1. Introduction to Molecular Implications on Health Caused by Herbal and Traditional Medicine

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Oxygen can be a tricky and deceptive ally to have. There is a plethora of medical evidence that points towards the fact that oxidative stress can cause damage to your cells and tissues. Despite this, the free radicals that are created as a result of oxidative stress also occur during a normal metabolism and as a result contribute to variations in a human being’s health as well as to the inception of disease. Free radicals can be thought of as molecules with an odd number of electrons. The odd or unpaired electron is very reactive because it proactive searches to pair with another free electron. Free radicals are created when a human being’s metabolism is in an oxidative state and is producing energy. Free radicals contribute to things such as:

  • Enzyme-catalyzed reactions
  • Electron transport in mitochondria
  • Signal transduction and gene expression
  • Activation of nuclear transcription factors
  • Oxidative injury to molecules, cells and tissues
  • Antimicrobial action of neutrophils and macrophages
  • Aging and disease

Normal metabolisms need oxygen to function, which is a free radical itself. Scientists assume that due to evolution, oxygen was chosen as the terminal electron acceptor for respiration. Oxygen is biradical as two unpaired electrons of oxygen spin in the same direction, and therefore not as dangerous as some other free radicals. Other varieties of oxygen-derived free radicals including superoxide and hydroxyl radicals, that are generated during metabolism or via ionizing radiation are more powerful oxidants and as a result can be more dangerous.

On top of the studies conducted on the biological effects of these particular reactive oxygen variants, studies on reactive nitrogen variants has been gradually increasing over the years. NO, or nitrogen monoxide (nitric oxide), is a free radical created by NO synthase (NOS). This enzyme modulates physiological reactions such as vasodilation or producing signals in the brain. When the body is experiencing inflammation, on the other hand, NOS or iNOS synthesis is induced. The iNOS contributes to an overproduction in NO, which results in injury. Even of more concern is that excessive amounts of NO can react with superoxide to generate the highly toxic product peroxynitrite. Oxidation of lipids, proteins and DNA can happen, which contributes to a higher risk in tissue damage.

Reactive oxygen as well as nitrogen variants are contributors to the process of normal cell regulation where it’s imperative for signal transduction to function properly using oxidants and redox status. The signaling cascade contributing to inflammatory reactions are derived from oxidative stress being a critical upstream factor, through their stimulation of adhesion molecules and chemoattractant production. When hydrogen peroxide is broken down to generate hydroxyl radicals, the transcription factor for the simulation of inflammatory reactions, NF-kB, might also be mobilized. The excessive production of these responsive variants is poisonous, secreting cytostatic effects, resulting in membrane injuries, and mobilizing the pathways of cell death, which includes apoptosis and necrosis.

Research has shown that all diseases include the presence of some form of free radicals. The majority of these diseases have free radicals as a secondary cause in addition to the primary disease process, but for some diseases free radicals seem to be the primary cause. From this we can extrapolate the existence of a thin red line that divides the usefulness and impact on health and disease of oxidants and antioxidants. In order to guarantee some degree of a healthy aging experience, the balance between these must be maintained.

Oxidative stress as a medical terminology implies the antioxidant status of cells and tissues is changed by their contact with oxidants. As a result, the redox status is impacted by how much a cell’s components are in an oxidized state of being. Generally speaking, there is a reducing environment inside cells that act as a shield against the startup of the process of oxidative damage. Protein misfolding or aggregation is not allowed as the reducing environment contains disulfide bonds (S-S) that do not spontaneously generate as sulfhydryl groups are kept in a reduced state (SH). The reducing environment is sustained by the process of oxidative metabolism and by the activities of antioxidant enzymes and substances, among them glutathione, thioredoxin, vitamins E and C, and enzymes such as superoxide dismutase (SOD), catalase and the selenium-dependent glutathione and thierodoxin hydroperoxidases, whose purpose is to clear away reactive oxygen variants.

