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

Living and working with a doctorate as an Aboriginal person in Australia

Veronica Arbo

Bridging epistemologies - indigenous views

1st ed

Indigenous research : Aboriginal knowledge creation

Veronica Arbonhttp://batchelorpress.com/books/ngoonjook-edition-3

In the 'dragon's den': challenging the forces of colonialism

Declining Indigenous student enrolments and outcomes, despite complex strategies to both attract students and limit attrition within the academy, are evident. Advocated Indigenous changes, at many levels, have not powerfully impacted the 'dragon's den'. Indigenous knowledge remains on the periphery, as an add-on to agendas not of Aboriginal making, limited in the content, processes, and practices of universities. Critical questions have to be asked about whether being captured by the economic purpose of education or, far worse, the blinding 'assimilative intent' of colonialism is acceptable. The author states that Aboriginal people know what they want, what is required and, with discussion among themselves, can succeed in achieving required outcomes for today's world. This paper argues that speaking about knowledges, what is needed to be known, how it is known, and what Aboriginal people do, provides the possibility to affirm and shift focus within the 'dragon's-den'.V. Arbo

Landscape as metaphor for the interaction between different ways of knowing

Veronica Arbon & Hinton Lowehttp://longuevill.cart.net.au/details/615876.htm

Indigenous at the heart: research in a Climate Change Project

Indigenous involvement at all stages of research has been called for over several decades and is now an increasingly accepted requirement. This paper outlines the research approaches of the Community Based Adaptation to Climate Change: The Arabunna, South Australia project, which in the initial development phase identified a number of basic tenets. The intent is to outline these tenets, discuss the level of Indigenous involvement and activity within this project and analyse the approach taken in the context of key features articulated within Indigenous research over previous decades. Finally, this paper reflects on future research directions, particularly the importance of informed Indigenous involvement, the need for respectful relationships in multi- knowledges and multi- disciplinary research and the importance of communication.Veronica Arbon, Lester-Irabinna Rigne