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PubMedDate not supplied

Health sector reform in the former Soviet Republics of Central Asia.

Health services in the former Soviet Republics of Central Asia face many challenges, not least a rising burden of disease and severe economic constraints. Each government has developed proposals for reform. This paper describes the key elements of the proposals developed in each country. They have many features in common, such as financing based on social insurance, although they also have many differences, reflecting national political, economic and historical circumstances. While most attention so far has concentrated on the design of the proposed systems, it is argued here that there has been inadequate attention to the obstacles to implementation. These stem from the many adverse factors in the context within which reforms are taking place, weaknesses in the process of reform, and failure to involve the groups whose actions will be necessary for success. It is argued that governments and those advising them must place greater emphasis on the challenges of implementation, including the development of a much better understanding of the context within which change must take place.

Asia, Central↗
PubMed1999

[Sea buckthorn and sea buckthorn oils--recent developments in China and central Asia].

Since several years, sea buckthorn and sea buckthorn oils are booming in China, Russia and Central Asia. The background of this development is described and the different species and varieties of sea buckthorn are mentioned. The two different oils obtained from sea buckthorn (pulp oil and seed oil) and their composition is discussed. The use of sea buckthorn and its oils for medical and pharmaceutical purposes has its roots in ancient Tibet. The various "health claims", particularly by Russian and Chinese medical authorities, could not be discussed here. However, a number of recent papers are quoted here without further comment.

Agriculture↗
PubMed1993

Towards the rational management of the insect pests of tropical legume crops in Asia: review and remedy.

The productivity of legume crops, especially the pulses, has not increased markedly in 30 years. This is a serious matter in this time of exponential human population growth because legume crops provide essential diet components that are not present in cereals at a price that is affordable to the majority. The preferential allocation of research resources to cereal crops is one reason for this stagnation. I suggest that an international effort should be mounted to redress this situation. Most Asian legumes have in common a cadre of insect pests that are reducing yields to levels at which harvesting is not economic. The position is worsening because insecticide resistance in key production areas has rendered many species uncontrollable. The short-term remedy is to persuade farmers to reduce their dependence on insecticides. Long-term solutions should be aimed at a common policy centred on the principal components of integrated pest management (IPM) schemes. Governments should be supplied with information that will permit them to set priorities according to absolute crop loss indicators. These will in turn provide a rational basis for the subsequent development of regional strategies. The establishment of an IPM centre in Asia would support the facilitation of this ideal. Such an organization would become the focal point for collecting, developing and disseminating the information and technology needed to make a quantum leap in legume production.

Animals↗
PubMed1994

Molecular basis and hematological characterization of Hb H disease in southeast Asia.

We molecularly characterized sixty-seven cases of Hb H disease by the polymerase chain reaction. The strategy depends on amplifying the alpha-thalassemia-1 (alpha-thal-1) gene by primers flanking the breakpoint and sequence differences of the 3' end of the alpha-globin gene and the nonhomologous elements I, II, and III among different types of alpha-thala-2. In the 67 cases studied, all involved alpha-thal-1 of the Southeast Asia type (SEA) in combination with deletional or nondeletional alpha-thal-2. Thirty-two cases were of the deletion form and 35 cases were of the nondeletion form. In 32 cases of the deletion form, 29 cases were rightward deletion (-alpha 3.7), and three cases were leftward deletion (-alpha 4.2). We found that all of the nondeletion forms were alpha-thal-1 of SEA type with Hb CS. After the subtyping of Hb H with -alpha 3.7, 26 out of 29 were type I deletion and 3 out of 29 were type II deletion. Comparisons of clinical data of deletion forms and the nondeletion form showed that there were earlier occurrence of anemic symptoms and a larger erythrocyte volume in the nondeletion form group (P < 0.005).

Asia, Southeastern↗
PubMed2007

Health systems in East Asia: what can developing countries learn from Japan and the Asian Tigers?

The health systems of Japan and the Asian Tigers (Hong Kong, Korea, Singapore and Taiwan), and the recent reforms to them, provide many potentially valuable lessons to East Asia's developing countries. All five systems have managed to keep a check on health spending despite their different approaches to financing and delivery. These differences are reflected in the progressivity of health finance, but the precise degree of progressivity of individual sources and the extent to which households are vulnerable to catastrophic health payments depend on the design features of the system - the height of any ceilings on social insurance contributions, the fraction of health spending covered by the benefit package, the extent to which the poor face reduced copayments, whether there are caps on copayments, and so on. On the delivery side, too, Japan and the Tigers offer some interesting lessons. Singapore's experience with corporatizing public hospitals - rapid cost and price inflation, a race for the best technology, and so on - illustrates the difficulties of corporatization. Korea's experience with a narrow benefit package illustrates the danger of providers shifting demand from insured services with regulated prices to uninsured services with unregulated prices. Japan, in its approach to rate setting for insured services, has managed to combine careful cost control with fine-tuning of profit margins on different types of care. Experiences with DRGs in Korea and Taiwan point to cost-savings but also to possible knock-on effects on service volume and total health spending. Korea and Taiwan both offer important lessons for the separation of prescribing and dispensing, including the risks of compensation costs outweighing the cost savings caused by more 'rational' prescribing, and cost-savings never being realized because of other concessions to providers, such as allowing them to have onsite pharmacists.

