South East Research Articles

Building research capacity and capability to enhance the quality of living and dying addressing advancing frailty through integrated care: the ALLIANCE partnership.

Frailty affects around 10% of people aged over 65 years, increasing to 65% of those over 90 years. This number is increasing. Older people with frailty are projected to become the largest future users of care services as they near end of life. Living with frailty increases vulnerability to sudden deterioration, fluctuating capacity and mortality risk. This leads to complex needs, requiring integrated care, and an approach orientated towards living with, as well as dying from, advancing frailty. However, accessing care in a timely manner can be difficult. To develop a sustainable, cross-sectoral partnership to: identify priorities to improve integrated care delivery, and care transitions, for older people with advancing frailty develop organisations in which to conduct research submit study proposal(s) for funding. To establish Partnership infrastructure and identify key contacts across palliative and end-of-life care. To understand the strengths, weaknesses, barriers and enablers of research readiness and clinical services for people with advancing frailty. To support provider services to become research ready. To establish Partnership-wide research questions and develop research proposals. The Partnership brought together experts, by profession or experience (n = 244), across specialist palliative and geriatric care and local government, to improve the delivery of integrated care for older people with advancing frailty as they near end of life. Members included older people with frailty, unpaid carers, health, social and voluntary care professionals and academics, across the East Midlands, South East England and South West London. A survey of key contacts (n = 76) mapped and scoped the Partnership's strengths, weaknesses, barriers and enablers of services for people with advancing frailty, and service providers' research readiness. Forty-six key contacts responded. Most worked in the East Midlands (59%), in health care (70%) and in the community (58%). Survey findings were used to develop a service framework and to create a short list of potential research questions. Questions were refined and prioritised through coproduction with frail older people (n = 21), unpaid carer representatives (n = 7), health, social and voluntary care professionals (n = 11) and care home representatives (n = 3). The question chosen for bid development focused on ensuring what matters most to older people with frailty informs service development. This bid is currently being written. Partnership members were also supported to develop research readiness and enhance meaningful patient and public involvement by the development and curation of multiple resources. This work was challenging. The Partnership enabled the collaboration of diverse stakeholders and fostered opportunities to improve end-of-life care for older people with advancing frailty. However, the fluidity of the workforce, lack of finance to buy-out key contacts' time, limited service integration across sectors, lack of common language and concepts across sectors, need to build research understanding and readiness, and minimal evidence of engaging frail older people approaching end of life in determining service provision and research, made achieving the initial goals overly ambitious. Nevertheless, the Partnership developed a service framework for older people living and dying with advancing frailty, and is currently coproducing a clinically applied, translational research proposal. This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme as award number NIHR135262.

EP.14A.17 A Retrospective Study Looking at the Demographics and Occupations of Patients with Mesothelioma in Kent, South East England

EP.14A.17 A Retrospective Study Looking at the Demographics and Occupations of Patients with Mesothelioma in Kent, South East England

Evaluating forest conservation policies of Bhutan: sensitiveness and responsiveness to gender considerations

Putting gender at the centre of policy analysis is a crucial task, yet one rarely accomplished effectively. Gender research in South Asia has increasingly emphasised the importance of evolving dynamics and balancing the gender participation in forest policy and practice. Efforts have been undertaken to enhance women involvement in local governance including forest conservation through policy measures that include community forestry initiatives across South East Asia as well as in Bhutan. However, this has not led to a more equitable role for men and women in the forestry industry since it has not properly addressed the underlying issues of power dynamics and inequality. This investigation aimed to evaluate the incorporation of gender issues in Bhutan's forest policies over 50 years. In order to gauge the level of forest conservation policy responsiveness towards gender needs and demands, we employed content analysis and discourse analysis based on an analytical framework centred on various dimensions including socio-economic, socio-cultural, political and operational procedures. The results highlight that the policies concerning forest conservation utilized gender-neutral language when referring to the larger discourse of communities. Notably, terms with connotations specific to men outweigh those associated with women. While phrases specifically addressing women were irregularly and inconsistently employed in certain policy documents, discerning distinct trends in their usage remains challenging. The analysis underscores that only a limited number of forest policies in Bhutan display gender responsiveness, necessitating a greater comprehension of gender roles in forest conservation.

