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Eggleston Memorial Fund An of Medicine alumni established the Class of endowed fund established in 1989 by family quality bisoprolol 10mg hypertension heart rate, 1980 Scholarship Fund in 1995 to provide friends and colleagues of Dr effective 10 mg bisoprolol blood pressure stroke range. The income is to provide scholarship was created by members of the Class of 1983 assistance to needy medical students in the upon their 15th Reunion to provide assis- School of Medicine trusted bisoprolol 5mg blood pressure quiz. Robert Biggs Ehrman Scholarship Fund Class of 1986 Scholarship Fund Endowed Established in 1970 at the death of Mr order 10 mg bisoprolol visa heart attack 51. Engle Endowed Scholarship Fund Established previously served as his class representative. Sharon Fox Scholarship Fund in Memory Jean Epstein Memorial Fund This endow- of Henrietta B. The income from this income from which is to be used for student fund provides a scholarship to deserving aid in the School of Medicine. Ettinger Scholarship Fund lished as a bequest from the estate of Sallye Established by Mrs. Ettinger to provide schol- Lipscomb French as a memorial to her hus- arship assistance for students in the School band, Bernard S. Scholarship ship Fund This fund is in memory of Larry Established in 2000 by a gift from Dr. Scholar- arship Fund This fund was established in ship Fund This fund was established in 1999 1998 by Stuart L. Finesilver Memorial Schol- arship Fund This fund was established in arship Fund This fund was established in 1996 by Dr. Frances Blumenthal in memory vide scholarship support to students in the of her father, an alumnus of the Class of 1924. Firor Fund An endowed schol- able candidate applying for admission to the arship established in 1989 by the estate of Johns Hopkins University School of Medi- Mrs. Abraham Genecin Memorial Fischer Family Scholarship for Medical Fund This fund was established in 1999 by Education This scholarship fund recognizes Mrs. Rita Genecin and other donors to pro- the Hopkins family legacy of Janet Fischer, vide assistance to needy medical students. Givens to provide Fonkalsrud Endowed Scholarship Fund scholarships for students in the School of This fund was established in 2002 by Eric W. The couple has a life-long Emil Goetsch Fund for Medical Students affliation with the Johns Hopkins School of The income from this endowment, estab- Medicine. Fonkalsrud served on the fac- lished in 1963, is used for scholarships for ulty in the School of Medicine’s Department medical students. Preference in award of the scholarship is 1975) leadership at the Wilmer Eye Institute. Income from this fund will be used to provide Louis Hamman Memorial Scholarship assistance to deserving medical students. This is an endowed scholarship in memory David Goldfarb Family Endowment Estab- of the late Dr. The income is avail- Established in 1986 as a bequest from the able for a scholarship for a medical student estate of Lillian Ruth Goldman to provide whose fnancial need and developmental scholarship assistance to needy and deserv- promise justify such an award. Gordon for Medical Education This fund was Memorial Fund The fund was established in established in 1999 by Dr. It is to be used for the education of medical students be awarded to female students interested in specializing in the study of arthritic diseases, surgery. Hartsock Memorial Scholar- Scholarship Fund in Memory of Leonard ship Fund This scholarship was established L. Hartsock, an endowment, with income to be allocated Class of 1920, by members of his family and to aid deserving students in the School of friends to provide aid to needy and worthy Medicine. Gross Scholar- Morrison Leroy Haviland Scholarship Fund ship Fund This fund was established in 2002 Established in 1988 by Dr. Gross were well known for their honor of their father, Morrison Leroy Havi- care and compassion for others. This income is to be used for needy Fund provides fnancially needy students the medical students. Hayes to provide Education Established in 2000 by George scholarship assistance to needy medical W. Guynn Memorial in the School of Medicine who have demon- Scholarship Fund Established in 1995 by Dr. Guynn, the income from this fund John Helfman Scholarship Fund Estab- will be used to provide scholarship assis- lished as a bequest from the estate of John tance to needy medical students. Hicks Medical Research Schol- the Myers Family of Baltimore to recognize arship Fund A fund was established in 1972 the competence and compassion with which to be used for scholarships for students who Dr. Memorial Scholar- fund provides a scholarship to a third year ship in Medical Education This endowment medical student who intends to specialize in fund was established in 2002 by Panameri- internal medicine. Rowena Sidbury Hall, Class of 1943 (Febru- Preference is given to students from either ary), of Silver Spring, Maryland. She served Florida or Maryland who wish to specialize in as a member of the faculty in the School of the feld of cardiology. Hoelzer (d ‘02) to be used for Each year the Association designates for scholarships for students who would not be honor distinguished former members of