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Rates and Factors Associated with Major Modifications to First-Line Combination Antiretroviral Therapy: Results from the Asia-Pacific Region  [PDF]
Stephen Wright, Mark A. Boyd, Evy Yunihastuti, Matthew Law, Thira Sirisanthana, Jennifer Hoy, Sanjay Pujari, Man Po Lee, Kathy Petoumenos, on behalf of the International Epidemiologic Databases to Evaluate AIDS (IeDEA) Asia-Pacific HIV Observational Database (APHOD)
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0064902
Abstract: Background In the Asia-Pacific region many countries have adopted the WHO’s public health approach to HIV care and treatment. We performed exploratory analyses of the factors associated with first major modification to first-line combination antiretroviral therapy (ART) in resource-rich and resource-limited countries in the region. Methods We selected treatment naive HIV-positive adults from the Australian HIV Observational Database (AHOD) and the TREAT Asia HIV Observational Database (TAHOD). We dichotomised each country’s per capita income into high/upper-middle (T-H) and lower-middle/low (T-L). Survival methods stratified by income were used to explore time to first major modification of first-line ART and associated factors. We defined a treatment modification as either initiation of a new class of antiretroviral (ARV) or a substitution of two or more ARV agents from within the same ARV class. Results A total of 4250 patients had 961 major modifications to first-line ART in the first five years of therapy. The cumulative incidence (95% CI) of treatment modification was 0.48 (0.44–0.52), 0.33 (0.30–0.36) and 0.21 (0.18–0.23) for AHOD, T-H and T-L respectively. We found no strong associations between typical patient characteristic factors and rates of treatment modification. In AHOD, relative to sites that monitor twice-yearly (both CD4 and HIV RNA-VL), quarterly monitoring corresponded with a doubling of the rate of treatment modifications. In T-H, relative to sites that monitor once-yearly (both CD4 and HIV RNA-VL), monitoring twice-yearly corresponded to a 1.8 factor increase in treatment modifications. In T-L, no sites on average monitored both CD4 & HIV RNA-VL concurrently once-yearly. We found no differences in rates of modifications for once- or twice-yearly CD4 count monitoring. Conclusions Low-income countries tended to have lower rates of major modifications made to first-line ART compared to higher-income countries. In higher-income countries, an increased rate of RNA-VL monitoring was associated with increased modifications to first-line ART.
Cancers in the TREAT Asia HIV Observational Database (TAHOD): a retrospective analysis of risk factors
Petoumenos Kathy,Hui Eugenie,Kumarasamy Nagalingeswaran,Kerr Stephen J
Journal of the International AIDS Society , 2010, DOI: 10.1186/1758-2652-13-51
Abstract: Background This retrospective survey describes types of cancers diagnosed in HIV-infected subjects in Asia, and assesses risk factors for cancer in HIV-infected subjects using contemporaneous HIV-infected controls without cancer. Methods TREAT Asia HIV Observational Database (TAHOD) sites retrospectively reviewed clinic medical records to determine cancer diagnoses since 2000. For each diagnosis, the following data were recorded: date, type, stage, method of diagnosis, demographic data, medical history, and HIV-related information. For risk factor analyses, two HIV-infected control subjects without cancer diagnoses were also selected. Cancers were grouped as AIDS-defining cancers (ADCs), and non-ADCs. Non-ADCs were further categorized as being infection related (NADC-IR) and unrelated (NADC-IUR). Results A total of 617 patients were included in this study: 215 cancer cases and 402 controls from 13 sites. The majority of cancer cases were male (71%). The mean age (SD) for cases was 39 (10.6), 46 (11.5) and 44 (13.7) for ADCs, NADC-IURs and NADCs-IR, respectively. The majority (66%) of cancers were ADCs (16% Kaposi sarcoma, 40% non-Hodgkin's lymphoma, and 9% cervical cancer). The most common NADCs were lung (6%), breast (5%) and hepatocellular carcinoma and Hodgkin's lymphoma (2% each). There were also three (1.4%) cases of leiomyosarcoma reported in this study. In multivariate analyses, individuals with CD4 counts above 200 cells/mm3 were approximately 80% less likely to be diagnosed with an ADC (p < 0.001). Older age (OR: 1.39, p = 0.001) and currently not receiving antiretroviral treatment (OR: 0.29, p = 0.006) were independent predictors of NADCs overall, and similarly for NADCs-IUR. Lower CD4 cell count and higher CDC stage (p = 0.041) were the only independent predictors of NADCs-IR. Conclusions The spectrum of cancer diagnoses in the Asia region currently does not appear dissimilar to that observed in non-Asian HIV populations. One interesting finding was the cases of leiomyosarcoma, a smooth-muscle tumour, usually seen in children and young adults with AIDS, yet overall quite rare. Further detailed studies are required to better describe the range of cancers in this region, and to help guide the development of screening programmes.