Sharia as a New Culture System of Identity in the Post-Conlict Aceh, Indonesia

The research on Aceh in various fields has been conducted by many scholars so far. What is felt less of concern in academic studies is on current period of post-conflict Aceh after peace process between Free Aceh Movement and Indonesian Army since 2005. This article would like to discuss about contemporary situation, especially in the post-conflict Aceh, on what has been shifted dealing with socio-cultural in Acehnese society. However, it has been a big change and shifting within society in Aceh, particularly after sharia religious law stipulated as the main legal formal that is objected as social engineering. Why sharia is important to be studied here could be not separated from Aceh’s long history and its deep role of Islamization process to South East Asia. Beside it is used as an identity, sharia currently in Aceh has also chosen as the new culture system and as the way out of prolonged armed conflict in Aceh that has taken place for more than three decades (1976-2005). By using theory religion as a culture system, this article would like to discuss and analyze about how does sharia now in Aceh become a new culture system of identity that broadly changed Aceh and its society, not only in socio-cultural, but also any other dimensions of life in contemporary time. The findings show that sharia religious law which has been institutionalized and stipulated as the main legal formal is more being objected as social engineering projects for future oriented social transformation and being a new culture system of identity.

Casting a Long Shadow: Examining the Relationships between Vicarious and Direct Racism and Generalized Trust among Asian Communities in New Zealand during COVID-19

Utilizing a social learning perspective, this study investigated the associations between vicarious and direct racism and generalized trust among Asian communities in New Zealand during COVID-19, highlighting the comparability of their effects. Data from a cross-sectional online survey conducted in 2021 (N=1,377), were utilized to estimate the prevalence of vicarious and direct racism experiences and the distribution of since-COVID generalized trust. Linear regression was used to assess the association between experiences of racism and shifts in generalized trust. Findings indicate that almost 40% of participants experienced racism, with vicarious experiences of physical violence and unfair treatment being more prevalent, while direct experiences of microaggressions and verbal/written abuse were more common. Female, younger, Chinese, and South East Asian participants, those for whom English is a first language, and students reported disproportionate reductions in generalized trust. Negative associations were identified between vicarious and direct racism experiences and changes in generalized trust. Crucially, our analysis reveals that vicarious microaggression experiences have a greater negative association with generalized trust than direct experiences, challenging prevailing perceptions of their significance. Emphasizing a comprehensive approach to eliminating all forms of racism, the findings support the need for critical scrutiny of media reporting of racism and its influence on trust.

Evaluating the risk perception due to land subsidence within onyeama mine, South East Nigeria

This paper conducts a systematic evaluation of risk perception due to land subsidence monitored within a major coalmine in Nigeria. There is a general assumption in most hazard research that risk perception should be a first determinant of whether adaptive action is taken or not. To gain a comprehensive insight using land subsidence, we propose a technique that integrates quantitative evaluation (vulnerability assessment) and subjective evaluation (perception analysis) of human responses towards this environmental hazard. Perception of risk, which is dependent on risk magnitude appraisal and risk acceptance, was amplified into the overall risk constellation. Vulnerability assessment was conducted based on the human development index (HDI) at fourteen locations investigated for the study, with particular focus on building networks as an index for loss estimation. We exploit data from Sentinel-1 Synthetic Aperture Radar (SAR) Satellites and Small-Baseline Subset Differential Interferometric Synthetic Aperture Radar (SBAS-DInSAR) technique to map Onyeama Coal Mine in South – East, Nigeria. From the HDI and according to the vulnerability assessment, the margin of error (E) is estimated as 0.06754, with samples proportion of ρˆ= 0.85. The 95 % confidence interval for proportion is in the range of 0.783 to 0.917. The results indicates that with an average of a finite population size of N = 1413 buildings at each study location, about 85 % of the samples (n=100) do not recognize that land subsidence is ongoing and constantly affecting their buildings. As a result of this ignorance and lack of awareness, constantly progressing subsidence becomes normalized in peoples’ perceptions, and their outlook toward danger is not integrated into day-to-day habits. Thus, risk perception is a lesser determinant of mitigation responses towards slowly progressing subsidence, and not actual exposure leading to action.