the able to attend Johns Hopkins Medical School Johns Hopkins medical community. Morris Joseph has created a scholarship Memorial Scholarship Fund Established in fund to defray the cost of a room in Reed Hall 1992 by Dr. Kennedy’s 50th Class scholarship aid to needy medical students in Reunion, this fund was established in 1993 to the School of Medicine. Irene Sluckis to provide scholarship Koteen upon his eightieth birthday by his assistance in the School of Medicine. The income is to be used for scholar- Waddie Pennington Jackson Scholarship ship aid to fnancially needy students in the Fund This scholarship fund was established School of Medicine. Kress Scholarship Fund Estab- in memory of his wife, Bessie Gills Jackson, lished in 1987 by a bequest from the estate of income from which is to provide scholarship Milton Kress. The income from this endowed support for needy students in the School of gift is to be used as scholarships for needy Medicine. The stu- Edwin Bosley and Dorothy Duncan Jar- dents and amounts of each scholarship is rett Memorial Fund for Medical Scholar- to be selected by the Dean of the School of ships Established in 1977 by a gift from Mr. This fund honors ship monies will be made available to fnan- their children, Andrew J. Nancy Jenison Scholarship Fund izes their parents, Alan and Caroline Laster Through a generous bequest from Dr. Blanche Jenison, a member of the Class of Andrew and Steven Laster served as mem- 1911, a scholarship fund was established bers of the Johns Hopkins Hospital staff in in 1963 to provide fnancial assistance for the Department of Medicine. Maurice Lenarsky Scholarship Fund Board of the Johns Hopkins Hospital makes This fund was established in 1991 by Jane an annual contribution to the School of Lenarsky in honor of her father Dr.
Following this translation order bisoprolol 5mg without prescription heart attack remix dj samuel, Rowe began work with his own patients on their allergies purchase bisoprolol 10mg amex heart attack jaw pain. It was Rowe who first used systematic skin injections of allergens to produce reactions bisoprolol 10mg online blood pressure medication and ed. He found such tests bisoprolol 5mg discount hypertension quiz questions, however, to be ultimately unreliable and began to work on elimination diets. Rowe was still practising in the early nineteen sixties in California, where he introduced a new generation of students and doctors from Europe and America to clinical ecology. Dr Arthur Coca, a Professor at Cornell in the 1930s, was a founder of the Journal of Immunology. Many of these produced no outward signs, but did speed up the pulse, making the sufferer feel slightly unwell. In one of his books, he complained: The reason for it [the skepticism] is that the medical profession is again faced with scientific findings and their consequences that are so far out of line with settled concepts as apparently 11 to represent the impossible. In the late thirties, Dr Herbert Rinkel, then practising as an allergist, himself had a severe allergic response. For years previously Dr Rinkel had suffered from recurrent fatigues, headaches and a distressing runny nose. Some years later, still suffering from chronic health problems, Rinkel decided to eliminate eggs completely from his diet. But on his sixth eggless day, his birthday, he took a bite of angel-food cake, containing egg, and crashed to the floor in a dead faint. The experience led Rinkel to understand that some patients who showed symptoms of allergy might be ingesting a number of foods regularly and not know that they were causing an allergic response. After taking case histories of his apparently healthy students and nursing staff at the Northwestern University near Chicago, he came to the conclusion that two thirds of them had a history of food allergy. Randolph began to think that food allergy was also involved in alcoholism, and different forms of mental illness. It was the careful detective work of Randolph which gave clinical ecologists their first real understanding of the fact that many chemicals, other than those occurring in foods, could cause illness akin to allergy. One conclusion reached before the Second World War about allergic responses was that they were person-specific. For this reason, it has always been easy for orthodox practitioners to suggest that such individually experienced symptoms do not have a scientifically measurable organic base. Over the last twenty years, a major schism has developed between those doctors who are willing to accept only food intolerance as a classic cause of allergy, and those who have developed the work of the early clinical ecologists. This discomfort passes when the antigen has left the body and the cells have stopped breaking down. Clinical ecologists, however, are convinced that many chemical antigens, though they may cause a primary allergic response, are not dispelled from the body but stay as continual irritants to the immune system, often lodged in fatty tissue. The illnesses which are consequent upon this toxic storage and the toll which it takes on the immune system, can be long-term. They also believe that once a person is sensitised to a substance, future exposure can lead to dangerous and debilitating