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Lady era

By P. Jack. Uniformed Services Universty of the Health Sciences.

Consistent and long-term use of antioxidants lady era 100mg, along with lifestyle changes 100mg lady era, are your best defence lady era 100 mg. In one study 100 mg lady era, people who took multivitamins or supplements containing vitamins C or E for more than 10 years had a 60 percent lower risk of devel- oping cataracts (Archives of Ophthalmology , 2000: 118;1556–1563) . Complementary Supplements B-complex: Vitamins B2 and B3 protect glutathione in the eye , and some evidence shows protective benefits with supplements . Boost antioxidant and carotenoid intake by eating lots of berries , carrots , peppers, kale, collard greens, spinach, and broccoli. When a person with celiac disease eats gluten-containing food, the immune sys- tem reacts by producing antibodies, which attack the villi in the small intestine, reducing their ability to absorb nutrients. Over time, the reduced absorption of nutri- C ents leads to malnutrition and vitamin, mineral, and essential fatty acid deficiencies. This can damage the health of every organ and body system and increase the risk of many diseases, such as osteoporosis and depression. The cause of celiac is not known; however, three factors are typically present in those who develop the disease: genetic predisposition, a diet containing gluten, and a triggering event. Possible triggers include: introduction of grains into a baby’s diet, puberty, pregnancy, menopause, stress, viral or bacterial infection, and trauma (ac- cident, surgery). There is no cure for celiac disease, but the condition can be managed by following a gluten-free diet for life. Those who do not adhere to a gluten-free diet are at greater risk of developing os- teoporosis; cancer of the intestines, mouth, esophagus, or bowel; and neurological diseases (seizures and nerve damage). Once gluten is removed from the diet, the villi start to heal and intestinal inflammation subsides. Complete healing and regrowth of the villi may take several months in younger people and as long as two to three years in older people. For severe cases that don’t respond to dietary changes, medications such as prednisone are temporarily used to suppress the immune response. Vitamin, mineral, and essential fatty acid supplements are recommended to correct deficiencies and restore health. Dietary Recommendations Read labels carefully; look for products labelled gluten-free. When eating out, ask to speak directly to the chef as service staff may not be familiar with gluten and the many possible hidden sources. Cross-contamination can occur if gluten-free foods are prepared in unwashed bowls previously containing gluten, or cooked in the same pots or deep-fryer. Foods to include: • Lean meats, fish and poultry, fruits, vegetables, corn, potato, rice, quinoa, and soy. Healthy fats (fish, nuts, and seeds) are very important to help restore essential fatty acids, which are depleted in those with celiac disease. Foods to avoid: • Foods containing wheat, barley, rye, bulgur, Kamut, spelt, and triticale, such as breads, pasta, cereals, baked goods, crackers, and pies. Note: Dairy should be limited initially as damage to the intestines reduces the ability to di- gest lactose (dairy sugar). These studies used pure oats, free of gluten contamination, and the amount per day was limited. The Canadian Celiac Association has stated that consump- tion of pure, uncontaminated oats is safe in the amount of 50–70 g per day (1/2–3/4 166 cup of dry rolled oats) by adults and 20–25 g per day (1/4 cup of dry rolled oats) by children with celiac disease. Note: Some individuals may not tolerate even pure oats, in which case they should be completely avoided. Lifestyle Suggestions To promote healing and support immune function, it is important to get adequate rest, reduce stress, and strictly adhere to the gluten-free diet. C Top Recommended Supplements Digestive enzymes: May be depleted in those with celiac; they aid proper digestion of food and are particularly important in newly diagnosed individuals. Essential fatty acids: Are highly recommended to correct deficiencies, reduce inflammation, and promote healing of intestinal cells. Look for a product that provides both omega-3 (fish) and omega-6 (borage, primrose) fatty acids. Multivitamin and mineral complex: This is absolutely essential to correct deficiencies and promote healing. The most common deficiencies include calcium, magnesium, iron, zinc, vitamins D and K, and folic acid. Even those who are stable on a gluten-free diet and in remission may still have nutrient deficiencies and would benefit from a supplement. Those with severe malnutrition and deficiencies may require higher than typical amounts. Complementary Supplements Fibre: Often deficient in a gluten-free diet due to the elimination of many grains, so supple- ments can help improve bowel function and prevent constipation. Green Food supplement: Provides vitamins, minerals, and fibre; improves energy and recovery. Probiotics: Support intestinal health, restore normal flora, and improve bowel function. Look for a product that is non-dairy, stable at room temperature and provides at least 1 bil- lion live cells. Eat a healthy diet, including fruits, vegetables, lean protein, healthy fats, and glu- ten-free grains. There are various grades of cervical dysplasia, which are classified upon the extent of the abnormal cell growth. Low-grade cervical dysplasia progresses very slowly and typically resolves on its own. High-grade cervical dyspla- sia tends to progress quickly and usually leads to cervical cancer. An