Alterations in the redox status and the decrease of antioxidants happen throughout oxidative stress. The thiol redox status can be an effective index to go by as it pertains to oxidative stress mostly due to the fact that metabolism and NADPH-dependent enzymes sustain cell glutathione (GSH) almost entirely in its reduced state of being. Oxidized glutathione, also known as glutathione disulfide or GSSG, collects under conditions of having been in contact with oxidants, and this alters the ratio of oxidized to reduced glutathione. An increase in this ratio points towards the presence of oxidative stress. A lot of tissues are comprised of hefty amounts of glutathione, 2-4 mM in erythrocytes or neural tissues and up to mM in hepatic tissues. Reactive variants of oxygen and nitrogen can be directly impacted by glutathione to decrease the levels of this substance, the cell’s foremost preventative antioxidant.

The current consensus among medical researchers is that the decrease of oxidative stress can contribute to improvements on a clinical level. Free radicals can be produced in excessive amounts, or the natural antioxidant system defenses can falter, initially commencing the process of oxidative status, and then eventually metamorphing into oxidative damage and illness. Two diseases that result from this oxidative stress are cancer and heart disease. Oxidation of low density lipoproteins in human beings is regarded as the first phase towards the progression and gradual development of atherosclerosis, which is the precursor to cardiovascular disease. Injury to the DNA as a result from oxidation jump starts the process of carcinogenesis.

Convincing support for the contribution of free radicals to the development of diseases is derived from epidemiological research that presents a strengthened antioxidant status is connected to a reduced risk of a number of diseases. Vitamin E leading to the stalling of the development of cardiovascular disease is one that comes to mind. An enhanced antioxidant status is also connected to a smaller risk of cataracts and cancer, and some recent studies indicate an inverse correlation between antioxidant status and the manifestation of rheumatoid arthritis and diabetes mellatus. Alas, the number of implications where antioxidants can be effective in the prevention and treatment of an illness is on the rise.

Oxidative stress nonetheless remains a secondary cause for most diseases instead of a primary cause. Some diseases that are primarily caused by oxidative stress include inflammatory bowel disease, retinal ischemia, cardiovascular disease and restenosis, AIDS, ARDS and neurodegenerative diseases such as a stroke, Parkinson’s disease and Alzheimer’s disease. These implications might provide evidence sufficient enough to suggest antioxidant treatment is feasible as there is a clear contribution of oxidative stress to oxidative damage in these diseases.

In these series of articles we will explore oxidative stress and it’s impact on the many illness that can be harmful to our organ systems by highlighting empirical evidence and medical benefits of applying this knowledge. These series of articles will also concentrate on crucial natural antioxidant enzymes and antioxidant substances that encompass vitamins A, E and C, flavonoids, polyphenols, carotenoids, lipoic acid, among other nutrients that can be found in various foods and drinks. Oxidative stress can be detrimental to the maintenance of human health. There is an increasing body of literature that presents evidence pointing in the direction of the conclusion that a balance between oxidants and antioxidants is required for the long term sustainability of human health and the prevention of pathological responses that lead to the development of illnesses. These series of articles is available for all to read but is primarily focused on informing researchers in biomedical sciences and clinicians. The fact that we can undoubtedly provide ourselves and our patients with the ability to age in a healthy and sustainable manner requires knowledge regarding how oxidants and antioxidants can positively or adversely affect biological systems.

3. Abnormal Behavior Throughout the Ages

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GRAY AREAS OF ABNORMALITY

For this thought experiment, we will need to determine whether or not these two students show signs of abnormality.

In the year between her 19th and 20th birthday, Donna, who is 5’8, dropped from 160 to 125 pounds.

The weight loss commenced when she had gotten sick with the flu and lost 15 pounds.