Clinical profile, laboratory characteristics and prognostic factors in patients with miliary tuberculosis

BackgroundMiliary tuberculosis (TB) is a severe form of pulmonary TB. It is uncommon in immunocompetent patients. In this study, we aimed to investigate features of miliary TB (clinical, biological, and radiological) and to determine factors associated with unfavorable outcomes in a population of patients in the South East Tunisia where TB remains endemic. MethodsThis is a retrospective study including patients diagnosed with miliary TB between 2006 and 2023. Factors independently associated with poor prognosis were determined by multivariate logistic regression analysis. ResultsMiliary tuberculosis (TB) accounted for 1.8% (n = 36) of all TB cases diagnosed during the study period. A notable female predominance was observed, comprising 66.6% of the cohort. The median age of patients was 47.5 ± 11.33 years. The predominant clinical manifestations included cough (88.8%), loss of appetite (77.7%), and fever (58.3%). Radiologically, a typical miliary pattern was present in 83.3% of patients, although only 36.1% had positive sputum samples on direct smear microscopy. Notably, all patients tested negative for HIV serology. Extrapulmonary TB involvement was documented in 55.5% of cases. All patients were treated with first-line anti-TB medications, and the outcome was favorable in 77.7% (n = 28) of patients. However, 16.6% (n = 6) of patients succumbed to the disease. Factors significantly associated with unfavorable outcomes included age ≥ 65 years (odds ratio (OR) = 0.39; p = 0.03), diabetes (OR = 0.13; p = 0.046), presence of fever (OR = 2.89; p = 0.01), and oxygen saturation ≤ 92% at admission (OR = 3.2; p = 0.001). ConclusionOur study identified advanced age, diabetes, fever at baseline, and low oxygen saturation on admission as significant predictors of poor prognosis in patients with miliary tuberculosis. These findings highlight the need for early identification and targeted management of high-risk individuals to improve clinical outcomes.

The Need for Enhanced Physical Activity Levels among Adults in South East Nigeria: Barriers, Implications, and Recommendations

Abstract Physical activity (PA) is globally recognized as essential for overall health, particularly in preventing noncommunicable diseases among adults. However, the level of PA among adults in South East Nigeria presents a complex scenario marked by disparities and challenges. This study examines PA levels among adults in South East Nigeria, identifies barriers, and proposes strategies for improvement. Despite the World Health Organization recommendations, studies indicate that a significant portion of adults in South East Nigeria do not meet PA guidelines, with notable disparities between urban and rural areas. Recommendations include establishing community-based initiatives, increasing research efforts, leveraging health-care providers’ roles, and promoting grassroots advocacy for PA as well as involving stakeholders at all levels to create a supportive environment conducive to increased PA levels and improved public health outcomes.