estimated 66 percent of cervical dysplasia cases progress to cancer within 10 years. Cervical cancer constitutes more than 10 percent of cancers worldwide and is the second leading cause of death in women between the ages of 15 and 34. With early identifica- tion, treatment, and consistent follow-up, nearly all cases of cervical dysplasia can be cured and cervical cancer can be prevented. In some cases woman may notice: • Abnormal bleeding • Genital warts • Low back pain • Spotting after intercourse • Vaginal discharge Note: These symptoms are not unique to cervical dysplasia and may indicate a different problem. Every woman should have an annual Pap test beginning at age 18 and con- tinuing on past menopause. Many women stop having this done later in life, which is dangerous since the highest incidence of cervical cancer is among those over age 65. Cervical dysplasia is curable, although the lifetime recurrence rate is 20 percent. For early stages of cervical dysplasia doctors may simply recommend frequent moni- toring, as pre-cancerous changes may disappear on their own. The most commonly used procedures include laser therapy, cryocauterization (use of extreme cold to de- stroy abnormal tissue), and loop excision (using a wire loop to remove tissue). Your doctor takes a little scraping of cells in the cervical area for analysis by a laboratory. These natural therapies do not replace the need for regular medical examinations and doctor’s supervision. Dietary Recommendations Foods to include: • Increase intake of whole grains, fresh vegetables, and fruits. They also contain vitamin C, folate, and beta-carotene, which have been found to be deficient in those who develop cervical dys- plasia. Foods to avoid: • Alcohol, caffeine, refined foods, food additives, sugar, and saturated fats may affect hor- mone balance, impair immune function, and worsen symptoms. C • Red meat and dairy products may contain dioxins and chemicals that act as estrogen- mimickers. Lifestyle Suggestions • Minimize exposure to environmental estrogens or xenoestrogens (phthalates, parabens, and dioxins), which are present in pesticides, plastics, and certain skin care products. Indole-3-carbinol: A compound found naturally in cruciferous vegetables that aids in de- toxification of estrogen, protects liver function, and may protect against hormonal cancers. In one study supplements were found to improve lesions in those with cervical dysplasia. Complementary Supplements B-vitamins: Some research has shown that women with low dietary intakes of vitamins B1, B2, B12, and folic acid are at greater risk of developing cervical dysplasia and those with higher intakes of these nutrients from food and supplements are at lower risk. Not specifically studied for cervical dysplasia, but may help by reducing the harm- ful effects of estrogen. However, it is known that vitamin C sup- ports immune function and is an antioxidant that protects against cellular damage. Beta-carotene: Some research suggests that a deficiency in beta-carotene increases the risk of cervical dysplasia and cancer, and that supplements may promote a regression or decline C in the signs of cervical dysplasia. It is thought that women are more likely to report the symptoms to their doctors than men. However, these drugs can cause side effects that may actually be worse than the symptoms of the condition. These medications include antidepressants (Paxil, Zoloft, and Wellbutrin), anti-anxiety drugs (Xanax and Ativan), anti-inflammatory drugs (Motrin), and allergy drugs (antihistamines and decongestants). C Food to avoid: • Processed and fast foods contain chemicals that may trigger allergic reactions and stress the body, worsening symptoms. Lifestyle Suggestions • Reduce stress—promote relaxation with meditation, yoga, stretching, and breathing exer- cises. Try to get a combination of both aerobic activities (walking, biking, and swimming) along with resistance training (working out with weights or machines) and stretching. B-vitamins are required for energy production, enzyme reactions, and many other vital body processes. Without functioning valves to prevent the backflow of blood, the blood pools in the veins, causing them to enlarge. It often starts with the failure of a single valve, which creates a high-pressure leak in the venous system. After a series of valves have failed, the affected veins can no longer direct blood upward toward the heart. This scenario often continues as increasing numbers of valves fail under the strain and high pressure, and more and more veins become affected. Options include: Ablation/sclerotherapy/laser: Procedures that destroy the damaged vein; blood is rerouted through other veins, and the damaged vein is absorbed by the body. Bypass: An artificial or transplanted vein is connected to the damaged vein to help improve blood flow. C Compression stockings: They provide firm support to improve blood flow back to the heart and prevent leg swelling; available for both men and women; custom or- dered to size. Valve repair: A surgical procedure to shorten the valves and improve valve function. These foods are also high in antioxidants and good fats, both of which are helpful for circulation. Foods to avoid: • Saturated fats (animal fats) and trans fats (fast food and processed food) impede circula- tion, cause free radical damage, and trigger inflammation. Lifestyle Suggestions • Exercise regularly: Activities that involve the calf muscle will help pump blood back to the heart. Move around, flex your ankles, circle your foot, do calf raises, and shift your body weight. It has a quick onset of action (one to two weeks) and is not associated with