The Significance of HIV ‘Blips’ in Resource-Limited Settings: Is It the Same? Analysis of the Treat Asia HIV Observational Database (TAHOD) and the Australian HIV Observational Database (AHOD)  [PDF]
Rupa Kanapathipillai, Hamish McManus, Adeeba Kamarulzaman, Poh Lian Lim, David J. Templeton, Matthew Law, Ian Woolley
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0086122
Abstract: Introduction Magnitude and frequency of HIV viral load blips in resource-limited settings, has not previously been assessed. This study was undertaken in a cohort from a high income country (Australia) known as AHOD (Australian HIV Observational Database) and another cohort from a mixture of Asian countries of varying national income per capita, TAHOD (TREAT Asia HIV Observational Database). Methods Blips were defined as detectable VL (≥ 50 copies/mL) preceded and followed by undetectable VL (<50 copies/mL). Virological failure (VF) was defined as two consecutive VL ≥50 copies/ml. Cox proportional hazard models of time to first VF after entry, were developed. Results 5040 patients (AHOD n = 2597 and TAHOD n = 2521) were included; 910 (18%) of patients experienced blips. 744 (21%) and 166 (11%) of high- and middle/low-income participants, respectively, experienced blips ever. 711 (14%) experienced blips prior to virological failure. 559 (16%) and 152 (10%) of high- and middle/low-income participants, respectively, experienced blips prior to virological failure. VL testing occurred at a median frequency of 175 and 91 days in middle/low- and high-income sites, respectively. Longer time to VF occurred in middle/low income sites, compared with high-income sites (adjusted hazards ratio (AHR) 0.41; p<0.001), adjusted for year of first cART, Hepatitis C co-infection, cART regimen, and prior blips. Prior blips were not a significant predictor of VF in univariate analysis (AHR 0.97, p = 0.82). Differing magnitudes of blips were not significant in univariate analyses as predictors of virological failure (p = 0.360 for blip 50–≤1000, p = 0.309 for blip 50–≤400 and p = 0.300 for blip 50–≤200). 209 of 866 (24%) patients were switched to an alternate regimen in the setting of a blip. Conclusion Despite a lower proportion of blips occurring in low/middle-income settings, no significant difference was found between settings. Nonetheless, a substantial number of participants were switched to alternative regimens in the setting of blips.
Excerpt from Militarized Currents: Toward a Decolonized Future in Asia and the Pacific  [cached]
Setsu Shigematsu,Keith L. Camacho
Journal of Transnational American Studies , 2011,
Abstract: Foregrounding indigenous and feminist scholarship, this collection analyzes militarization as an extension of colonialism from the late twentieth to the twenty-first century in Asia and the Pacific. The contributors theorize the effects of militarization across former and current territories of Japan and the United States, demonstrating that the relationship between militarization and colonial subordination shapes bodies of memory, knowledge, and resistance.
Are Fluctuations in Energy Consumption Transitory or Permanent? Evidence From a Panel of East Asia & Pacific Countries  [cached]
Hakan Kum
International Journal of Energy Economics and Policy , 2012,
Abstract: This paper examines the unit root properties of energy consumption per capita for 15 East Asia & Pacific countries employing the Lagrange Multiplier (LM) panel unit root test with one structural break for 1971-2007. When we apply the LM univariate test without break, we find a unit root in per capita consumption for Brunei Darussalam, Indonesia, Japan, North Korea, South Korea and Myanmar. However, when we apply LM unit root with structural break, we find overwhelming evidence that there is no unit root in per capita energy consumption for these 15 East Asia & Pacific countries.
Asia-Pacific and European Economic Competitiveness: An Analysis of Economic-Power-Shift from the West to the Emerging Giants
Sheriff Ghali Ibrahim
Journal of Economics Theory , 2012,
Abstract: The global economic meltdown has marked a new dawn in the economic interplay between the West and countries in the Asia pacific region. This study is a regional economic excursion at identifying the nature of economic-institutional-changes that pave a way for economic power shift from the West to the Asian region. The study analyses some of the key areas of economic advancement, indices and dynamics of economic recession. Findings show that the Western economies are facing a great economic hardship on one hand, while on the other hand, the economies of the Asia pacific especially the emerging giants are becoming more prosperous and rapidly growing. The study concludes that with the global economic debacle, few years to come, the economies of the Asian emerging giants will outstrip the economies of the west and become the world leading economies. The study recommends a fair competition that would open a way for the development of the third world among other things.