Transfer of rare earth elements from clay-sized fraction to phosphate in East South Pacific Ocean: Implication for REY-rich sediment related to hydrothermal influence

Pelagic sediment enriched in critical metals (e.g. rare earth elements and yttrium, REY) has attracted much attention in recent years. Extensive research has focused on identifying the specific host mineral of REY in bulk pelagic sediment, however, research on clay-sized fraction of REY-rich sediment has not been fully understood yet. In this study, we aimed to investigate the host phase and migration mechanism of REY in clay-sized fractions from two cores, GC23 and GC17, located on the western and eastern sides of the East Pacific Rise (EPR), respectively. To the best of our knowledge, this is the first comprehensive investigation of the clay-sized fraction of REY-rich sediment associated with hydrothermal activity. Results show that GC23 contains negligible clay minerals but well-crystallized Fe oxyhydroxides, while GC17 is rich in smectite and poor-crystallized Fe oxyhydroxides. REY are predominantly hosted in poorly crystallized Fe-Mn oxyhydroxides, with some phosphorus selectively scavenged by Fe oxyhydroxides from seawater. In addition, fluorapatite nanocrystals were first observed within the matrix of Fe oxyhydroxides using transmission electron microscopy (TEM), indicating the formation of fluorapatite. The post-Archean average shale (PAAS)-normalized REY patterns show similar seawater-like patterns in both the clay-sized and silt-sized fraction. The clay-sized fractions primarily derived from hydrothermal plumes plays an important role in scavenging REY from ambient seawater. This study represents a significant step towards understanding the formation of REY-rich sediment related to hydrothermal activity. A two-stage mineralization process is proposed for the formation of REY-rich sediment near the EPR fields. Firstly, REY are initially scavenged by hydrothermal Fe-Mn oxyhydroxide particles from seawater during their lateral dispersion with hydrothermal plumes under low sedimentation rate until they are buried by newly formed precipitates. With the process of early diagenesis, poor crystallized Fe oxyhydroxides will be experienced recrystallization. Subsequently, REY would be released into porewater with the process of recrystallization due to their tendency to remain in a poorly crystallized phase. Ultimately, they are captured by biogenic apatite and/or fluorapatite. The case study indicates that REY-rich sediments may primarily formed within the dispersion area of hydrothermal plumes. Simultaneously, the necessity of slow sedimentation rates, greater water depth, and deep currents all accountable for the formation of REY-rich layers.

Green hotspots? Unveiling global hotspots and shifting trends in carbon credit projects

AbstractThis study examines the spatiotemporal patterns of verified carbon credit projects from 2004 to 2022, utilizing data from the Gold Standard Foundation (GSF) registry and employing spatial autocorrelation (Moran's I) and hot spot analysis (Getis‐Ord Gi*) in ArcGIS Pro. South Asia and East Africa emerged as key hotspots for carbon credit projects. Hotspots transitioned from China, Brazil, Peru, Panama, and Cambodia (2004–2016) to India, Kenya, Rwanda, and Uganda (2017–2022) with Turkey remaining a hotspot throughout the period. Overall, the analysis reveals a statistically significant Moran's I of 0.07 and a z‐score of 3.04, indicating spatial clustering of projects and a less than 1% likelihood that the clustering is a result of random chance. The spatial pattern and types of projects align with socio‐economic conditions and environmental protection objectives in different regions. Domestic energy efficiency projects are prevalent, such as improved cookstoves, biogas digesters, and borehole technologies for safe water access. These findings prompt the deduction that socio‐economic conditions wield substantial influence on investor preferences in carbon credit projects. Hence, the study contends that the overarching goal transcends mere carbon emissions mitigation; it extends to elevating the socio‐economic well‐being of local populations. By pinpointing geographical hotspots and elucidating temporal shifts, this study equips stakeholders with strategic insights into investment in carbon credit projects and highlights evolving investor interests in the carbon credit landscape, bridging the gap between environmental objectives and socio‐economic imperatives.

Evaluation of logistics factors on successful delivery of building construction projects in South East Nigeria

Evaluation of logistics factors on successful delivery of building construction projects in South East Nigeria

Supporting primary care practitioners to promote dementia risk reduction in Australian general practice: outcomes of a cross-sectional, non-randomised implementation pilot study.