any side effects or drug interactions. Dosage: 600 mg once daily of a product standardized to provide 95 percent diosmin and 5 percent hesperidin. Over 30 clinical studies have found diosmin safe and effective for improving vein disor- ders, including chronic venous insufficiency and varicose veins. C Horse chestnut seed extract: Promotes circulation, improves vein wall tone, and relieves swelling. It may cause nausea and upset stomach and can enhance the effect of blood-thinning medications. Pine bark extract: A flavonoid that offers antioxidant activity, strengthens capillaries, improves circulation, and supports vein health. In addition to diosmin and pine bark, other antioxidants to consider include vitamins C and E, bilberry, and grape seed extract. Butcher’s broom: Improves the strength and tone of the veins, acts as a mild diuretic, and has mild anti-inflammatory effects. Gotu kola: Is a plant extract shown in preliminary research to reduce swelling, pain, fatigue, sensation of heaviness, and fluid leakage from the veins. Boost intake of fibre and antioxidant-rich foods; reduce your intake of saturated fats, processed foods, and sodium. Exercise regularly, elevate your feet when resting, and avoid standing or sitting in the same spot. Most people contract cold sores during childhood, although some people get them C later in life. After infection with the virus, it can remain dormant for long periods of time and then periodically cause outbreaks, particularly when the immune system is weakened. An outbreak of cold sores causes: • Clusters of tiny, red, fluid-filled blisters • Crusting once they burst • Pain Cold sores typically last for seven to 10 days. Contact your doctor if: the sores do not heal within two weeks; the symptoms are severe; you get frequent recurrences; you C experience pain or irritation in your eyes. Prescription antiviral drugs such as Valtrex and Zovirax may shorten the dura- tion and severity of the infection, but are not approved for prevention. These drugs are expensive, associated with side effects (nausea, vomiting, and headache), and are not recommended for children, pregnant women, or those with impaired kidney or liver function. Over-the-counter products that may be recommended include: Aspirin, acetaminophen (Tylenol) or ibuprofen: Oral medications that help re- duce pain. Dietary Recommendations Foods to include: • Foods high in the amino acid lysine (legumes, fish, meat, and dairy) may help to reduce levels of arginine. Foods to avoid: • Foods that contain high amounts of arginine (chocolate, nuts, whole grains, and gelatin) allow the cold sore virus to thrive.

The research participant first read the list of words to the learner and then began testing him on his learning lady era 100 mg. The experimenter sat behind the teacher and explained to him that each time the learner made a mistake he was to press one of the shock switches to administer the shock 100mg lady era. Moreover 100 mg lady era, the switch that was to be pressed increased by one level with each mistake lady era 100mg, so that each mistake required a stronger shock . Once the learner (who was , of course , actually the experimental confederate) was alone in the shock room , he unstrapped himself from the shock machine and brought out a tape recorder that he used to play a prerecorded series of responses that the teacher could hear through the wall of the room . After the next few mistakes , when the shock level reached 150 V, the learner was heard to exclaim, “Let me out of here. At this point the experimenter responded to participants‘ questions, if any, with a scripted response indicating that they should continue reading the questions and applying increasing shock when the learner did not respond. Although all the participants gave the initial mild levels of shock, responses varied after that. Some refused to continue after about 150 V, despite the insistence of the experimenter to continue to increase the shock level. Still others, however, continued to present the questions and to administer the shocks, under the pressure of the experimenter, who demanded that they continue. In the end, 65% of the participants continued giving the shock to the learner all the way up to the 450 V maximum, even though that shock was marked as “danger: severe shock‖ and no response had been heard from the participant for several trials. In other words, well over half of the men who participated had, as far as they knew, shocked another person to death, all as part of a supposed experiment on learning. In case you are thinking that such high levels of obedience would not be observed in today‘s modern culture, there is fact evidence that they would. Milgram‘s findings were almost exactly replicated, using men and women from a wide variety of ethnic groups, in a study conducted this [40] decade at Santa Clara University (Burger, 2009). In this replication of the Milgram experiment, 67% of the men and 73% of the women agreed to administer increasingly painful electric shocks when an authority figure ordered them to. The participants in this study were not, however, allowed to go beyond the 150 V shock switch. Although it might be tempting to conclude that Burger‘s and Milgram‘s experiments demonstrate that people are innately bad creatures who are ready to shock others to death, this is not in fact the case. Rather it is the social situation, and not the people themselves, that is responsible for the Attributed to Charles Stangor Saylor. When Milgram created variations on his original procedure, he found that changes in the situation dramatically influenced the amount of conformity. Conformity was significantly