Education and awareness of modern health care amongst aboriginal people: the case of the Jakuns of Peninsular Malaysia

Previous studies have indicated that the resettlement of the Orang Asli communities into areas nearer to towns was with the intention of improving the health conditions of the aboriginals. Subsequent researches have since focused on the relation between mainstream orthodox medical approaches and traditional healing practices in search of improved approaches to advance further the health cause of the aboriginal communities. However, none of these works have addressed the central question of how the Orang Asli have been adapting themselves to the mainstream healthcare system while still holding strong beliefs in their traditional medicine. To close the gap this study examined the readiness and intentions of the Orang Asli in adapting to modern health care approach amidst old traditional health beliefs and healings practices. A qualitative study based on in-depth interviews and field observations was carried out at a Jakun village of Kampung Kedaik, Rompin, Pahang involving 12 male and 13 female informants between 18 – 70 years old. Results of the study showed that as the Orang Asli people received proper education they appeared to think about health differently. Most of the informants preferred modern over traditional medicine predominantly because of their deteriorating faith in, and relative inaccessibility to traditional medicine. The findings implied that in this modern day most of the indigenous communities were open to social change which in this context included modern health care so as to improve their health conditions

Strategies and options for increasing and sustaining fisheries and aquaculture production to benefit poorer households in Asia [PDF in letter standard]

The last three decades have wi tnessed dramatic changes in the structure of supply and demand for fish, especially in Asia. This WorldFish research study sponsored by the Asian Development Bank focussed on nine developing countries û Bangladesh, China, India, Indonesia, Malaysia, the Philippines, Sri Lanka, Thailand, and Vietnam, all active players in the transformation of global fish supply and demand. The study, broken into five components and reported here, considered: 1) the profile of key aquaculture technologies and fishing practices; 2) analysis of policies, institutions and support services; 3) socioeconomic profile of major stakeholders in the fisheries sector; 4) projections of fish demand and supply in the nine Asian countries; and 5) formulation of national action plans based on the findings and recommendations of the study.Research, Fisheries, Economic analysis, Aquaculture, Fish consumption, Trade, Policies, Socioeconomic aspects, Technology, Fishery products, Asia, China, People's Rep., Bangladesh, India, Indonesia, Malaysia, Philippines, Malaysia, Sri Lanka, Thailand, Vietnam,

Strategies and options for increasing and sustaining fisheries and aquaculture production to benefit poorer households in Asia

The last three decades have witnessed dramatic changes in the structure of supply and demand for fish, especially in Asia. This WorldFish research study sponsored by the Asian Development Bank focussed on nine developing countries – Bangladesh, China, India, Indonesia, Malaysia, the Philippines, Sri Lanka, Thailand, and Vietnam, all active players in the transformation of global fish supply and demand. The study, broken into five components and reported here, considered: 1) the profile of key aquaculture technologies and fishing practices; 2) analysis of policies, institutions and support services; 3) socioeconomic profile of major stakeholders in the fisheries sector; 4) projections of fish demand and supply in the nine Asian countries; and 5) formulation of national action plans based on the findings and recommendations of the study

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background: In this study, we aimed to evaluate the effects of tocilizumab in adult patients admitted to hospital with COVID-19 with both hypoxia and systemic inflammation. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. Those trial participants with hypoxia (oxygen saturation <92% on air or requiring oxygen therapy) and evidence of systemic inflammation (C-reactive protein ≥75 mg/L) were eligible for random assignment in a 1:1 ratio to usual standard of care alone versus usual standard of care plus tocilizumab at a dose of 400 mg–800 mg (depending on weight) given intravenously. A second dose could be given 12–24 h later if the patient's condition had not improved. The primary outcome was 28-day mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). Findings: Between April 23, 2020, and Jan 24, 2021, 4116 adults of 21 550 patients enrolled into the RECOVERY trial were included in the assessment of tocilizumab, including 3385 (82%) patients receiving systemic corticosteroids. Overall, 621 (31%) of the 2022 patients allocated tocilizumab and 729 (35%) of the 2094 patients allocated to usual care died within 28 days (rate ratio 0·85; 95% CI 0·76–0·94; p=0·0028). Consistent results were seen in all prespecified subgroups of patients, including those receiving systemic corticosteroids. Patients allocated to tocilizumab were more likely to be discharged from hospital within 28 days (57% vs 50%; rate ratio 1·22; 1·12–1·33; p<0·0001). Among those not receiving invasive mechanical ventilation at baseline, patients allocated tocilizumab were less likely to reach the composite endpoint of invasive mechanical ventilation or death (35% vs 42%; risk ratio 0·84; 95% CI 0·77–0·92; p<0·0001). Interpretation: In hospitalised COVID-19 patients with hypoxia and systemic inflammation, tocilizumab improved survival and other clinical outcomes. These benefits were seen regardless of the amount of respiratory support and were additional to the benefits of systemic corticosteroids. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Proteasome inhibition by lactacystin in primary neuronal cells induces both potentially neuroprotective and pro-apoptotic transcriptional responses: a microarray analysis

Although inhibition of the ubiquitin proteasome system has been postulated to play a key role in the pathogenesis of neurodegenerative diseases, studies have also shown that proteasome inhibition can induce increased expression of neuroprotective heat-shock proteins (HSPs). The global gene expression of primary neurons in response to treatment with the proteasome inhibitor lactacystin was studied to identify the widest range of possible pathways affected. Our results showed changes in mRNA abundance, both at different time points after lactacystin treatment and at different lactacystin concentrations. Genes that were differentially up-regulated at the early time point but not when most cells were undergoing apoptosis might be involved in an attempt to reverse proteasome inhibitor-mediated apoptosis and include HSP70, HSP22 and cell cycle inhibitors. The up-regulation of HSP70 and HSP22 appeared specific towards proteasome inhibitor-mediated cell death. Overexpression of HSP22 was found to protect against proteasome inhibitor-mediated loss of viability by up to 25%. Genes involved in oxidative stress and the inflammatory response were also up-regulated. These data suggest an initial neuroprotective pathway involving HSPs, antioxidants and cell cycle inhibitors, followed by a pro-apoptotic response possibly mediated by inflammation, oxidative stress and aberrant activation of cell cycle proteins