Background Primary care practitioners worldwide are urged to promote dementia risk reduction as part of preventive care. To facilitate this in Australian primary care, we developed the Umbrella intervention, comprising a waiting room survey and patient information cards for use in consultations. Educational and relational strategies were employed to mitigate implementation barriers. Methods In this cross-sectional, non-randomised implementation study within the South East Melbourne Primary Health Network, we employed mixed-methods outcome evaluation. Antecedent outcomes (acceptability, appropriateness, and feasibility) and actual outcomes (adoption, penetration, and fidelity) were assessed from the perspective of primary care practitioners and patients. Results Five practices piloted the intervention and implementation strategies, including 16 primary care practitioners engaging with 159 patients. The Umbrella intervention was deemed acceptable, appropriate, and feasible, but penetration was limited. Approximately half of eligible primary care practitioners used the intervention, with moderate fidelity. Engagement with implementation strategies was similarly limited. While most strategies were well-received, improvements in online peer discussions and staff readiness were desired. Conclusions The Umbrella intervention is a viable approach to promoting dementia risk reduction in Australian general practice, supported by educational and relational strategies. Stakeholder-informed refinements to enhance uptake are recommended before advancing to a definitive trial.

Youth Unemployment and Socio-Economic Development in South East Nigeria: The Nexus

Youth Unemployment and Socio-Economic Development in South East Nigeria: The Nexus

Older adults’ decisions regarding mobility to age in place in medium- and high-rise multi-storey residential buildings in urban settings: A case study of South East Queensland, Australia

Population ageing and urbanisation requires a more thorough understanding and monitoring of older adult residential mobility trends. Many older adults move to urban areas and previous studies have been carried out on ageing in place in traditional low-rise residential buildings. However, there is little in the literature about the important push and pull factors influencing older adult moves to medium- and high-rise multi-storey residential buildings in urban areas as they age. This case study research considered the housing migration model of push and pull factors used in elderly residential mobility and investigated the older adults' decision-making regarding mobility to age in place in medium- and high-rise multi-storey residential buildings in South East Queensland, Australia. The study revealed how the older adults expressed a desire to age in place in multi-storey residential buildings in urban areas and identified it as an important element of quality of life. Many older adults chose to move house to high density urban areas from low density urban areas between the ages of 65 and 84. The ‘pull’ factor to significantly influence the decisions of movers was a low maintenance property and lifestyle change from a large suburban home whereas the ‘push’ factor was upkeep difficulties of the house related to old age. This study makes empirical contributions to knowledge in ageing residential mobility trends in urban areas and concludes by providing policy recommendations for developing more effective housing, public spaces, transportation, and community activities and services for older adults, including highlighting a number of recommendations for future research.

Interrogating Performance Management on Employee Service Delivery in Federal Training Centres in South East Nigeria

Interrogating Performance Management on Employee Service Delivery in Federal Training Centres in South East Nigeria

ASSESSING THE INFLUENCE OF CONTINUOUS PROFESSIONAL DEVELOPMENT PROGRAMMES ON THE TEACHING METHODOLOGIES OF HISTORY TEACHERS IN SENIOR SECONDARY SCHOOLS IN RIVERS STATE, NIGERIA

The study assessed the influence of continuous professional development programmes on the teaching methodologies of history teachers in senior secondary schools in Rivers State. Three research questions with corresponding three hypotheses guided the study. The study adopted descriptive survey designs. The population for the study consisted of 604 History teachers in public senior secondary schools in Rivers State. A retrieved sample was used for analysis, and there were 280 respondents. Stratified random sampling was used to stratify Rivers State into Rivers East, Rivers West and Rivers South East senatorial districts. Stage Quota sampling technique was applied to select History teachers from each senatorial district in Rivers State. The instrument constructed was a questionnaire titled “Influence of Continuous Professional Development Programmes on the Teaching Methodologies of History Teachers Questionnaire (ICPDPTMHTQ). The content and face validity instrument was validated by experts and History head teachers. Cronbach alpha was used to determine the reliability index of 0.80. Out of 302 copies of the instrument distributed to the respondents, 280 copies of the instruments were returned. Multiple Regression statistics method associated with ANOVA and t-test was used to answer research questions and test the hypotheses at 0.05 level of significance. The findings revealed that Continuous professional development significantly enhances teaching methods for history teachers in Rivers State. However, project-based learning, field trips, virtual tours, game-based learning, visual learning, and the Socratic method show no significant influence, indicated by high p-values and low coefficients. The study recommended that school administrators should be encouraged to offer CPD programmes that include training on innovative teaching strategies, like project-based learning and field trips, to enhance the overall effectiveness of history instruction.<p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0702/a.php" alt="Hit counter" /></p>