reduced when people were allowed to choose their own shock level rather than being ordered to use the level required by the experimenter, when the experimenter communicated by phone rather than from within the experimental room, and when other research participants refused to give the shock. These findings are consistent with a basic principle of social psychology: The situation in which people find themselves has a major influence on their behavior. The research that we have discussed to this point suggests that most people conform to the opinions and desires of others. People with lower self-esteem are more likely to conform than are those with higher self-esteem, and people who are dependent on and who have [41] a strong need for approval from others are also more conforming (Bornstein, 1993). People who highly identify with or who have a high degree of commitment to a group are also more likely to conform to group norms than those who care less about the group (Jetten, Spears, & [42] Manstead, 1997). Despite these individual differences among people in terms of their tendency to conform, however, research has generally found that the impact of individual difference variables on conformity is smaller than the influence of situational variables, such as the number and unanimity of the majority. We have seen that conformity usually occurs such that the opinions and behaviors of individuals become more similar to the opinions and behaviors of the majority of the people in the group. However, and although it is much more unusual, there are cases in which a smaller number of individuals is able to influence the opinions or behaviors of the larger group—a phenomenon known as minority influence. Minorities who are consistent and confident in their opinions may [43] in some cases be able to be persuasive (Moscovici, Mugny, & Van Avermaet, 1985). Nemeth and Kwan (1987) found that participants working together in groups solved problems more creatively when only one person gave a different and unusual response than the other members did (minority influence) in comparison to when three people gave the same unusual response. It is a good thing that minorities can be influential; otherwise, the world would be pretty boring indeed. When we look back on history, we find that it is the unusual, divergent, innovative minority groups or individuals, who—although frequently ridiculed at the time for their unusual ideas—end up being respected for producing positive changes. Another case where conformity does not occur is when people feel that their freedom is being threatened by influence attempts, yet they also have the ability to resist that persuasion. In these cases they may develop a strong emotional reaction that leads people to resist pressures to [46] conform known aspsychological reactance (Miron & Brehm, 2006). Reactance is aroused when our ability to choose which behaviors to engage in is eliminated or threatened with elimination. The outcome of the experience of reactance is that people may not conform at all, in fact moving their opinions or behaviors away from the desires of the influencer. Consider an [47] experiment conducted by Pennebaker and Sanders (1976), who attempted to get people to stop writing graffiti on the walls of campus restrooms. In the first group of restrooms they put a sign that read “Do not write on these walls under any circumstances! They found that there was significantly less graffiti in the second group of restrooms than in the first one. It seems as if people who were given strong pressures to not engage in the behavior were more likely to react against those directives than were people who were given a weaker message. A child who feels that his or her parents are forcing him to eat his asparagus may react quite vehemently with a strong refusal to touch the plate. And an adult who feels that she is being pressured by a car salesman might feel the same way and leave the showroom entirely, resulting in the opposite of the salesman‘s intended outcome. The tendency to help others in need is in part a functional evolutionary adaptation and in part determined by environmental factors. Some helping is based on reciprocal altruism, the principle that if we help other people now, those others will return the favor should we need their help in the future. The result of this learning is norms about helping, including the reciprocity norm and the social responsibility norm. The typical outcome of conformity is that our beliefs and behaviors become more similar to those of others around us. The important influence of the social situation on conformity was demonstrated in the research by Sherif, Asch, Milgram, and others. New evolutionary perspectives on altruism: Multilevel-selection and costly-signaling theories. Some neo-Darwinian decision rules for altruism: Weighing cues for inclusive fitness as a function of the biological importance of the decision. My sibling’s but not my friend’s keeper: Reasoning about responses to aggressive acts. Altruism on American television: Examining the amount of, and context surrounding, acts of helping and sharing. Effects of violent video games on aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, and prosocial behavior: A meta-analytic review of the scientific literature. Gender differences in young adolescents’ experiences of peer victimization: Social and physical aggression. Dysfunction in the neural circuitry of emotion regulation—A possible prelude to violence. Hot and crowded: Influence of population density and temperature on interpersonal affective behavior. Catharsis, aggression, and persuasive influence: Self-fulfilling or self-defeating