Physical activity (PA) can help individuals maintain physical function and independence. The association between PA and functional limitations (FL) has not been explored in the Native Hawaiian and Pacific Islander (NHPI) population. The purpose of this study was to examine relationships between PA and FL among NHPI adults (age ≥ 45 years) living in the United States. Cross-sectional data from the 2014 NHPI-National Health Interview Survey (N = 628) was used to create three constructs of FL based on responses from the Functioning and Disability Survey Module: needing equipment/assistance, having difficulty walking, and having difficulty with performing self-care and other fine motor activities. We used 2-stage least squares regression to examine the relationship between PA and FL of NHPI adults while accounting for the potential endogeneity of PA to FL. Compared to NHPI adults who met the guideline for recommended levels of aerobic and strengthening PA, those who met only the strengthening guideline experienced less difficulty in two FL constructs (use of medical equipment/assistance and difficulty walking). Those who met the aerobic guideline reported even less difficulties in all three FL constructs. NHPI adults who met both the aerobic and strengthening guidelines experienced the least difficulties in all three FL constructs compared to those who met neither PA guidelines. PA is associated with function in this adult NHPI population. Aerobic guidelines alone may be more beneficial than meeting the strengthening guideline alone; however, meeting both the aerobic and strengthening guidelines is most protective against FL. [ABSTRACT FROM AUTHOR]

Despite the call to internationalize counseling psychology and calls for improved mentoring to Asian international students enrolled in counseling psychology training programs, there is a dearth of literature to help trainers understand this population's clinical training experiences. The present study explored the practicum experiences of Asian international students (N = 10) in counseling psychology programs using the consensual qualitative research method. Data analysis yielded five domains: Learning Outcomes, Challenges, Resources, Behavioral Strategies, and Suggestions. Participants described how they navigated their cross-cultural practicum training in the face of unique challenges and how they adapted, as well as relied on support systems. As our participants reflected on their cross-cultural clinical training experiences, they shared the lessons they learned and provided suggestions for current and future international students, supervisors, and programs. Scholarly and practical implications for this population are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Educational inequalities in cardiometabolic diseases (CMD) are globally recognised; nonetheless, the evidence on potential explanatory mechanisms and effective strategies for CMD prevention and inequality reduction is relatively scarce in Asia. Therefore, the current study examined the extent and potential mediators of the association of education level with CMD conditions (i.e., hypertension and diabetes) in an advanced economy in Asia.Design: A cross-sectional study.Setting: This territory-wide cross-sectional Population Health Survey in 2014-2015 was performed in Hong Kong. Demographic, socio-economic and lifestyle factors were collected via questionnaire, while clinical data on blood pressure and glucose levels, lipid profiles and anthropometric measures were obtained during health examination. Hypertension and diabetes statuses were objectively defined by both clinical data and the use of relevant medications.Participants: 2297 community-dwelling adults aged between 15-84 years recruited via systematic replicated sampling of living quarters.Results: Multivariable binary logistic regression analysis showed that lower education level was significantly associated with hypertension among women but not men, whereas similar pattern was also observed for diabetes and other related clinical risk factors. Also, general and abdominal obesity were independently associated with hypertension and diabetes among both women and men, and substantially mediated the observed inequalities across education levels among women. Specifically, abdominal obesity was a particularly strong risk factor and mediator for diabetes.Conclusion: Educational patterning of CMD was more apparent among women in Hong Kong. Obesity control appears to be important for both overall CMD prevention and reduction of educational inequalities in CMD among women. [ABSTRACT FROM AUTHOR]

Studies have shown that there is a disparity between males and females in south-east Asia with regard to oral cancer morbidity. A previous study found that oral cancer tissue showed loss of heterozygosity of the X-linked lncRNA XIST gene. We suggest that XIST may play an important role in oral cancer morbidity when associated with sex. Saliva contains proteins and RNAs that are potential biomarkers for the diagnosis of diseases. This study investigated salivary XIST expression and the correlation to clinical–pathological data among oral squamous cell carcinoma patients. Salivary XIST expression was only observed in females, and a high proportion of females with OSCC lack salivary lncRNA XIST expression (88%). The expression showed no correlation with alcohol consumption, betel quid chewing, or cigarette smoking habits. People lacking salivary lncRNA XIST expression had a significantly increased odds ratio of suffering from OSCC (OR = 19.556, p < 0.001), particularly females (OR = 33.733, p < 0.001). The ROC curve showed that salivary lncRNA XIST expression has acceptable discrimination accuracy to predict the risk of OSCC (AUC = 0.73, p < 0.01). Lack of salivary lncRNA XIST expression was associated with an increased risk of OSCC. We provided an insight into the role of salivary lncRNA XIST as a biomarker to predict the morbidity of OSCC. [ABSTRACT FROM AUTHOR]