Southeast Asia Studies

Rất lâu trước Islam giáo, đạo Hindu đã trở thành tín ngưỡng cốt lõi của người dân nơi đây. Vai trò Hindu giáo trong đời sống xã hội của người Bali ngày càng thể hiện rõ nét, tham gia vào nhiều lĩnh vực và chi phối mọi hoạt động sống của họ. Đạo Hindu ở Bali mang theo những ý tưởng tâm linh, huyền thoại và truyền thuyết, có thể thấy qua việc thực hành các nghi lễ độc đáo gắn với môi trường tự nhiên và đời sống con người hay thế giới tâm linh, cụ thể là thờ cúng tổ tiên và các vị thần. Người Bali có niềm tin vào cả các linh hồn tốt và xấu, các lực lượng tích cực và tiêu cực để tìm sự cần bằng trong cuộc sống. Họ quan niệm thế giới là nơi sinh sống của một loạt các vị thần vô hình hay ma quỷ, cũng như những linh hồn tổ tiên của họ. Từ đó, các hoạt động tôn giáo tràn ngập hầu hết trong mọi khía cạnh của đời sống, đến mức các sự kiện tôn giáo dường như chiếm một phần ba lịch biểu xã hội Bali. Những lễ vật nhỏ được gọi là “canang sari” được làm từ lá chuối dành cho các vị thần xuất hiện trên khắp Bali vào mỗi buổi sáng, trong mọi ngóc ngách và trên mọi bức tượng phong hóa. Lễ vật thậm chí còn được ném khắp vỉa hè và bãi biển vì họ tin rằng cả ma quỷ và linh hồn xấu cũng có thể được xoa dịu bằng đồ cúng. Ý nghĩa chính của những nghi lễ được thực hiện bởi người Bali như một lời cảm ơn hoặc xoa dịu các thế lực tâm linh tích cực lẫn tiêu cực này để đảm bảo sự bình yên và thịnh vượng trong cuộc sống của họ. Bên cạnh đó, đời sống tâm linh còn được thể hiện qua các nghi lễ liên quan đến những giai đoạn trong cuộc đời của mỗi con người hay gọi một cách ngắn gọn là nghi lễ vòng đời. Từ lúc bước vào trần thế cho đến lúc chuyển sang thế giới linh hồn đều được đánh dấu bằng hàng loạt các nghi lễ và nghi thức thờ cúng khác nhau.

BACKGROUND: Transfusion safety rests heavily on the health of blood donors. Although they are perceived as being healthier than average, little is known about their long-term disease patterns and to which extent the blood banks' continuous efforts to optimize donor selection has resulted in improvements. Mortality and cancer incidence among blood donors in Sweden and Denmark was investigated. STUDY DESIGN AND METHODS: All computerized blood bank databases were compiled into one database, which was linked to national population and health data registers. With a retrospective cohort study design, 1,110,329 blood donors were followed for up to 35 years from first computer-registered blood donation to death, emigration, or December 31, 2002. Standardized mortality and incidence ratios expressed relative risk of death and cancer comparing blood donors to the general population. RESULTS: Blood donors had an overall mortality 30 percent lower (99% confidence interval [CI] 29%-31%) and cancer incidence 4 percent lower (99% CI 2%-5%) than the background population. Mortality rates and cancer incidence were lowest for outcomes that are recognized as being related to lifestyle factors such as smoking or to the selection criteria for blood donation. Blood donors recruited in more recent years exhibited a lower relative mortality than those who started earlier. CONCLUSION: Blood donors enjoy better than average health. Explicit and informal requirements for blood donation in Scandinavia, although mostly of a simple nature, have successfully refined the selection of a particularly healthy subpopulation.

Background Blood transfusions may influence the recipients' cancer risks both through transmission of biologic agents and by modulation of the immune system. However, cancer occurrence in transfusion recipients remains poorly characterized. Methods We used computerized files from Scandinavian blood banks to identify a cohort of 888 843 cancer-free recipients transfused after 1968. The recipients were followed from first registered transfusion until the date of death, emigration, cancer diagnosis, or December 31, 2002, whichever came first. Relative risks were expressed as ratios of the observed to the expected numbers of cancers, that is, standardized incidence ratios (SIRs), using incidence rates for the general Danish and Swedish populations as a reference. All statistical tests were two-sided. Results During 5 652 918 person-years of follow-up, 80 990 cancers occurred in the transfusion recipients, corresponding to a SIR of 1.45 (95% confidence interval [CI] = 1.44 to 1.46). The SIR for cancer overall decreased from 5.36 (95% CI = 5.29 to 5.43) during the first 6 months after transfusion to 1.10 or less for follow-up periods more than 2 years after the transfusion. However, the standardized incidence ratios for cancers of the tongue, mouth, pharynx, esophagus, liver, and respiratory and urinary tracts and for squamous cell skin carcinoma remained elevated beyond 10 years after the transfusion. Conclusions The marked increase in cancer risk shortly after a blood transfusion may reflect the presence of undiagnosed occult cancers with symptoms that necessitated the blood transfusion. The continued increased risk of tobacco-and alcohol-related cancers suggests that lifestyle and other risk factors related to conditions prompting transfusion rather than transfusion-related exposures per se are important to the observed cancer occurrence in the recipients.

Background and Objectives Even with appropriate donor deferrals and advanced screening tests, the risk of disease transmission through blood transfusion cannot be completely disregarded. Efficient monitoring of possible disease transmission between blood donors and recipients should be an important component of a comprehensive haemovigilance system. Materials and Methods We assembled the Scandinavian Donations and Transfusions (SCANDAT) database, with data on virtually all blood donors and recipients who have been registered at least once in any of the computerized local blood bank databases in Sweden and Denmark since the start of computerized registration in 1966. The records of these individuals, with their entire computerized donation and/ or transfusion histories and all donor-component-recipient connections, were linked to nationwide population and health registers to attain essentially complete followup for up to 36 years regarding reproduction, hospital morbidity, cancer, and death. Results After data cleaning, the database contained 1 134 290 blood donors who contributed 15 091 280 records of donations and 1 311 079 recipients who received 11 693 844 transfusions. The data quality in the existing data sources was satisfactory. From the data obtained from local blood banks, 4•6%, 1•6%, and 6•4% of the person, donation, and transfusion records, respectively, had to be discarded after review of the legitimacy of recorded values, and comparisons with independent, external databases. Conclusion It is possible to use existing computerized data, collected in routine health care, in haemovigilance systems for monitoring long-term outcome and disease concordance in blood donors and transfusion recipients.

Multidrug-resistant tuberculosis is a major issue worldwide; however, accessibility to drug susceptibility testing (DST) is still limited in developing countries, owing to high costs and complexity. We developed a proportion method on 12-well microplates for DST. The assay reduced the time to results to <12 days and <10 days when bacterial growth was checked with the naked eye or a microscope, respectively. Comparison with the Canetti-Grosset method showed that the results of the two assays almost overlapped (kappa index 0.98 (95% CI 0.91-1.00) for isoniazid, rifampicin, streptomycin; and kappa index 0.92 (95% CI 0.85-0.99) for ethambutol). The sequencing of genes involved in drug resistance showed similar level of phenotype-genotype agreement between techniques. Finally, measurement of the MICs of rifampicin and ethambutol suggests that the currently used critical ethambutol concentration should be revised, and that the current molecular drug susceptibility tests for rifampicin need to be re-evaluated, as in vitro rifampicin-sensitive isolates could harbour drug resistance-associated mutation(s).