Delivery of Health Care↗
PubMed1994

Nucleotide sequence of the core region of hepatitis C virus in Pakistan and Bangladesh and the geographic characterisation of hepatitis C virus in south Asia.

A large number of complete and partial hepatitis C virus (HCV) sequences have been reported and classified into several genotypes, although none have been reported from South Asia. We have determined and evaluated partial sequences in the core region of HCV obtained from patients with chronic hepatitis in Pakistan and Bangladesh. Nucleotide sequences from these viruses show significant homology with the Japanese HCV-TR isolate (91.7%-97.9%) and low homology with other Japanese, American, and UK isolates including HCV-1, HC-J4, HC-J6, HC-J8, and E-b1 (79.3%-86.2%). The homologies of their deduced amino acids sequence with HCV-1, HC-J4, HC-J6, HC-J8, E-b1, and HCV-TR were 84.3%-89.8%, 85.0-87.9%, 84.1%-86.9%, 84.3%-87.0%, 90.2%-93.1%, and 89.8%-93.5%, respectively. These results suggest that our clones might be classified into the same genotype as HCV-TR. Further analysis using molecular evolutionary methods strongly supported the classification of these sequences with the HCV-TR genotype. Moreover, we could not detect any isolates which were closely related to our clones or HCV-TR in countries outside the South Asian area. These data further support the association of HCV genotypes with distinct geographic regions.

Amino Acid Sequence↗
PubMed2025

Epstein-Barr Virus Sequence Variations Among the Understudied Nasopharyngeal Carcinoma Patients of Diverse Ancestries in Southeast Asia.

Epstein-Barr virus (EBV) is associated with cancers, including lymphomas and nasopharyngeal carcinoma (NPC). To date, risk variants for NPC were mainly identified from Chinese populations, which dominated the world's total number of cases. Although Southeast Asia (SEA) countries have among the world's top yet intriguingly diverse NPC age-standardized incidence rates across subpopulations, data on EBV from SEA remains scarce. In this study, we examined 83 NPC patients of different ancestries for the presence of risk haplotypes associated with the Southern Chinese NPC and generated and analyzed 67 EBV sequences (from tissue, patient-derived xenografts and lymphoblastoid cell lines of 60 NPC patients) together with 838 published EBV genomes. Our study revealed that NPC patients of non-Chinese ancestry had fewer risk variants and haplotypes that are associated with Southern Chinese NPC and clustered distinctly from lymphomas, Southern Chinese NPC, and non-cancer controls. The distribution of non-synonymous variants was similar among NPC patients of Chinese ancestry, irrespective of geographical location. Meanwhile, non-synonymous variants in genes related to packaging, latency, and structural proteins such as BPLF1, LF3, and LMP1 varied across different ancestries. Our findings suggest possibilities of EBV adaptation to host genetics for NPC pathogenesis and warrant further research for the understudied NPC subpopulations.

Adult↗
PubMed2001

Forest fires and environmental haze in Southeast Asia: using the 'stakeholder' approach to assign costs and responsibilities.

The 'seasonal haze' problem is one which afflicts large parts of Southeast Asia in years of drought. The major cause is forest, bush and field fires in the states of Kalimantan and Sumatra in Indonesia, and to a lesser extent in Sabah, Sarawak, and other parts of Malaysia. Almost all of these fires now seem preventable, since they are intentionally set to clear land for cultivation. Theoretically, the government authorities at central, provincial and local levels in these countries should be responsible for controlling activities in their territory. In practice, however, air pollution control through regulatory policies and practices is extraordinarily difficult to implement and maintain in a situation of this kind in developing countries, especially at a time of crippling economic setbacks. Moreover, the establishment of legal liability, through an international tribunal or otherwise, hardly seems a politically feasible course of action for the government of an affluent 'victim state' such as Singapore. Faith in the usual solutions--science, regulation, law and diplomacy--is weakened by one's sense of current realities. The purpose of this paper is to review the issues and suggested responses, the cost implications of each, the responsibilities as well as entitlements that might apply to the various stakeholders, and the special role of Singapore as an affluent 'victim state'. We also discuss the incentive mechanisms that would be needed to manage forest fires.