prophecies? Chronic violent video game exposure and desensitization to violence: Behavioral and event-related brain potential data. Relation of threatened egotism to violence and aggression: The dark side of high self-esteem. Proactive and reactive aggression among school bullies, victims, and bully- victims. Relational and physical victimization within friendships: Nobody told me there’d be friends like these. Insult, aggression, and the southern culture of honor: An “experimental ethnography. Field experiments examining the culture of honor: The role of institutions in perpetuating norms about violence. A focus theory of normative conduct: Recycling the concept of norms to reduce littering in public places. Self-monitoring without awareness: Using mimicry as a nonconscious affiliation strategy. Strength of identification and intergroup differentiation: The influence of group norms. Summarize the advantages and disadvantages of working together in groups to perform tasks and make decisions. Just as our primitive ancestors lived together in small social groups, including families, tribes, and clans, people today still spend a great deal of time in groups. We study together in study groups, we work together on production lines, and we decide the fates of others in courtroom juries. A rock band that is writing a new song or a surgical team in the middle of a complex operation may coordinate their efforts so well that it is clear that the same outcome could never have occurred if the individuals had worked alone. But group performance will only be better than individual performance to the extent that the group members are motivated to meet the group goals, effectively share information, and efficiently coordinate their efforts. Because these things do not always happen, group performance is almost never as good as we would expect, given the number of individuals in the group, and may even in some cases be inferior to that which could have been made by one or more members of the group working alone. Working in Front of Others: Social Facilitation and Social Inhibition [1] In an early social psychological study, Norman Triplett (1898) found that bicycle racers who were competing with other bicyclers on the same track rode significantly faster than bicyclers who were racing alone, against the clock. This led Triplett to hypothesize that people perform tasks better when there are other people present than they do when they are alone. Subsequent findings validated Triplett‘s results, and experiments have shown that the presence of others can Attributed to Charles Stangor Saylor. The tendency to perform tasks better or faster in the presence of others is known as social facilitation. However, although people sometimes perform better when they are in groups than they do alone, the situation is not that simple. Perhaps you remember an experience when you performed a task (playing the piano, shooting basketball free throws, giving a public presentation) very well alone but poorly with, or in front of, others. Thus it seems that the conclusion that being with others increases performance cannot be entirely true. The tendency to perform tasks more poorly or more slowly in the presence of others is known as social inhibition. According to Zajonc, when we are with others we experience more arousal than we do when we are alone, and this arousal increases the likelihood that we will perform thedominant response, the action that we are most likely to emit in any given situation (Figure 14. Zajonc argued that when the task to be performed was relatively easy, or if the individual had learned to perform the task very well (a task such as pedaling a bicycle), the dominant response was likely to be the correct response, and the increase in arousal caused by the presence of others would create social facilitation. On the other hand, when the task was difficult or not well learned (a task such as Attributed to Charles Stangor Saylor. A meta-analysis by [4] Bond and Titus (1983), which looked at the results of over 200 studies using over 20,000 research participants, found that the presence of others significantly increased the rate of performing on simple tasks, and also decreased both rate and quality of performance on complex tasks. Although the arousal model proposed by Zajonc is perhaps the most elegant, other explanations have also been proposed to account for social facilitation and social inhibition. One modification argues that we are particularly influenced by others when we perceive that the others are [5] evaluating us or competing with us (Baron, 1986). In one study supporting this idea, Strube, [6] Miles, and Finch (1981) found that the presence of spectators increased joggers‘ speed only when the spectators were facing the joggers, so that the spectators could see the joggers and assess their performance. The presence of others did not influence joggers‘ performance when the joggers were facing in the other direction and thus could not see them. Working Together in Groups The ability of a group to perform well is determined by the characteristics of the group members (e. When the outcome of group performance is better than we would expect given the individuals who form the group, we call the outcome a group process gain, and when the group outcome is worse than we would have expected given the individuals who form the group, we call the outcome a group process loss. One group process loss that may occur in groups is that the group members may engage in social loafing, a group process loss that occurs when people do not work as hard in a group Attributed to Charles Stangor Saylor. In one of the earliest social