Her friends complimented her on her new physique and she gained the motivation to further decrease her weight. This included cutting her daily caloric intake to 1100, avoiding sugars and carbohydrates, and jogging several miles per day for exercise. There are times when she is so hungry that it takes a toll on her academic performance, as she could think about nothing else but eating. Despite this, she is extremely satisfied with her new physique and wants to keep it for as long as possible, so she is determined to eat as little as possible despite the overwhelming feeling of hunger. She feels also wouldn’t hurt to lose a few more pounds so she can fit into a smaller, cuter skirt she saw at the mall the other day.

Her twin brother Donald is what most people might consider to be an alcoholic. He drinks anywhere between 4-7 beers a day, and despite his excessive consumption of alcohol, does not feel drunk after it. Due to this, he might top off the night with a few shots of alcohol, especially on Saturday nights going out at a bar or nightclub.

He has received several citations for underage drinking, and proudly displays them on the wall in his dorm room as trophies. Donald’s grades are not up to their fullest potential and he does not take much interest in his classes. He also finds it difficult to complete assignments.

Are Donna and Donald’s behaviors abnormal to you? How would you assess their level of dysfunction, distress, deviance and danger for either of the twins?

QUESTIONS TO ASK ONESELF

  1. What do you think is the mental health continuum model?
  2. What is cultural relativism in your mind? What do you think are some advantages and disadvantages of using this approach to determining abnormality?
  3. How do you use the criteria of unusualness to determine levels of abnormality? What do you think are some advantages and disadvantages for this criterion?
  4. What do you think is the distress criteria for determining abnormality? What issues arise from it’s use, and how can it be effective in identifying and determining abnormal behaviors?
  5. What do you think is the mental illness criteria for determining abnormality? What issues arise from it’s use, and how can it be effective in identifying and determining abnormal behaviors?
  6. What are the four words that start with the letter D for determining abnormal behaviors?

Take what you know and thought about from the previous six questions and attempt to apply it to this scenario:

Chad has several arrests for sexual assault against a minor and had recently been convicted of throwing a bottle of water in the face of an elderly woman in an argument over a parking space. On his medical record are listed a number of diagnosis’s for mental health disorders, including attention deficit and hyperactivity disorder, conduct disorder and substance abuse issues. The judge at Chad’s last trial made the remark that Chad did not seem to care about the consequences of his own behavior nor the idea of going to jail. Which of the following criterion could be used to determine that Chad’s behavior is NOT abnormal?

A. Cultural Relativism

B. Unusualness

C. Distress

D. Mental Illness

1. Clinically Tested Herbal Treatments – History and Regulatory gfInsights in America

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In the United States of America, there are 4 regulatory classifications as it pertains to botanicals and herbs:

  1. Food
  2. Dietary Supplement
  3. Over the Counter Medication (OTC)
  4. Prescription Drug (Rx)

The DSHEA or the Dietary Supplement Health and Education Act of 1994 states that most herbs and botanical ingredients must be regulated as dietary supplements. We will go over how the DSHEA is used to regulate herbs and botanicals in the US, how they were subject to regulation and enforcement historically before the existence of the DSHEA, and how the DSHEA came into being to provide this regulatory framework. The DHSEA also goes on to encompass outlining regulatory requirements for either over the counter or prescription based drugs that contain botanical ingredients.

Food, medicine and clothing has often been derived from plants across all countries on the planet throughout their various life cycles. The estimation for the percentage of plants used in producing medicine ranges from 10 to 15 percent across 300,000 higher species. Yet only 1 percent of plants are used for the purposes of producing food or food related byproducts. In the early 1900’s and prior to that, plants were the primary means of medication in the United States. The majority of them were listed in the United States Pharmacopeia, and were prescribed by the doctors of the time. Concoctions made from herbal ingredients were the primary go to remedies of the times.