Air Pollution↗
PubMed1998

Molecular phylogeny of Dipetrocarpaceae in Southeast Asia based on nucleotide sequences of matK, trnL intron, and trnL-trnF intergenic spacer region in chloroplast DNA.

To obtain a refined molecular phylogeny of dipterocarp species in Southeast Asia, nucleotide sequences of matK, the intron of trnL, and intergenic spacer region between trnL and trnF in chloroplast DNA were determined in 16 species throughout 10 genera. In the resultant trees Southeast Asian dipterocarp species were divided into two clusters. One cluster consisted of Anisoptera, Vatica, Cotylelobium, and Upuna, all with the base chromosome number of x = 11. The second cluster consisted of Hopea, Shorea, Neobalanocarpus, Dryobalanops, Parashorea, and Dipterocarpus, mostly with the base chromosome number of x = 7. Dipterocarpus was the only genus that had the base chromosome number x = 11 in the latter cluster. This result suggests that the chromosome number changed from x = 11 to x = 7 after Dipterocarpus branched in the latter cluster. Other evolutionary changes of morphological characters are also discussed.

Asia, Southeastern↗
PubMed1999

Vicariant patterns of fragmentation among gekkonid lizards of the genus Teratoscincus produced by the Indian collision: A molecular phylogenetic perspective and an area cladogram for Central Asia.

A well-supported phylogenetic hypothesis is presented for gekkonid lizards of the genus Teratoscincus. Phylogenetic relationships of four of the five species are investigated using 1733 aligned bases of mitochondrial DNA sequence from the genes encoding ND1 (subunit one of NADH dehydrogenase), tRNA(Ile), tRNA(Gln), tRNA(Met), ND2, tRNA(Trp), tRNA(Ala), tRNA(Asn), tRNA(Cys), tRNA(Tyr), and COI (subunit I of cytochrome c oxidase). A single most parsimonious tree depicts T. przewalskii and T. roborowskii as a monophyletic group, with T. scincus as their sister taxon and T. microlepis as the sister taxon to the clade containing the first three species. The aligned sequences contain 341 phylogenetically informative characters. Each node is supported by a bootstrap value of 100% and the shortest suboptimal tree requires 29 additional steps. Allozymic variation is presented for proteins encoded by 19 loci but these data are largely uninformative phylogenetically. Teratoscincus species occur on tectonic plates of Gondwanan origin that were compressed by the impinging Indian Subcontinent, resulting in massive montane uplifting along plate boundaries. Taxa occurring in China (Tarim Block) form a monophyletic group showing vicariant separation from taxa in former Soviet Central Asia and northern Afghanistan (Farah Block); alternative biogeographic hypotheses are statistically rejected. This vicariant event involved the rise of the Tien Shan-Pamir and is well dated to 10 million years before present. Using this date for separation of taxa occurring on opposite sides of the Tien Shan-Pamir, an evolutionary rate of 0.57% divergence per lineage per million years is calculated. This rate is similar to estimates derived from fish, bufonid frogs, and agamid lizards for the same region of the mitochondrial genome ( approximately 0.65% divergence per lineage per million years). Evolutionary divergence of the mitochondrial genome has a surprisingly stable rate across vertebrates.

Animals↗
PubMed2000

Molecular systematics and biogeography of the fanged frogs of Southeast Asia.

Our analysis of parts of the mitochondrial ribosomal 12S and 16S genes from 39 populations of Southeast Asian ranid frogs confirms that the fanged frogs are a monophyletic clade. This group, properly called Limnonectes, appears to have arisen in the early Tertiary at a time when free faunal exchange was possible among Southeast Asia, Borneo, Sumatra, Java, and, probably, Sulawesi. Four species groups are tentatively identified within the clade. Part of group 1 includes species related to L. kuhlii that occur in Borneo. Another part of group 1 includes species from Malay Peninsula and Thailand that are related to L. pileata. Species group 2, L. leporina, occurs only in Borneo. Species group 3 is restricted to species distributed in Sulawesi and the Philippines. Species group 4 includes L. blythii and relatives. There is a lack of compatibility between phylogenetic hypotheses generated from molecular and morphological data sets. These differences are related, in large part, to whether some species of Limnonectes have secondarily lost fangs or whether lack of fangs represents the primitive condition.

Animals↗
PubMed2001

H9N2 influenza A viruses from poultry in Asia have human virus-like receptor specificity.