Cost-effectiveness of MLC601 in post-stroke functional recovery compared with placebo - the CHIMES & CHIMES-E studies

BackgroundDespite progress in stroke therapy (e.g., revascularisation interventions by thrombolysis and/or thrombectomy, organised stroke care), many stroke survivors will have impairment of neurological function. We aimed to compare the cost-effectiveness of an oral natural formulation, MLC601, versus placebo in functional recovery among subjects receiving standard of care after an ischemic stroke of intermediate severity assessed with NIH Stroke Scale at baseline (b-NIHSS 8–14).MethodsA Markov cohort model with a 2-year time horizon was developed to simulate patients from a published randomised placebo-controlled clinical trial of MLC601 in their post-stroke functional recovery assessed by modified Rankin Score (mRS), from a health system perspective. Transition probabilities were derived from a multi-centre clinical trial in South East Asia. As cost and utility data were not collected in the trial, therefore we extracted them from the published literature. The main outcomes were incremental cost, incremental quality-adjusted life-year (QALY) gained, and incremental cost-effectiveness ratio (ICER). Besides base-case and sensitivity analyses, we performed subgroup analyses to explore the heterogeneity of patients with poor-prognosis factors (b-NIHSS 10–14, stroke onset to treatment time > 48 h, rehabilitation during first 3 month). All costs are expressed in 2022 Euro and USD, with an annual discount rate of 3% applied to costs and QALYs.ResultsBase-case analysis showed that MLC601 was cost-effective compared with placebo, with €5,080 saved and 0.45 QALY gained, resulting in an ICER of -€11,352.50 per QALY gained. Similarly, results from subgroup analyses indicated that the use of MLC601 was a dominant strategy in all subgroups with poor-prognosis factors. Sensitivity analyses revealed the results were robust.ConclusionCompared with placebo on top of standard stroke care, MLC601 was cost-effective in post-stroke functional recovery over two years. Due to the lack of cost and utility data from the study population, the results might not be generalizable to other settings. Further studies with country-specific data are needed to confirm the results of this study.Trial registrationURL http://www.clinicaltrials.gov. Unique identifier NCT00554723 November 7, 2007.

Changes in 10-Year Predicted Cardiovascular Disease Risk for a Multiethnic Semirural Population in South East Asia: Prospective Study.