The Food and Drug Administration was handed the authority to regulate drug safety standards as well as enforce them in 1938, and this is the year that marked the official start of regulation of medicine in the United States. The Food, Drug and Cosmetic Act had accountability rest with the FDA in screening and enforcing possible unethical, criminal and unsafe practices using drugs, cosmetics and food, as well as the mislabeling of them for fraudulent purposes in addition to chemical modification using ingredients or formulas deemed to be unsafe or not provide the desired effect to a patient.

Botanical based treatments paved the way for the creation of stronger, more chemically synthesized drugs, as a result of demand during World War 2, especially in the area of antibiotics and medication used for treating trauma of all sorts. The federal government gave incentives to pharmaceutical companies traditionally known for their production of botanical ingredient based medications, to shift to more chemistry based drugs. These companies were Merck, Lily and Parke-Davis. Single-entity chemicals had proven themselves to have an increased consistency, were easier to measure and more specifically focused to achieving a certain effect while avoiding others than their herbal forefathers.

In 1951, the Durham-Humphrey Act was passed by Congress to outline a regulation in which any chemical based drug that would be too toxic in certain amounts or have serious adverse effects to the human body in certain quantities must be supervised and administered by an individual screened and licensed by a legal body that vests in him the authority to give out such a drug to the uneducated masses who would take that drug.

Drug manufacturers as a result were also forced to label their drugs as either Rx, which means prescription, or OTC, which means over the counter.

In 1962, the Food, Drug and Cosmetic Act was amended and additional clauses were added to include the testing and screening of drugs, so that advertisers could label them to be “proven safe and effective”. The FDA subsequently followed up with instructions regarding requirements for safety and efficacy testing to have a drug qualify for their approval. Approval became mandatory before marketing of the drug to the public for consumption. Older drugs that were being sold prior to these rules coming into effect were allowed to continue being sold and marketed as long as their ingredients and labels remained the same as before.

In 1972, the FDA commenced a thorough review of all over the counter medications to evaluate their safety and efficacy. Medications that were found to be mostly safe and effective (GRASE) were labeled a Category 1 and given the green light for marketing efforts. Ingredients found in previously issued OTC drugs that were deemed to be unsafe or ineffective were taken off the OTC list and labeled a Category 2 drug, and were no longer allowed to be sold as over the counter medication or forced it’s manufacturer to change the recipe so they did not use those ingredients if they wanted to sell the drug as OTC. If it was difficult to test safety and efficacy due to a lack of data regarding the ingredient to identify it’s effects more well, they were labeled Category 3.

Due to the lack of commercial sponsors willing to spend money on research into botanical ingredients, that were previously found in many over the counter medications, they were either moved into Category 2 as a precaution or in Category 3. Post 1972 the number of botanical ingredients still classified as drugs under the act had significantly diminished, producers of herbs had to market their products as a food supplement as opposed to a medication.

1. Herbs on the Net – Preface

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Nature, whose sweet rains fall on unjust and just alike, will have clefts in the rocks where I may hide, and secret valleys in whose silence I may weep undisturbed. She will hang the night with stars so that I may walk abroad in the darkness without stumbling, and send the wind over my footprints so that none may track me to my hurt: she will cleanse me in great waters, and with bitter herbs make me whole.

Oscar Wilde, De Profundis

One of the greatest changes in recent history when it comes to the medical profession is the rediscovering of a field of medicine and therapy known as “alternative medicine”. Both healthcare professionals in addition to for profit institutions like hospitals and pharmaceutical firms alike are dismayed at the resurgence of practices and medications that only a few decades ago were considered primitive, barbaric, ineffective, unscientific and even superstitious.

Acupuncture, homeopathy, traditional Chinese medicine and massage therapy are no longer considered relics of forgotten time but have instead started to gain the foothold they once had, pushing out many modern medicines and practice as the primary means of solving a medical problem. A controversial yet highly publicized practice among these is that of herbal medicine. The mainstream media as well as publishing mediums, both in print format as well as online, are consistently being filled with information regarding herbs like St. John’s wort or Ginkgo bilboa.