illness. Clinical Ecology and Chemicals The decades which followed the Second World War brought a new consciousness about the environmental causes of illness. Following the Second World War there was almost constant weapons testing which involved the releasing of radioactive matter into the atmosphere. The nineteen fifties and sixties were decades of anxiety, when minds were continually preocupied with the effects of strontium 90 and atomic fall-out. This concentration led to a greater public education about the nature of the food chain than has probably occurred before or since. Strontium 90, released through nuclear explosions into the air, comes to earth in rain or drifts down as fallout, lodges in soil, enters into the grass or corn or wheat grown there, and in time, 12 takes up its abode in the bones of a human being, there to remain until death. By the early sixties there existed serious concern about the effect upon foods from chemicals which were either used in their cultivation or production. The substances which were common in these preparations were lime and copper sulphate, lead arsenate, mercury and arsenic. The development and manufacture of nerve gases, which paralysed the nervous system, which began in earnest after the First World War, had immediate consequences for agriculture. Following the Second World War, the main ingredients in nerve gases, organophosphorous compounds, were used as pesticides. They had certain advantages over chlorinated hydrocarbons, one being that they degraded more quickly. Production of synthetic pesticides in America after the Second World War went from 124,259,000 pounds in 1947 to 637,666,000 pounds in 14 1960. From the very beginning of the use of these substances, illnesses were recorded in direct relation to their use. Awareness of the unhealthy effects of pesticides was felt first in those countries which had developed intensive farming techniques, such as America, Canada, Australia and New Zealand. The initial use of pesticides in the fifties and sixties killed thousands of birds, wild animals and insects. In her book The Silent Spring, published in 1962, Rachel Carson quotes extensively from patients who became severely ill as a consequence of exposure to pesticides and insecticides. She sprayed the entire basement thoroughly, under the stairs, in the fruit cupboards and in all the protected areas around ceiling and nausea and extreme anxiety and nervousness. Within the next few days she felt better, however, and apparently not suspecting the cause of her difficulties, she repeated the entire process in September, running through two more cycles of spraying, falling ill, recovering temporarily, spraying again. After the third use of the aerosol new symptoms developed: fever, pain in the joints and general malaise, acute phlebitis in one leg. Their toxicity was first noted in 1919 and it was estimated that by 1939 six human deaths had occurred as a result of industrial operations with 17 these chemicals. Certain organophosphates will be commonly found in grain and therefore in animal feedstuff and bread. The most prevalent of these auxin herbicides are 2,4,5-T and 2,4-D; the former contains dioxin, an impurity produced during the manufacturing process. Perhaps most importantly, little longitudinal research has been done into the accumulated storage levels of a multiplicity of such toxic substances in the human body. Generally, animal welfare means keeping animals in good short-term condition before they are slaughtered. Most animals reared for meat are nowadays perfunctorily given regular doses of antibiotics, the residues of which are passed on to the consumers. Cattle and sheep are sprayed continuously with chemicals to keep them sterile and free from smaller insects and bacteria. Whatever the cumulative effect upon the inner biology of the animals, the workers who have to douse them are prone to chronic illnesses.
Markers of possibility are found in utterances like: “All of the symptoms you have could be a migraine”; markers of certainty can be found in expressions such as: “I’d definitely suggest […]” buy bisoprolol 5mg mastercard high blood pressure medication z. The results indicate that users offer suggestions that are drawn from mental processes and general knowledge cheap bisoprolol 10mg free shipping heart attack or heartburn, as in the following examples: (8) I actually read once that B vitamins should be taken as a balanced thing quality 10 mg bisoprolol blood pressure chart age 70, so if you’re taking one cheap bisoprolol 10 mg otc blood pressure chart resting, you could balance it by taking a B-complex with it, so you get some of each. Credibility and Responsibility in User-generated Health Posts 205 (9) I assume there is a trigger in your food or combinations of food that combined with body rhythms trigger the migraines. In some (rare) occasions, in fact, the members report information obtained by their own doctors for other users’ specific health problem: (10) User1: I’ve read somewhere that the hormones in birth control pills mimic early pregnancy hormones. He said that multiple studies show that while natural menopause can make migraines either better or worse (just like estrogen-containing birth control) surgical