Cardiovascular disease (CVD) risk factors tend to cluster and interact multiplicatively and have been incorporated into risk equations such as the Framingham risk score, which can reasonably predict CVD over short- and long-term periods. Beyond risk factor levels at a single time point, recent evidence demonstrated that risk trajectories are differentially related to CVD risk. However, factors associated with suboptimal control or unstable CVD risk trajectories are not yet established. This study aims to examine factors associated with CVD risk trajectories in a semirural, multiethnic community-dwelling population. Data on demographic, socioeconomic, lifestyle, mental health, and cardiovascular factors were measured at baseline (2013) and during follow-up (2018) of the South East Asia Community Observatory cohort. The 10-year CVD risk change transition was computed. The trajectory patterns identified were improved; remained unchanged in low, moderate, or high CVD risk clusters; and worsened CVD risk trajectories. Multivariable regression analyses were used to examine the association between risk factors and changes in Framingham risk score and predicted CVD risk trajectory patterns with adjustments for concurrent risk factors. Of the 6599 multiethnic community-dwelling individuals (n=3954, 59.92% female participants and n=2645, 40.08% male participants; mean age 55.3, SD 10.6 years), CVD risk increased over time in 33.37% (n=2202) of the sample population, while 24.38% (n=1609 remained in the high-risk trajectory pattern, which was reflected by the increased prevalence of all major CVD risk factors over the 5-year follow-up. Meanwhile, sex-specific prevalence data indicate that 21.44% (n=567) of male and 41.35% (n=1635) of female participants experienced an increase in CVD risk. However, a stark sex difference was observed in those remaining in the high CVD risk cluster, with 45.1% (n=1193) male participants and 10.52% (n=416) female participants. Regarding specific CVD risk factors, male participants exhibited a higher percentage increase in the prevalence of hypertension, antihypertensive medication use, smoking, and obesity, while female participants showed a higher prevalence of diabetes. Further regression analyses identified that Malay compared to Chinese (P<.001) and Indian (P=.04) ethnicity, nonmarried status (P<.001), full-time employment (P<.001), and depressive symptoms (P=.04) were all significantly associated with increased CVD risk scores. In addition, lower educational levels and frequently having meals from outside were significantly associated to higher odds of both worsening and remaining in high CVD risk trajectories. Sociodemographics and mental health were found to be differently associated with CVD risk trajectories, warranting future research to disentangle the role of psychosocial disparities in CVD. Our findings carry public health implications, suggesting that the rise in major risk factors along with psychosocial disparities could potentially elevate CVD risk among individuals in underserved settings. More prevention efforts that continuously monitor CVD risk and consider changes in risk factors among vulnerable populations should be emphasized.

Rise and Fall of Democracy in Regional Government: From Assignment to Election

Indonesia has been trying to develop democracy since the early independence. Assignment of the head of the region conducted from 1945 to 1999. After the big reformation in 1999, which started in 2004, Indonesia started a new chapter with the direct election model for regional heads. This research tries to find the philosophy of Indonesia’s choice to select its regional leader according to the law provided. The research is normative research with a conceptual and comparative approach. The results show that the election of regional leaders in Indonesia has not always been in line with the sovereignty of the people and the concept of democracy. Political choice has had a very significant impact. However, as it turns out into practice, as an emerging country in South East Asia, even though an assignment and not by the general election, leaders or regional heads are also considered as democratic as long as it is still on the path of openness, fair game and also according to people’s approval, including if it comes from the regional representative’s choice of candidates.

Dairy Consumption at Breakfast among Southeast Asian Children: Associations with Nutrient Intake from the South East Asian Nutrition Surveys II (SEANUTS II).

Children's rapid growth requires adequate nutrient intake, with breakfast, especially when incorporating dairy, playing an important role. This study examined associations between dairy consumption at breakfast and energy and nutrient intake among children in Southeast Asia. Utilizing the cross-sectional South East Asian Nutrition Surveys II dataset, using a 24 h dietary recall and questionnaires distributed among 10,286 children aged 2 to 12 years from Malaysia, Thailand, Indonesia, and Vietnam, we investigated the impact of dairy consumption at breakfast on nutrient intake and examined associations between breakfast consumption and the prevalence of stunting and overweight/obesity among 10,135 children. Although most of the children consumed breakfast, only 37%, 27%, 16%, and 18% in Malaysia, Thailand, Indonesia, and Vietnam, respectively, included dairy in this meal, with younger children being significantly more likely to consume dairy at breakfast (p < 0.001). Dairy consumers had significantly higher intakes of vitamins A, B12, and D and calcium both at breakfast and throughout the day (p < 0.001). Breakfast skippers had a 29% increased risk of being overweight/obese. Dairy consumption at breakfast was associated with enhanced nutrient intake and overall diet quality among Southeast Asian children. The association between breakfast habits and anthropometric outcomes highlights the need to address nutritional deficiencies and promote healthy growth and development.