Where they were previously a niche to be found mostly in health food shops, herbal medicines and remedies are widely available in pharmacies as well as in abundance online. These herbal remedies are frequently consumed to assist with a wide range of ailments, from depression to erectile dysfunction, and frequently without the authorization or consultation of their family doctor.

After some deliberation and bouts of self denial, in the mid 1990’s physicians generally began to accept the popularity of herbal medicines. Health science libraries tend to possess an incredible amount of information compiled over the years, but it is nonetheless difficult to navigate. However, there is a compendium of knowledge that is often briefly summarized and easily accessible in modern times.

Databases, encyclopedias and search engines can help people find exactly what they’re looking for. Even when it pertains to prescription drugs and over the counter medication, those who know how to seek will be able to find what they’re looking for, both in scientific and technical detail as well as something understandable to the layman.

In the past, there have been several publications and books that served as a decent emporium for the classification and summarization of herbs and plants used for medicinal purposes. Among these are:

  • Martindale: The Extra Pharmacoepia
  • The Dispensatory of the United States of America

In the late 1990’s, there was an increase in frequency as well as volume of questions related to herbal medicine that were posted by patients to their physicians. The common textbook material often taught to physicians and used as a reference for modern medicine and chemical drugs did not contain sufficient enough information covering herbal remedies. An author by the name of Varro Tyler had two books that were often referred to by some physicians to their patients who needed advice in their field:

  • The Honest Herbal
  • Herbs of Choice

1. The Bladder as an Organ and it’s Functions

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Bladder – An organ that’s a sack and usually hollowed out that fills up with a liquid byproduct of the body’s processes called urine so it can be eventually released.

Pelvis – A bodily structure below the abdomen that is held in place by the hip bones.

Rectum – The end tip of the large intestines that communicates with the sigmoid colon above and the anus below.

Uterus – An organ in the reproductive system of females where the fetus is grown that is muscular and pelvic.

Urethra – The tube leading from the bladder through the oriface in the vagina in females and penis in males, which carries urine out to be discharged.

Prostate – A male reproductive system gland that is located below the bladder and envelops the urethra partially, and is also the canal that empties the bladder and produces a fluid that is partially the composition of semen.

The bladder is the sac where urine is gathered inside the body. One alternative medical terminology for the bladder is the word “vesical”, which has it’s roots in the Latin word “vesicular”. The pelvis is the location of the bladder. The sac of the bladder itself is soft and round. The rectum in men or uterus for women is located behind the bladder. Urine is collected into the bladder through an opening in each end of the bladder. Urine is kept inside the bladder until the person it belongs to feels the need to urinate. The urine is pushed out of the urethra when the muscles in the bladder walls squeeze the urine out. In women the urethra is short, about 1 inch. In men it’s significantly longer as it needs to pass through the prostate and then the penis in order to get to the tip of the penis where it widens and opens up.

The kidneys are located in the center of the abdomen, underneath the lower ribcage. The purpose of the kidneys is to act as a filtration system for the blood in order to convert some of it to urine. The urine produced by the kidneys then travels through the renal pelvis and into the ureters. The urethra are a tubular contraption that are soft to the touch and have a similar circumference to a pencil. The purpose of the urethra is to allow urine to flow from the kidneys into the base of the bladder, where they protrude and connect.

The capacity of the adult bladder is 400 ml of urine. The bladder wall consists of three layers: the urothelium is the interior layer that is touching the urine, the central layer is made up of muscle fibers that contract to squeeze urine out by upping the pressure on the inside of the bladder in order to get the urine to flow out, and the exterior layer is a thin, protective layer named the serosa that is meant to prevent the sac from bursting.

