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      A socio-ecological critique on India’s local health traditions amidst rising incidence of global pandemics

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          Abstract

          Introduction

          The COVID-19 crisis has exposed inadequacy to deal with such health emergencies. The state of healthcare facilities in India is shambolic, which is further exacerbated by the exclusivity of modern health systems. The authors argue for vertical and horizontal expansion of the existing system to include traditional medicine systems, in favor of an urgently needed holistic and more inclusive healthcare system.

          Methods

          Secondary data were collected from free online resources, including preprints, reprints and databases, J-gate Plus, PubMed and Web of Science, using keywords such as, “folk medicine”, “folk medicine AND India”, “traditional Indian medicines”, “indigenous Indian medicines AND India”, “Indian ethnomedicines”, “Indian AND folk AND medicine”, “indigenous Indian medicine”.

          Results and Conclusions

          Insufficiently robust public healthcare infrastructure, lack of enough qualified health professionals, and poor use of its traditional medicinal systems, are limiting the access of basic healthcare facilities to a large section of the Indian population. Despite vehement opposition and criticism from modern health system practitioners, indigenous and local healing traditions do offer benefits and share a common global goal of health and healing. The objectives of Universal Health Coverage and Health for All as enshrined in the Sustainable Development Goals (SDGs) cannot be achieved without their involvement, especially in remote and economically disadvantaged regions of the country. Even a sub-optimal utilization of its biological and human resources and related traditional knowledge can not only profoundly change the health, but also the economic landscape of India. Here, we have nuanced the constrains posed by the emerging health challenges, status and prospects of the great and little traditions of the Indian System of Medicines in fulfilling the urgent healthcare needs of the country. The authors based their arguments on the available evidence, rather than emotive ideas or, as a fan of Indian traditional medicines, and suggest for the purposeful inclusion of traditional health systems and practitioners more actively in India’s health care delivery systems. The country must not squander the opportunities offered by its traditional medicinal systems.

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          Most cited references37

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          Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017

          Summary Background The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. Methods We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Findings Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1–4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0–8·4) while the total sum of global YLDs increased from 562 million (421–723) to 853 million (642–1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6–9·2) for males and 6·5% (5·4–7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782–3252] per 100 000 in males vs s1400 [1279–1524] per 100 000 in females), transport injuries (3322 [3082–3583] vs 2336 [2154–2535]), and self-harm and interpersonal violence (3265 [2943–3630] vs 5643 [5057–6302]). Interpretation Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury. Funding Bill & Melinda Gates Foundation.
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            Protected area targets post-2020

            Outcome-based targets are needed to achieve biodiversity goals.
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              Is Open Access

              The lunar-tide cycle viewed by crustacean and mollusc gatherers in the State of Paraíba, Northeast Brazil and their influence in collection attitudes

              Traditional human communities have a wide knowledge of their environment. Collection of animals in estuarine and coastal areas are directly influenced by tidal cycles. The aim of this study is to evaluate the understanding of the tides associated with the lunar cycle held by people who gather crustaceans and molluscs in the State of Paraiba. The empirical knowledge of 20 crab gatherers and 30 mollusc gatherers was recorded through open interviews and structured questionnaires. The results showed that the gatherers have an accurate comprehension of tidal phenomenon based on their exploitation of natural resources, which perpetuates through generations.
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                Author and article information

                Journal
                J Herb Med
                J Herb Med
                Journal of Herbal Medicine
                Elsevier GmbH.
                2210-8033
                2210-8041
                11 June 2022
                11 June 2022
                : 100578
                Affiliations
                [a ]Centre of Life Science, School of Natural Science, Central University of Jharkhand, Ranchi, Jharkhand-835205
                [b ]Department of Botany, Indira Gandhi National Tribal University, Amarkantak 484 887, M.P., India
                Author notes
                [* ]Corresponding author.
                Article
                S2210-8033(22)00047-1 100578
                10.1016/j.hermed.2022.100578
                9188285
                35722654
                1e9bb01f-e1c2-4c56-9696-1fa0f2d2bb7d
                © 2022 Elsevier GmbH. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 11 March 2021
                : 21 November 2021
                : 7 June 2022
                Categories
                Article

                bioprospection,capacity building,ethnomedicine,floristic diversity, ism,lhts,traditional pharmacological knowledge

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