Comparative Economic Performance and Stock Market Performance: Some Evidence from the Asia-Pacific Region  [cached]
Sayeeda Bano,Sriya Kumarasinghe,Yih Pin Tang
Asian Journal of Finance & Accounting , 2011, DOI: 10.5296/ajfa.v3i1.716
Abstract: This study looks at interdisciplinary research in the fields of economics, finance and socioeconomic relations addressing the question whether the ranking of countries by major economic, social, and financial performance indicators provide any guide to the rate and pattern of growth and development in the Asia-Pacific region. The paper also examines the extent of balanced and sustained growth in selected 14 Asia-Pacific countries. It analyses data on MSCI returns, GDP growth, and HDI to rank and correlate the overall performance of each country during the 1993-2009 period. Gini Index and CPI are also included to provide added insights. The results show that developing countries like India, Indonesia, Pakistan, and Sri Lanka are at the top on most of the financial and economic indicators, while Japan is the lowest except on HDI, where the bottom rankings goes to India, Indonesia and Pakistan. Overall, the results indicate no significant relationships between a country’s stock market returns and its GDP growth. Nonetheless, the results suggest that for balanced and sustainable well-being, economic growth in the less-developed countries need to be matched by concomitant improvements in social welfare, income distribution, transparency and accountability.
Do Asia-Pacific Region Universities Need a Recognition Framework for Foreign Educational Credentials? Implications of Survey Data from Japan  [PDF]
Takashi Sekiyama
Creative Education (CE) , 2018, DOI: 10.4236/ce.2018.93026
Abstract: This paper explores whether Asia-Pacific universities deem it necessary to systematically evaluate and recognize academic qualifications and credentials obtained in foreign countries. The international framework for facilitating the recognition of foreign qualifications was established by UNESCO. The Asia-Pacific Regional Convention on the Recognition of Qualifications in Higher Education 2011 was entered into force in February 2018. However, only a few of UNESCO’s Asia-Pacific member states have ratified it. Considering the rapid internationalization of higher education in Europe, the slowness of some Asia-Pacific states to establish a recognition framework for foreign credentials is a mystery. This paper explores the idea that Asia-Pacific countries’ universities do not feel a need to systematically evaluate foreign credentials because their international student bodies are small. The results of questionnaire surveys in Japan imply that the progress in internationalization seems to be key to extending foreign credential evaluation to the UNESCO Asia-Pacific member states. A focus on promoting student mobility in the region might encourage ratifications of the Asia-Pacific Regional Convention on the Recognition of Qualifications in Higher Education (Tokyo Convention).
HIV surveillance systems in the Asia Pacific region  [cached]
Virginia Loo,Tobi Saidel,Amala Reddy,Khin Cho Win Htin
Western Pacific Surveillance and Response , 2012,
Abstract: In 2011, the United Nations Joint Programme on HIV/AIDS (UNAIDS) Regional Support Team for Asia-Pacific conducted a stock-taking process of available strategic information in the Asia Pacific region. This paper summarizes the progress of HIV surveillance for 20 countries in the region, covering population size estimates of key populations at higher risk, HIV case reporting, HIV sentinel surveillance and probability surveys of behavioural and biological markers. Information on surveillance activities was obtained from publically available surveillance reports and protocols, supplemented by personal communication with the UNAIDS monitoring and evaluation advisers and surveillance experts in country. Key findings include substantial efforts in broadening the number and types of HIV surveillance components included in national HIV surveillance systems and adopting approaches to make surveillance more cost-efficient, such as integrating routine programme monitoring data and passive surveillance case reporting systems. More investment in regularly analysing and applying surveillance data to programme strengthening at the subnational level is needed but will require additional capacity-building and resources. The ability to triangulate multiple sources of surveillance data into a more comprehensive view of the HIV epidemic will be enhanced if more investment is made in better documentation and dissemination of surveillance activities and findings.
Research priorities for public relations: The Asia Pacific insights from an international Delphi study
Tom Watson
PRism Online PR Journal , 2008,
Abstract: This Delphi study reviewed the research priorities for public relations research on an international scale. There was strong participation by academics, practitioners, and professional leaders in Australasia and, to a lesser extent, Asia, among the international panel of experts. The study itself was the first to be completed since the Australian/New Zealand team of Synnott and McKie in 1997, which was based on earlier studies in the United States by McElreath (1980, 1989 & 1994). This study found that Asia-Pacific research priorities were broadly in line with the rest of the world. The role of public relations in the strategic operation of organisations, and the creation of value by public relations through social capital and relationships, were ranked as the top two priorities. Some outcomes were comparable with earlier studies; for instance, evaluation of public relations programmes ranked third in this study and was also among the leaders in the most recent similar study. Only ‘management of relationships’ was wholly new. The findings set important directives for the next decade of research, ensuring that students, academics, professional bodies, and other researchers spend their research resources wisely by targeting the areas which are most needed by the discipline.
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