1. Herbal Remedies – An Introduction

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In spite of recent advancements in Western medicine, particularly ones involving chemicals and pharmaceutical drugs, there has been a resurgence in the medical field for the endorsement of herbal remedies as an alternative medicine for the treatment of various ailments. There has been a rise in the use of herbs such as garlic, coneflower and ginger as home remedies, in addition to an ever growing repertoire of over the counter herbal medicines and supplements that are now a common sight in supermarkets and pharmacies alike.

A growing list of hundreds of herbal supplements can be found in pharmacies and health food stores, ranging from arnica montana to withania somnifera, with additional thousands that can be bought online. At no other point in history is there such a detailed compendium of information available on herbal remedies, as well as their cultivation, availability and accessibility. Regardless of what they are used for, whether it’s for the prevention of disease, the maintenance of good health or the treatment of an existing ailment, will be effective in improving the health and verve of those who take them correctly and consistently.

Even though having a wide array of products to choose from, it can get disparaging to have to figure out which ones are right for you, as well as which combinations are safe. The problem with this abundance of different products still does not adequately inform the consumer as to their function – how would you know whether the elderflower is for period pains or for sinus congestion? In this case the elderflower or sambucus nigra is meant for periods, and the white peony or paeonia lactiflora is meant for sinus congestion.

Despite having this knowledge in terms of what herb is used to treat what bodily calamity, there are still pieces of the puzzle missing in order to get a proper picture to make an informed choice.

Questions such as: How can you ascertain that the herbal remedy will be effective? What preparation method should be used for the remedy – tablet, tea or tincture? Has it been studied and tested enough to be proven safe? What categories of people should be excluded from this medicine? How about pricing? How can we differentiate between an overpriced product and a regular priced product? Does more expensive actually mean better quality? How do we know? Is only one herb sufficient to carry out the task or do we need multiple in synchrony to be fully effective? Does it pose a risk if you combine it with other medications that you are on?

Even though it is impossible to go through all the factors in just a few hundred pages of information, these series of articles will attempt to compartmentalize and summarize the most fundamental knowledge that is needed to both know what is safe as well as what is effective for our purpose.

Where synthetic medication tends to be synthesized inside a laboratory, herbal medication is foraged from forests and fields worldwide. Their therapeutic abilities is the gorgeously divine connection between animals and plants on our planet. We will see sketches and photographs of various plants presented in this book, and their aesthetic beauty and gentle nature coupled with their otherworldly healing abilities will encourage environmental awareness and preservation efforts.

If in doubt, pharmacists and health food store workers can sometimes provide valuable information to consumers on choosing the right product for their needs, and one should never underestimate the knowledge they hold about herbal remedies.

1. Introduction to Medicine Used by African Americans During Slavery in Colonial America

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When a slave became sick, we received the best care we could be given from our own. The master let our old mammy doctor take care of us by giving us herbs she gathered in the woods, which included cami seeds, peach tree leaves, red oak bark, used for fever, chills and malaria, in addition to privet weed for tuberculosis, and things that the white doctor could not cure. But if we got an arm or a leg broken then master would still take us to the white doctor to get it fixed, but that was all he could do as our mammy did much better than the white doctor with her herbal teas. When she gave you a tea made from herbs you knew it would end up curing most of your ailments.John Mosley, born in Texas, in 1851

Academics have historically been able to determine certain points of intricate social relationships of those living under slavery by examining medical work and healthcare in those times, bringing them to a better understanding of that life. How a society practices medicine can offer a glimpse into relationships of an interpersonal and economic degree. In the United States in particular, these practices have been able to provide this data throughout all eras of the country’s existence. The difference in quality in medical care experienced by the white race historically in the United States as opposed to other races, in particular blacks during slavery, provides many insights into certain social, economic and cultural dynamics. Despite this breadth of information regarding the majority of society, historians have run into trouble attempting to get insights into the healthcare experiences of slaves. The reasons for this lack of information is due to inadequate keeping of medical records, the scarcity of data for this purpose in particular, and the general illiteracy rate at the time.