psychology experiments, [7] Ringelmann (1913; reported in Kravitz & Martin, 1986) had individual men, as well as groups of various numbers of men, pull as hard as they could on ropes while he measured the maximum amount that they were able to pull. In fact, the loss was so large that groups of three men pulled at only 85% of their expected capability, whereas groups of eight pulled at only 37% of their expected capability. This type of process loss, in which group productivity decreases as the size of the group increases, has been found to occur on a wide variety of tasks. Group process losses can also occur when group members conform to each other rather than expressing their own divergent ideas. Groupthink is a phenomenon that occurs when a group made up of members who may be very competent and thus quite capable of making excellent decisions nevertheless ends up, as a result of a flawed group process and strong conformity Attributed to Charles Stangor Saylor. Groupthink is more likely to occur in groups whose members feel a strong group identity, when there is a strong and directive leader, and when the group needs to make an important decision quickly. The problem is that groups suffering from groupthink become unwilling to seek out or discuss discrepant or unsettling information about the topic at hand, and the group members do not express contradictory opinions. Because the group members are afraid to express opinions that contradict those of the leader, or to bring in outsiders who have other information, the group is prevented from making a fully informed decision. Analyses of the decision-making processes in these cases have documented the role of conformity pressures. The group members begin to feel that they are superior and do not need to seek outside information. Although many other countries rely on judges to make judgments in civil and criminal trials, the jury is the foundation of the legal system in the United States. The notion of a ―trial by one‘s peers‖ is based on the assumption that average individuals can make informed and fair decisions when they work together in groups.

An example of a national initiative is the current South African research and development programme for novel drug development from indigenous medicinal plants (see www 100 mg lady era. Initially destined to run over 3 years (2004–6) lady era 100mg, the programme is on-going and has published some of its preliminary findings lady era 100 mg. When we came to the Coperbergh in October 100mg lady era, it was being gathered from the surrounding hills by everybody (to serve as a supply for the whole year) . They use it as the Indians use betel or areck , being in extremely cheerful mood most evenings at their gatherings . Both usage and mode of preparation of canna have continued almost unchanged to the present day . Patented (World Patent 9746234 , 1997 , Gericke and van Wyk), standardised alkaloid preparations derived from Sceletium tortuosum (L. Brown and other Sceletium species are currently under investigation for the treatment of psychiatric and psycho- logical conditions including depression, anxiety, drug dependence and bulimia. Furthermore, it is being increasingly recognised that the efficacy of whole plant extracts may be the product of a complex balance between various secondary chemicals involving synergistic and solubilising effects, as well as a possible mitiga- tion of toxicity. This legally permissible but ethically questionable practice will persist until such time as all African states have adequate legislation in place for protection of traditional medical systems and practitioners. The most common approach is to prepare plant extracts of varying polarity and test these separately for activity, often using a single in vitro bioassay. There are some flaws in this approach, namely that aqueous infusions are used in African traditional medical practice and, second, that a single bioassay is probably insufficient to demonstrate activity. There have been some studies using traditional dosage forms,58–60 but few that take into account the effects of genetic or environmental variability on plant secondary chemistry/bioac- tivity. A different approach has been taken by the phytomedicines industry, which utilises whole plant products or extracts of plant species used as tradi- tional medicines. Safety Much benefit is to be gained from the rational use of traditional medicines within the formal healthcare system in Africa. In vitro antiplasmodial and in vivo antimalarial activity of some plants used traditionally for the treatment for malaria by the Meru community in Kenya. In vitro antiplasmodial activity of medicinal plants native to or naturalised in South Africa. Studies on the antiplasmodial properties of some South African medicinal plants used as antimalarial remedies in Zulu folk medicine. In vitro antiplasmodial activity of ethnobotanically selected South African plants. Antiplasmodial activity of extracts of selected medic- inal plants used by local communities in Western Uganda for the treatment of malaria. Aiton Africa spasm and diarrhoea to assess the safety of indigenous traditional herbal remedies and to address the problem of serious adverse events associated with their consumption, particularly by neonates and young children. It is accepted that a proportion of patients treated by western allopathic practitioners will develop iatrogenic complications; by the same token it can be expected that those treated by traditional healers might develop similar complications. Indeed, concern has been expressed recently in Australia at the unacceptably high number (80 000/year) of allopathic drug-related