Governance in Southeast Asia: Issues and Options

This paper attempts to analyze governance systems in Southeast Asia and proposes some policy suggestions that can improve governance practices in the region. It also discusses the links between governance and official development assistance (ODA) and the role of the Japan Bank for International Cooperation. To put the discussion on governance systems in a proper context, the paper discusses the governance and growth nexus in Southeast Asia; describes the operating governance systems in Southeast Asia; analyzes economic governance, more specifically in the areas of economic management and growth, revenue generation, social spending, access to services, cost of doing business, and corporate governance; and examines political governance, focusing on the rule of law and judicial independence, conflict management, and voice participation.governance, development program, corruption

Governance in Southeast Asia: Issues and Options

This paper attempts to analyze governance systems in Southeast Asia and proposes some policy suggestions that can improve governance practices in the region. To put the discussion on governance systems in a proper context, the paper discusses the governance and growth nexus in Southeast Asia; describes the operating governance systems in Southeast Asia; analyzes economic governance, more specifically in the areas of economic management and growth, revenue generation, social spending, access to services, cost of doing business, and corporate governance; and examines political governance focusing on the rule of law and judicial independence, conflict management, and voice participation.governance, development program, corruption

Governance in Southeast Asia: Issues and Options

This paper attempts to analyze governance systems in Southeast Asia and proposes some policy suggestions that can improve governance practices in the region. To put the discussion on governance systems in a proper context, the paper discusses the governance and growth nexus in Southeast Asia; describes the operating governance systems in Southeast Asia; analyzes economic governance, more specifically in the areas of economic management and growth, revenue generation, social spending, access to services, cost of doing business, and corporate governance; and examines political governance focusing on the rule of law and judicial independence, conflict management, and voice participation.governance, development program, corruption

Mainstreaming human security in the Philippines: options and prospects for non-state actors in light of the "ASEAN way"

"Der 'ASEAN Way', der konsensuelle Entscheidungsprozesse, informelle Strukturen und Prozesse sowie das Prinzip der Nichteinmischung in die inneren Angelegenheiten der Mitgliedstaaten betont, hat direkte Auswirkungen auf die Weiterentwicklung menschlicher Sicherheit auf den Philippinen. Innerhalb dieses Rahmens erweiterte ASEAN die sicherheitspolitische Agenda um Probleme wie Armut, Epidemien, Nahrungsmittelsicherheit, Menschenrechte und Klimawandel. Es erfolgte jedoch keine Vertiefung des Sicherheitsbegriffs durch einen Fokuswechsel vom Staat hin zu Individuen und Gruppen - und das obwohl der 'ASEAN Way' ausreichend Operationalisierungsspielraum für normative nicht-staatliche Sekuritisierung böte. Philippinische NGOs beteiligen sich an politischen Entscheidungsprozessen, beeinflussen und vermitteln eigene politisch relevante Werte und Normen, und stellen sogar eigene Regeln auf. Für die im Kontext eines 'weichen' staatlichen Rahmens agierende philippinische Regierung wären daher die am meisten angemessenen Aufgaben bei der Verwirklichung der Agenda menschlicher Sicherheit die Stärkung der vorhandenen internationalen Strukturen, die Erweiterung des demokratischen Spielraums für nicht-staatliche Akteure sowie der Beitritt zu zwischenstaatlichen Regime und quasi-diplomatischen Arrangements. Damit könnten Transaktionskosten gesenkt und die Reziprozität innerhalb ASEANs gefördert werden." (Autorenreferat)"Progress in human security in the Philippines is influenced by the 'ASEAN Way', which underscores consensual approach to decision-making, informal structures and processes, and the principle of non-interference in member-countries' internal affairs. Along these lines, ASEAN broadened the agenda of security to encompass problems like poverty, epidemics, food security, human rights, and climate change, but failed to deepen security from a focus on the state to a focus on human individuals and communities. Yet the 'ASEAN Way' offers enough tolerance for 'operationalizing' possibilities for normative non-state securitization. Philippine NGOs have intervened in the decision-making process, shaped and disseminated politically relevant values and norms, and have taken the initiative to set rules themselves. For the Philippine government laboring under 'soft state' conditions, the most appropriate role based on a human security agenda would be to strengthen existing institutional structures, expand the democratic space for non-state actors, and join inter-state regimes and quasi-diplomatic arrangements, thereby reducing transaction costs and facilitating reciprocity within ASEAN." (author's abstract

Dependencia funcional, deterioro cognitivo y características de la marcha en adultos mayores con enfermedades crónicas