H9N2 influenza A viruses are currently widespread in chickens, quail, and other poultry in Asia and have caused a few cases of influenza in humans. In this study, we found that H9N2 viruses from Hong Kong live bird markets have receptor specificity similar to that of human H3N2 viruses. In addition, the neuraminidase of poultry H9N2 viruses has mutations in its hemadsorbing site, a characteristic resembling that of human H2N2 and H3N2 viruses but differing from that of other avian viruses. Peculiar features of surface glycoproteins of H9N2 viruses from Hong Kong suggest an enhanced propensity for introduction into humans and emphasize the importance of poultry in the zoonotic transmission of influenza viruses.

Amino Acid Substitution↗
PubMed2007

Ethnic aspects of cancer trials in Asia.

New drugs which have potential in cancer therapy are emerging every day and there is an increasing demand for trial patients all over the world. Asia being the most populated continent, as well as a large market for drug sales, has its own epidemiology of disease. The Asian races also have specific genomics that might affect response to drug treatment. In addition, there are cultural issues to be considered when considering clinical trials. In conclusion, more clinical trials should be done among Asian populations for the best results of drug treatment.

Antineoplastic Agents↗
PubMed1994

Spirit possession in South Asia, dissociation or hysteria? Part 1: Theoretical background.

Psychoanalytic theory appears flawed in its notions of universal oedipal conflict and repression, and unsuitable for the study of pathological spirit possession in South Asia. The biological theory of contemporary psychiatry is no more effective in this analysis because mental illnesses are constituted within culture-bound categories of experience. Dissociation theory offers a better theoretical tool for this type of research. A summary of the history of paradigm shifts in psychiatric theory relevant to spirit possession is presented.

Anthropology, Cultural↗
PubMed1993

Hemoglobin E and codon 17 nonsense: two beta-globin gene mutations common in Southeast Asia detected by the use of ARMS.

Hemoglobin E (codon 26 GAG-->AAG) and codon 17 nonsense (AAG-->TAG), two clinically important mutations of the beta-globin gene, are common in Southeast Asia. The detection of these mutations using allele-specific PCR is described. Together with the previously reported method for the detection of the common Southeast asian codon 41-42 frameshift mutation (del CTTT), it is possible to identify the vast majority of clinically important beta-globin gene mutations in Southeast Asian populations by means of nonradioactive methods.

Alleles↗
PubMed1994

A Y-associated allele is shared among a few ethnic groups of Asia.

In our previous study, both of Y-associated alleles, Y1 and Y2, were detected in Japanese and Koreans, but only the Y1 allele was detected in each of other populations including Chinese in both Beijin and Guangzhou areas, Caucasians, Africans, and Jewish. In the present study, these observations were extended to other ethnic groups in East Asia. Evenks in central Siberia and Khalkhs in Mongolia had only the Y1 allele. On the other hand, two ethnic groups, Fo-lo and Hakka, in Taiwan had both of the Y1 and the Y2 alleles. Three of the eight Y2-positive men, 2 Fo-lo and a Hakka, shared family name Chen. Both Hakka people and ancestors of Chen families could be traced to the Province of Henan in northern China in early 4th century. They arrived in Fujian/Guangdong area in the south-east China via various routes and then some of them migrated to Taiwan in the 18th century. It is tempting to speculate that the Y2 allele may be originated from an ancestral population in Henan from which, Japanese, Koreans, and some of the Taiwanese diverged.

Alleles↗
PubMed1996

Long Y-associated (GATA)n alleles were observed in a few ethnic groups in Asia.

A Y-associated polymorphic locus, DYS19, was analyzed in a few ethnic groups in Asia and compared with that in Caucasians and Negroes. The locus contains 4-nucleotide repeats, (GATA)n, and the length of the repeated segments can be determined by the polymerase chain reaction (PCR). The predominant allele was 202 bp followed by 198 bp in all the 3 Asian populations examined. Long repeats that were rare in other populations were found more frequently in these Asian populations.

Alleles↗
PubMed1977

Spontaneour Robertsonian fusion leading to karyotype variation in the house mouse - first report form Asia.

The occurrence of spontaneous Robertsonian fusion leading to 2n=39 chromosomes (NF=40) in the house mouse (Mus musculus domesticus) has been reported for the first time from Asia. 3 phenotypically normal female mice collected from 2 distantly located populations of India (Tripura and Calcutta) show centric fusion in somatic chromosomes between pairs 2 and 16, and 8 and 14 respectively. C-banding analysis revealed that the (sub)metacentric has been originated by fusion between the broken/eroded centromeres of 2 telocentric chromosomes.

Animals↗