These series of articles attempt to examine the medical care provided to slaves by non-slaves as well as other slaves during the antebellum and Civil War era. Our focus will surround practices used by African Americans at the time, both free men and those who were enslaved, for the treatment of diseases and injuries, in particular alternative medicine and plant based, or herbal, medicine. Through the study of folk medical practices utilized by slaves at that time, in conjunction with the materia medica written about it, we can form some understanding of the complexity of human relationships during slavery.

1. Preface and Introduction to Herbal Medicine in Pregnancy and Lactation

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Pregnant women often take over the counter medication during their pregnancy. It is somewhat intriguing to know this happens as many pregnant women assume it’s a healthier alternative to prescription medication, which often undergo clinical studies to assess risk of teratogenicity. Media and advertising contribute to pregnant women not having a full understanding regarding the risk factors of natural health products and supplements. Studies have not thoroughly examined the rate of women that use natural health products and herbal supplements, but despite this, some studies have concluded that there might be up to 60 percent of pregnant women who take these types of supplements either during the pregnancy or during planning and preparation for a pregnancy. Pregnant women refer to natural remedies such as peppermint and ginger tea to alleviate symptoms of nausea and vomiting. One study in North Carolina involving midwives shows that half of the respondents recommended that their patients use some sort of herbal medicines for pregnancy related issues.

Regardless of the facts, one must keep in mind that almost half of all pregnancies are unplanned and having to take some sort of medication or being exposed to harmful chemicals is not unheard of during the first trimester of the pregnancy. Even though it’s commonplace that natural health products are used by pregnant women as well as lactating women, there are not enough clinical studies that can provide insight into how harmful these products can potentially be. Those who have done the research published monographs that list 1/3 of natural health food products on the market as having the potential to cause harmful effects during pregnancy and lactation. The problem with these findings is that how this information is assessed in order to come to the conclusion of being harmful – most of the findings derive their data from that of research into using herbs as abortifacients, which are substances that induce abortions, or uterine stimulants, as well as data of genotoxicity and teratogenicity from animals. Data for the effectiveness of these natural supplements also tends to be very limited in publications on this subject.

The data presented in these series of articles are among the few that will look at the insufficient level of research into natural health supplementation’s impact on pregnancy and lactation. Even though the herbs, supplements, and vitamins used by pregnant women in this list is not complete, it does list many of the commonly used ones at the time of this publication. Through meta-analysis of various studies used to compile these series of articles and the research within, the qualitative level of the evidence used for the studies has been thoroughly examined to determine the safety of various natural food supplements used by pregnant and lactating women. The newest research from medical literature should be inserted into those supplements making claims that include “use of this herbal product should occur only after careful assessment of the benefits and risks of this product”. Healthcare providers that are constantly catering to patients need a source that is reliable and easy to be accessed when it comes to the effects of natural products and supplements on pregnancy and lactation. It is our imperative that this text be utilized by healthcare professionals whenever possible to use as a reference for any pregnant patients who might pose questions as to the safety of natural health supplements during their state of being. In addition to this, as natural health supplements become increasingly popular, hopefully these texts will be useful and relevant to those who seek information.

Pregnancy and lactation are a basic part of the human experience and condition, providing nurture for thousands of years of human development and biological evolution. Despite being around for as long as humans have been birthed, it has been and still remains a painful and unpleasant experience for many women throughout this time. Ever since the earliest days of the caveman and tribal humans, it was commonplace to use plants and herbs found in the wild as a way to alleviate the aches and pains, and smooth the process that was pregnancy, the delivery of newborns and lactation. Despite the advancement of Western medicine and the standardization internationally to apply this style of medical science, herbs and natural health supplements are commonly used alongside Western medicine in many cultures. The next section, The History of Botanical Concoctions as an Aide to Pregnancy, Delivery and Lactation, will examine some historically used herbs during these processes, and will serve to provide references to their respective documented cases.

1. Introduction and History of Female Hormonal Variations and Menstrual Cycle Processes

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The fact that the period comes earlier in life nowadays, coupled together with an improved diet, not as many pregnancies and an extended life expectancy will mean that the average woman will experience more periods throughout her life than previous generations did. The “average” Australian woman is set to start menstruating at the age of 12 or 13, up until between the ages of 25 and 35, afterwards we can expect 2-3 pregnancies every two years, and breast feeding for 3 to 9 months after having each child. After this statistically possible routine, her period cycle will be regular on a monthly basis until she turns the age of 50, when she enters into menopause. Statistically, Australian women should have an average of about 360 to 400 periods throughout their lifetimes.

Historically, girls in Australia began to menstruate around the ages of 14-15 and often times this was the indicator that a girl had entered into fertility and thus was married shortly thereafter. The age at which girls gave birth to children was much earlier, and it was not unusual for a woman to have many children as long as she was not negatively impacted by sexually transmitted diseases, inadequate nutrition or poor health. It was also common for women to pass away during childbirth, so this would have been one obstacle to rearing more children. In addition to this, contraception was not as effective as it is in modern times, and the frequency with which women got pregnant was often determined by the period of their ability to breast feed and produce milk, as it was both ascertained that a woman should not engage in sexual activity while actively being able to breastfeed, as well as for the duration of the breast feeding cycle it was believed that the woman was less fertile.

Back then, it was scientific opinion that having sexual relations was to bring about the period, and having the period return was believed to be harmful to sustaining the baby, as the “white blood”, or the woman’s breast milk, was thought to be diverted from the breasts to the womb. During this era, it was common for women to be either pregnant or breastfeeding most of the time, as long as they were fertile, and only experienced 40 periods in total. The menstrual cycle and menstruation are both influenced by lifestyle, diet and stress, and can effect both how easy or difficult a cycle is, as well as how often it occurs. These things do not occur to us as obviously in modern times as they would have in the early 1900’s, for example, as in modernity we are accustomed to using painkillers for relief, together with birth control tablets, to ease the symptoms of the menstrual cycle.

As we continue on with new developments in medicine, we are beginning to increasingly and in greater depth understand the menstrual cycle and it’s dependence on both nutrition as well as nurture in a harmonious environment. Many women would rather use some alternative or herbal medicine, or homeopathic treatment or home remedy to deal with the symptoms and pain of their menstrual cycle, over medication like painkillers and other chemicals. Other than that, there are alternatives for women who would rather grow their medicine in the garden, taking a more natural approach to alleviating their menstrual pains, or change something about their lifestyle that will help bring harmony to their menstrual cycles. There are a variety of surgical, medical and herbal treatments in relations to menstrual issues. No treatment or another should be misconstrued as being more adequate in it’s menstrual healing capacity than another. The fact that the number of periods the average woman will live through has increased by ten times will automatically generate the chance for new issues to arise. Despite this, over time we have learned what works help alleviate these symptoms and distract from the suffering caused by the menstrual cycle.

Guidelines for Establishing a Workflow for Nurses

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Healthcare delivery systems are undergoing constant change and reform due to an ever increasingly aging populace combined with the results of this aging populace: more debilitating diseases in conjunction with healthcare needs that are increasingly of greater complexity. The fact that people tend to move around a lot more often in modern times gives weight to the fact it is increasingly difficult to find healthcare workers such as live in nurses, at home visits and with personal support workers. In the mean time, how medicine as a field is being approached and practiced has also begun to shift vastly, as there are technological and pharmacological developments in conjunction with lesser time for patients being admitted into hospitals, where they are discharged a lot faster than they previously were before in order to do tests that were previously done while the patient was still hospitalized, now are being done on separate times, requiring the patient to commute back to the hospital for these assessments. Patients are also being increasingly pressed by healthcare providers to follow healthcare regimens at home, to execute them and evaluate themselves, without the assistance of a healthcare delivery professional.