hospital- isations, which represent a major (but largely avoidable) public health problem. Possible causative factors were identified as: • inappropriate administration of traditional remedies to neonates and toddlers • excessive or prolonged self-medication, e. The review noted that there was also a need to give attention to possible interactions between traditional and western allopathic medicines taken concurrently. Pending the outcome of toxicological studies, interim preven- tive measures (aimed at reducing the number of hospital admissions due to poisoning by traditional remedies) were suggested. In South Africa some disruption of tradi- tional lifestyle has inevitably accompanied migration from rural to urban milieu. One result is that the traditional healer practising in the city is now Traditional medical practice in Africa | 109 obliged either to travel long distances to obtain necessary materia medica or to rely on imported stock, the origin and mode of collection/preparation of which may be unknown to the prescriber. In the latter case, an important component of traditional quality assurance is lost. The establishment of nurseries and farms supplying plant material of consistent quality would help to minimise accidental overdosage due to natural variability in potency. Another result of urbanisation in South Africa appears to be ‘the irre- sponsible quackery and reckless profiteering racket into which the erstwhile dignified practice of traditional medicine is currently degenerating in the townships and cities’ (Zondi, personal communication in Ref. This is a phenomenon of which traditional healers are well aware and which they seek to eradicate (Kubukeli, personal communication). Registration and certification of traditional healers, as is required for their western allopathic counterparts, have been proposed as a solution and may contribute to a reduction in the incidence of poisoning. The best of drugs, in the hands of the irresponsible or ignorant, is potentially dangerous. It may be necessary to alert the public, by means of a media campaign, to the hazards of self-medication with traditional herbs known to have deleterious side effects. Although it is not possible to say if the South African experience holds true for other African states, it would be surprising if the effects on traditional medical practice of cultural disruption occasioned by urbanisation, political unrest, war or climate change would not be felt throughout the continent. These findings are a cause for concern and further toxicological studies are necessary before the species concerned can be prescribed with confidence. Quality assurance Quality assurance of medicines rests on the establishment of standards relating to their identity, purity and potency. This constitutes the first step 110 | Traditional medicine in the process of bringing traditionally used plant species from the field into the clinic, dispensary and hospital. Similar programmes have been undertaken in Mozambique, Zambia, Zimbabwe, Botswana and Malawi. Primarily a disease of the rural poor in Africa, Plas- modium falciparum malaria causes more deaths than any other infectious agent in young African children and is responsible for almost 40% of these deaths. The efficacy of such remedies has been demonstrated by the successful development of modern antimalarials from traditionally used Cinchona and Artemisia spp. Twenty years later, Africa’s fragile oral knowledge systems are threatened by war, famine, political instability and urbanisation (with concomitant loss of the ‘ecosystem generation’). Unsustainable harvesting practices, delib- erate habitat destruction and climate change threaten the survival of the plant species on which Africa’s traditional healers depend. The greatest threat to traditional medical practice, however, is the burgeoning global population, whose growth and consumption of natural resources places plant diversity at risk in most parts of the world. The quantity of wild plant material exported from Africa and destined for the international pharma- ceutical trade is enormous, but pales into insignificance compared with that required by the trade in crude drugs used in traditional medical practice, within individual states or across regional borders. This has resulted in a disregard for traditional conservation practices and ‘an opportunistic scramble for the last bag of bark, bulbs or roots’. High rates of unemployment and low levels of formal education have also given rise to an increasing number of medicinal plant vendors, plying their trade in the marketplace (Figure 5. The period 2001–10 has been declared the Decade of African Traditional Medicine and an Africa Health Strategy (2007–15) has been formulated, focusing on the strengthening of health systems for equity and development in Africa. Conclusion There is no doubt that Africa’s rich botanical biodiversity and well-estab- lished traditional medical systems can be harnessed for the provision of better healthcare throughout the continent. The neces- sary expertise and infrastructure do not exceed the capabilities of the average African university School of Pharmacy. Toen wy in Oktober omtrent den Coperbergh quamen, weird door alle man ‘tselvs op d’omliggende bergen (tot voorraad vant geheele jaar) ingesamelt ‘t welck zy gelijk d’Indianers den betel of areck gebruijcken, synde seer vroolijk van humeur, meest alle avonden in haer ‘tsamenkomst. The Traditional Medical Practitioner in Zimbabwe: His principles of practice and pharmacopoeia. Manchester: Manchester University Press in association with the International African Institute, 1986: 50–86. Riding the wave: South