Objetivo: Identificar el nivel y relación de dependencia funcional (DF), deterioro cognitivo (DC) y características de la marcha en adultos mayores (AM) con enfermedades crónicas, habitantes del área metropolitana de Saltillo, Coahuila. Método: Diseño descriptivo correlacional. Muestra constituida por 105 AM de 60 años o más, usuarios de los Centros de Atención e Integración Familiar (CAIF). El tamaño de la muestra se determinó a través del paquete estadístico nQuery Advisor 7.0 considerando análisis de correlación bivariada, nivel de significancia de 0.5 y potencia del 95%. El muestreo fue por conveniencia. La recolección de datos se realizó a través de una cédula de datos socio-demográficas conjuntamente con cuatro instrumentos: para DF 1. Actividades Básicas de la Vida Diaria (AVD) y 2. Actividades Instrumentales de la Vida Diaria (AIVD); para DC 3. Mini Mental State Examination MMS-E; para las características de la marcha, 4. Sistema para Análisis de Marcha GaitRite ©, alphas de 0.730, 0.765, 0.720 y 0.811, respectivamente. Resultados. La edad promedio de los AM participantes es de 75 años (X = 75 ± 6) y escolaridad de 5 años (X = 5 ± 3). La mayor parte son mujeres (81.9%); que viven sin pareja (74.3%) y reportan alguna enfermedad crónico-degenerativa (65%) como Diabetes, 32.4%; Hipertensión, 61% y Enfermedades Articulares, 42%. La prevalencia de: dependencia severa en ABVD 5.7% y AIVD 21.9 %; DC 24 %; Los AM con mayor edad y menor escolaridad, reportan mayor grado de DC (r= .251; p<.05; r= -.259; p<.05, respectivamente) y dependencia para realizar ABVD (r=.297; p<.05) y AIVD (r=.351; p<.05); Por lo menos, el 30% de AM presentabó dificultades para mantener el equilibrio. Además, el 60% presentó dificultades para sentarse porque tienen problemas al medir la distancia entre su propio cuerpo y la silla, caen en la silla o se apoye en él con movimientos inseguros. 29% presentaba dificultades para elevar su pie derecho completamente. Discusión y Conclusiones. Los resultados de este estudio confirman lo que la literatura reporta acerca de la prevalencia y asociación de DF, DC y presencia de enfermedades crónicas características del AM como Diabetes e Hipertensión. Es necesario profundizar en el análisis de este estudio incorporando mediciones acerca del tiempo de diagnóstico de la enfermedad crónica, co-morbilidad, síntomas de depresión y diferencias de género, entre otros aspectos. También los factores asociados a la problemática de la marcha. Para el profesional de Enfermería, la continuidad de este fenómeno de estudio, fortalecerá el cuerpo de conocimientos disciplinares y la atención a las complejas necesidades de cuidado a la salud que demanda este segmento de la población. Palabras Clave: Adulto Mayor, Dependencia Funcional, Deterioro Cognitivo, Marcha

Targeting Cx43 and N-Cadherin, Which Are Abnormally Upregulated in Venous Leg Ulcers, Influences Migration, Adhesion and Activation of Rho GTPases

Venous leg ulcers can be very hard to heal and represent a significant medical need with no effective therapeutic treatment currently available

Personality profiles of cultures: aggregate personality traits

Personality profiles of cultures can be operationalized as the mean trait levels of culture members. College students from 51 cultures rated an individual from their country whom they knew well (N = 12, 156). Aggregate scores on Revised NEO Personality Inventory scales generalized across age and gender groups, approximated the individual-level Five-Factor Model, and correlated with aggregate self-report personality scores and other culture-level variables. Results were not attributable to national differences in economic development or to acquiescence. Geographical differences in scale variances and mean levels were replicated, with Europeans and Americans generally scoring higher in Extraversion than Asians and Africans. Findings support the rough scalar equivalence of NEO-PI-R factors and facets across cultures, and suggest that aggregate personality profiles provide insight into cultural differences

Effect of aliskiren on post-discharge outcomes among diabetic and non-diabetic patients hospitalized for heart failure: insights from the ASTRONAUT trial

Aims The objective of the Aliskiren Trial on Acute Heart Failure Outcomes (ASTRONAUT) was to determine whether aliskiren, a direct renin inhibitor, would improve post-discharge outcomes in patients with hospitalization for heart failure (HHF) with reduced ejection fraction. Pre-specified subgroup analyses suggested potential heterogeneity in post-discharge outcomes with aliskiren in patients with and without baseline diabetes mellitus (DM). Methods and results ASTRONAUT included 953 patients without DM (aliskiren 489; placebo 464) and 662 patients with DM (aliskiren 319; placebo 343) (as reported by study investigators). Study endpoints included the first occurrence of cardiovascular death or HHF within 6 and 12 months, all-cause death within 6 and 12 months, and change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) at 1, 6, and 12 months. Data regarding risk of hyperkalaemia, renal impairment, and hypotension, and changes in additional serum biomarkers were collected. The effect of aliskiren on cardiovascular death or HHF within 6 months (primary endpoint) did not significantly differ by baseline DM status (P = 0.08 for interaction), but reached statistical significance at 12 months (non-DM: HR: 0.80, 95% CI: 0.64-0.99; DM: HR: 1.16, 95% CI: 0.91-1.47; P = 0.03 for interaction). Risk of 12-month all-cause death with aliskiren significantly differed by the presence of baseline DM (non-DM: HR: 0.69, 95% CI: 0.50-0.94; DM: HR: 1.64, 95% CI: 1.15-2.33; P < 0.01 for interaction). Among non-diabetics, aliskiren significantly reduced NT-proBNP through 6 months and plasma troponin I and aldosterone through 12 months, as compared to placebo. Among diabetic patients, aliskiren reduced plasma troponin I and aldosterone relative to placebo through 1 month only. There was a trend towards differing risk of post-baseline potassium ≥6 mmol/L with aliskiren by underlying DM status (non-DM: HR: 1.17, 95% CI: 0.71-1.93; DM: HR: 2.39, 95% CI: 1.30-4.42; P = 0.07 for interaction). Conclusion This pre-specified subgroup analysis from the ASTRONAUT trial generates the hypothesis that the addition of aliskiren to standard HHF therapy in non-diabetic patients is generally well-tolerated and improves post-discharge outcomes and biomarker profiles. In contrast, diabetic patients receiving aliskiren appear to have worse post-discharge outcomes. Future prospective investigations are needed to confirm potential benefits of renin inhibition in a large cohort of HHF patients without D

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI &lt;18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For school&#x2;aged children and adolescents, we report thinness (BMI &lt;2 SD below the median of the WHO growth reference) and obesity (BMI &gt;2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit