The intent of this chapter is to provide a brief overview of common conditions and topics that may be encountered on a general inpatient rehabilitation unit; for an in-depth review of the topics, please see the corresponding chapters in this textbook.
Ethnopharmacological relevanceGeological materials, such as minerals, have a long history of usage as ingredients in multicompound formulations of Himalayan Sowa Rigpa medicine – as well as in its localized form of Bhutanese traditional medicine (BTM) – for treating various disorders for over thousand years. Yet, hardly any scientific research has been done on their ethnopharmacological efficacy and chemistry.
Aim of the study
This study documents and correlates the rarely explored ethnopharmacological and chemical identification of various minerals and their ethnomedicinal uses in BTM formulations for the first time.
Material and methods
A five stage cross-disciplinary process was conducted as follows: (1) a review of classical literature of Sowa Rigpa texts (Tibetan medical texts, pharmacopoeias and formularies) that are still in use today; (2) listing of mineral ingredients according to Sowa Rigpa names, followed by identification with common English and chemical names, as well as re-translating their ethnomedical uses; (3) cross-checking the chemical names and chemical composition of identified Sowa Rigpa minerals with various geological mineral databases and mineral handbooks; (4) authentication and standardization of Sowa Rigpa names through open forum discussion with diverse BTM practitioners; (5) further confirmation of the chemical names of identified minerals by consulting different experts and pharmacognosists.
Results
Our current study lists 120 minerals as described in Sowa Rigpa medical textbooks most of which we were able to chemically identify, and of which 28 are currently used in BTM herbo-mineral formulations. Out of these 28 mineral ingredients, 5 originate from precious metal and stone, 10 stem from earth, mud and rocks, 8 are salts, and 5 concern ‘essences’ and exudates.
Conclusions
Our study identified 120 mineral ingredients described in Sowa Rigpa medical textbooks, out of which 28 are currently used. They are crucial in formulating 108 multicompound prescription medicines in BTM presently in use for treating more than 135 biomedically defined ailments.
This chapter contains sections titled:<br>Defining Global Health<br>The Social Determinants of Health<br>Global Studies of Science and Technology<br>International Health Policy<br>The Social Relations of Global Health Development<br>Conclusions<br>References
Chapter 4 draws primarily on fieldwork from Kathmandu and Mustang, Nepal, and Qinghai Province, China, focusing on the types of therapeutic encounters that occur in small, private clinics, and how individuals narrate their experiences of illness. Illness narratives introduce readers to an array of concerns regarding access to and affordability of health care in culturally Tibetan areas. One witnesses how and where Tibetan medicine fits into complex patterns of resort, issues of mistrust that surface with respect to biomedicine and state healthcare options, and the association between material and cosmological or spiritual understandings of illness causality. Next, the chapter discusses how social ecologies are at once maintained and transformed through migration and experiences of modernity, including the circulation of medicines between people from Nepal and China now living in the United States and their relatives back home. The final sections of this chapter discuss issues related to illness causality and how specific diseases and patterns of illness experience are linked to material, cosmological, and place-based understandings of the causes and conditions giving rise to health problems. One sees how medicine is a dynamic engagement between the oft-polarized extremes of science and religion.
This essay analyzes the impacts of global and national pharmaceutical governance on the production of traditional medicines--specifically the making and marketing of Tibetan medicines in contemporary China. Based on research conducted in Tibetan medical factories and with practitioners, producers, and consumers of Tibetan medicines in the Tibet Autonomous Region (TAR) and Qinghai Province between 2002-2010, this article presents ethnographic evidence for the ways Tibetan knowledge systems and the value of medicines themselves are being transformed through interlinked engagements with science, technology, and the market. I focus on the implementation of Good Manufacturing Practices (GMP) and related regulations: state-mandated standards that govern the conditions under which raw materials are evaluated, medicines are made, and finished products are sold. This article responds to calls for an anthropology of pharmaceutical practice in the context of social transformation. I propose that ethnography of Tibetan pharmaceutical production provides an apt illustration of global governance in action because it shows how shifts in medical production practices are tied to much larger processes of political and economic change within China and beyond. Further, my examination of points of incommensurability and ambivalence with respect to GMP regulations contributes to an anthropological analysis of the constitutive role cultural politics plays in the construction of value and meaning with respect to traditional medicine.
Effects of interventions for improving mental health of health professional students has not been established. This review analysed interventions to support mental health of health professional students and their effects. The full holdings of Medline, PsycINFO, EBM Reviews, Cinahl Plus, ERIC and EMBASE were searched until 15th April 2016. Inclusion criteria were randomised controlled trials of undergraduate and post graduate health professional students, group interventions to support mental health compared to alternative education, usual curriculum or no intervention; and post-intervention measurements for intervention and control participants of mindfulness, anxiety, depression, stress/distress or burnout. Studies were limited to English and short term effects. Studies were appraised using the PEDro scale. Data were synthesised using meta-analysis. Four comparisons were identified: psychoeducation or cognitive-behavioural interventions compared to alternative education, and mindfulness or relaxation compared to control conditions. Cognitive-behavioural interventions reduced anxiety (−0.26; −0.5 to −0.02), depression (−0.29; −0.52 to −0.05) and stress (0.37; −0.61 to −0.13). Mindfulness strategies reduced stress (−0.60; −0.97 to −0.22) but not anxiety (95% CI −0.21 to 0.18), depression (95% CI −0.36 to 0.03) or burnout (95% CI −0.36 to 0.10). Relaxation strategies reduced anxiety (SMD −0.80; 95% CI −1.03 to −0.58), depression (−0.49; −0.88 to −0.11) and stress (−0.34; −0.67 to −0.01). Method quality was generally poor. Evidence suggests that cognitive-behavioural, relaxation and mindfulness interventions may support health professional student mental health. Further high quality research is warranted.
"Tibetan medicine has come to represent multiple and sometimes conflicting agendas. On the one hand it must retain a sense of cultural authenticity and a connection to Tibetan Buddhism; on the other it must be proven efficacious and safe according to biomedical standards, often through clinical research. Recently, Tibetan medicine has found a place within the multibillion-dollar market for complementary, traditional, and herbal medicines as people around the world seek alternative paths to wellness. Healing Elements explores Tibetan medicine within diverse settings, from rural schools and clinics in the Nepal Himalaya to high-tech factories and state-supported colleges in the People's Republic of China. This multi-sited ethnography explores how Tibetan medicines circulate as commercial goods and gifts, as target therapies, and as panacea for biosocial ills. Through an exploration of efficacy - What does it mean to say Tibetan medicine "works"? - this book illustrates a bio-politics of traditional medicine in the twenty-first century. Healing Elements examines the ways traditional medicine interacts with biomedicine: from patient-healer relationships and the cultural meanings ascribed to affliction, to the wider circumstances in which practitioners are trained, healing occurs, and medicines are made, evaluated, and used. As such, it examines the meaningful, if contested, translations of science and healing that occur across distinct social ecologies"--Provided by publisher.
'Healing Elements' explores how Tibetan medicine circulates through diverse settings in Nepal, China, and beyond as commercial goods and gifts, and as target therapies and panacea for biophysical and psychosocial ills.
The article focuses on the study which aims to develop an informed consent process of Tibetan traditional medicine through a randomized placebo-controlled trial in Lhasa, China. The study reveals a process that enables the U.S. and Tibetan research team in meeting their ethical and logistical challenges, and examines the differences between the outcomes. Moreover, a step-by-step process on how participants would react to the research and informed consent process were presented.
This article explores the cultural epidemiology of rlung ("loong") disorder among Tibetans living in the cities and towns of the modern Chinese state of Tibet. Rlung, glossed as air or wind, is the most important of the three humors of the classical Tibetan ethnomedical system. Considered by Tibetans to be contingent upon multiple social, emotional, and religious phenomena, rlung disorders are fertile ground for the development of etiological discourses that incorporate the social and political crises that are part of the rapidly changing Tibetan plateau. In this essay I locate rlung disorder in a confluence of Tibetan ethnomedical constructions of the mind-body-universe linkage, in which rlung stands as the chief symbolic mediator, with ethnic conflict, rapid economic development, and the localization of global debates over Tibetan suffering and human rights.
Using data for 25,780 species categorized on the International Union for Conservation of Nature Red List, we present an assessment of the status of the world’s vertebrates. One-fifth of species are classified as Threatened, and we show that this figure is increasing: On average, 52 species of mammals, birds, and amphibians move one category closer to extinction each year. However, this overall pattern conceals the impact of conservation successes, and we show that the rate of deterioration would have been at least one-fifth again as much in the absence of these. Nonetheless, current conservation efforts remain insufficient to offset the main drivers of biodiversity loss in these groups: agricultural expansion, logging, overexploitation, and invasive alien species.Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
Though the threat of extinction is increasing, overall declines would have been worse in the absence of conservation.
Procedures of Informed Consent are considered a high priority for international biomedical research. However, informed consent protocols are not necessarily transferable across cultural, national or ethnic groups. Recent debates identify the need for balancing ethical universals with practical and local conditions and paying attention to questions of cultural competence when it comes to the Informed Consent process for clinical biomedical research. This article reports on the results of a two-year effort to establish a culturally appropriate Informed Consent process for biomedical research in the Tibet Autonomous Region in the People's Republic of China. A team of Tibetan and American researchers, physicians, health professionals and medical anthropologists conducted the research. The Informed Consent was specifically for undertaking a triple-blind, double placebo-controlled randomized clinical trial of a Tibetan medicine compared with Misoprostol for reducing postpartum blood loss. The findings suggest greater need for flexibility and cooperation in establishing Informed Consent protocols across cultures and nations.
Autism Spectrum Disorders are characterized by difficulties in communicating and cooperating with other people. Impairment in Theory of Mind (ToM), the ability to infer what another person is thinking, may contribute to these social deficits. The present study assesses the relationship between autistic traits and decision-making in a socioeconomic game environment that measures ToM and cooperation. We quantified participant strategy during game play with computer agents that simulated aspects of ToM or fixed strategy agents with static behaviors or heuristics. Individuals with higher Autism Quotient (AQ) scores cooperated less than subjects with low AQ scores with the ToM agents. In contrast, subjects with higher AQ scores cooperated more with fixed strategy agents. Additionally, subjects with higher AQ scores spent more time than low AQ subjects signaling cooperative intent in games with fixed strategy agents while spending less time signaling cooperation with adaptive agents, indicating a preference toward systemizing behaviors in the face of uncertainty. We conclude that individuals with high levels of autistic traits are less likely to utilize ToM as a cognitive strategy, even when it is beneficial, to achieve a desired outcome.
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