Africa’s contri- bution to ethnopharmacological research over the last 25 years. Policy and public health perspectives on tradi- tional, complementary and alternative medicine: an overview. In: Bodeker, G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. Manchester: Manchester University Press in association with the International African Institute, 1986. The professionalisation of indigenous medicine: a comparative study of Ghana and Zambia. Manchester: Manchester University Press in association with the International African Institute, 1986: 117–135. Manchester: Manchester University Press in association with the International African Institute, 1986: 151–62. Report of the Inter-Regional Workshop on Intellectual Property Rights in the Context of Traditional Medicine. Proceedings of an International Workshop on Traditional Knowledge, Panama City, 21–23 September 2005. A review of the taxonomy, ethnobotany, chemistry and pharmacology of Sutherlandia frutescens (Fabaceae). Galanthamine: a randomised double-blind, dose comparison in patients with Alzheimer’s disease. Antidiabetic screening and scoring of 11 plants traditionally used in South Africa. In vitro antiplasmodial activity of medicinal plants native to or naturalised in South Africa. The distribution of mesembrine alkaloids in selected taxa of the Mesembryanthemaceae and their modification in the Sceletium derived ‘kougoed’. Antimycobacterial activity of 5 plant species used as traditional medicines in the Western Cape Province (South Africa). Uses and abuses of in vitro testing in ethnopharmacology: visualizing an elephant. A pharmacognostical study of 26 South African plant species used as traditional medicines. The African cherry (Prunus africana): can lessons be learned from an over- exploited medicinal tree? Acute toxicity associated with the use of South African traditional medicinal herbs. Clinical and analytical aspects of pyrrolizidine poisoning caused by South African traditional medicines. Screening of medicinal plants used in South African traditional medicine for genotoxic effects. Searching for a Cure: Conservation of medicinal wildlife resources in east and southern Africa. In: Bodeker G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. In: Bodeker G, Burford G (eds), Traditional, Complementary and Alternative Medicine: Policy and public health perspectives. An Africa-wide Overview of Medicinal Plant Harvesting, Conservation and Health Care. A brief overview of other similar traditional medicine practices is also included. All healthcare providers, particularly those who practise in areas with substantial Chinese immigrant populations, will find it useful to have some background knowledge of this topic. Written in the form of a discourse between Huangdi and his ministers on the nature of health, it contains a wealth of knowledge, including aetiology, physiology, diagnosis, therapy and prevention of disease, as well as an in-depth investigation of such diverse subjects as ethics, psychology and cosmology. Entitled The Classic of Difficult Issues, it discusses the origins of the nature of illness, describes an innovative approach to diagnosis and outlines a system of therapeutic needling. It diffused from immigrant families into host communities and was promoted by subsequent media exposure. They brought their traditional medicine with them and it proved to be popular among the prospectors and their families, particularly as western medicine was largely unavailable in these remote areas. Its fundamental assertion, similar to the kindred philosophical systems of Confucianism and Taoism, is that contemplation and reflection on sensory perceptions and ordinary appearances are sufficient to under- stand the human condition, including health and illness. This assertion is fundamentally different from the western biomedical viewpoint, which gives privileged status to objective technology and quantitative measurement. It is based on a highly sophisticated set of practices designed to cure illness and to maintain health and well-being. These practices also represent an energetic intervention designed to re- establish harmony and equilibrium for each patient according to the holistic principle. Whenever the practitioner uses acupuncture or herbal medicine, prescribes a set of exercises or proposes a new diet, his or her activities are all considered to be mutually interdependent and necessary to restore (or maintain) health. This differs somewhat to how Chinese medicine is practised in China where doctors tend to specialise in acupuncture, herbal medicine or tuina massage. This difference is probably due to the fact that there are far more practitioners in China than in the West. Below is a brief description of the concepts that are fundamental to an understanding of how Chinese medicine is used: • Yin and yang • The five phases • The five substances • The organs • The meridians or channels. Although they are presented in discrete sections, they are all interlinked, like a jigsaw puzzle. Yin and yang According to Emperor Fu His, who lived in the Yellow River area of China, approximately 8000 years ago, the world and all life within it are made up of paired opposites, each giving meaning to the other. They may be viewed 122 | Traditional medicine as complementary aspects of the whole. Fu His formulated two symbols to represent this idea: a broken line and an unbroken line. These symbols depicted the two major forces in the universe – creation and reception – and how their interaction formed life. This duality was named yin–yang and represents the foundation of Chinese medicine.

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