menopause in 99% of the cases makes migraines much, much worse. As suggested by Fitneva (2001), cognitive resources cannot provide a solid certain background, so users tend towards a dimension based on possibility and probability. Use of health forums and negotiation of trust Health forums are a particularly intriguing space to consider with regard to information and source credibility, for several reasons. Although net users may be comfortable with technology and good at using it, they may lack the tools and abilities needed to effectively evaluate medical information. Such strategies are ‘analytic’ (people analyse information carefully), ‘heuristic’ (they use a more intuitive approach), or ‘social’ (they ask their social circle for advice). This section presents the findings of a small-scale survey of people in Italy aged 18-33 examining young adults’ beliefs about the credibility of information available on Italian health forums, and the reason why they choose to evaluate information as credible. Findings for the second research Credibility and Responsibility in User-generated Health Posts 207 question indicate that 75% of respondents use health forums but, among them, only 14. When asked why they do not trust information they find on health fo- rums, 75% of young adults reported doubts about the source of the in- formation (Table 3). In other words, as the analysis of these posts shows, the authorial presence is expressed only for support and is limited when expressing certainty and authority. Mental processes and general background knowledge, as well as mediated data, do not constitute a solid certain background on which the information may be expressed. To validate this, when people were asked why they do not trust information they find on health forums, 75% of young adults reported doubts about the source of the information. Final considerations The Internet offers confidential and convenient access to an unprece- dented level of information about a diverse range of subjects, and over time it has increased its perceived credibility. However, analysis of web pages raises significant questions about the relevance, coverage, and legitimacy of a lot of Internet health information (Rice/ Katz 2001: 31). Although content providers are expected to take steps to help control the most extreme content (Williams/Calow/Lee 2011), user agreements in the form of ‘terms of use’ are treated as membership contracts and in fact only protect one side’s rights, without assuming any responsibility for the content, for which the Credibility and Responsibility in User-generated Health Posts 209 users assume all the risk (Sözeri 2013). In healthcare environments, there is also concern that anonymity makes people likely to engage in antisocial behaviour and may promote misinformation and advice that runs contrary to clinical research. As suggested by Metzger and Flanagin (2013), the vast amount of information available online makes the origin of information, its quality, and its veracity less clear than ever before, shifting the burden on individual users to assess the credibility of information. In a time continuum that goes from temporary to permanent, in- formation is positioned on the temporary side, whereas knowledge is situated on the verge of permanent. On the other hand, research has shown that the degree to which adults believe information they find online varies according to the type or topic of information which they are searching for, and that assessments of credibility are related to the context in which the information is found (Flanagin/Metzger 2007; Hargittai et al. For example, people are less likely to find commercial information or information from special interest groups to be credible, probably because they recognize that these sources have a strong potential for 210 Marianna Lya Zummo bias (Flanagin/Metzger 2007). Research indicates that as people engage more, and more deeply, with the Internet, they may develop a healthy scepticism toward the believability of online information (Metzger/Flanagin 2013). In addition, Internet users know how to differentiate between the types of people they encounter online, even though those people are represented online by text (Lea/Spears 1992; Walther/Jang 2012). According to Fage-Butler and Nisbeth Jensen (2013), many posts have disclaimers, which underline that the advice given should not be deemed to be expert, and recommend that website users “see a qualified doctor before acting on any of the information on the forum” (2013: 27). Although previous studies show that the reader will change behaviour according to what is suggested online, it seems that a negotiation of trust is at play. In fact, a small-scale survey of Italian people aged 18-33 shows young adults’ beliefs about the credibility of information available on Italian health forums and the reason why they choose to evaluate information as credible. Patients Looking for Information on the Internet and Seeking Teleadvice: Motivation, Expectations, and Misconceptions as Expressed in E-mails Sent to Physicians. Ethical Challenges for User-Generated Content Publishing: Comparing Public Service Media and Commercial Credibility and Responsibility in User-generated Health Posts 215 Media. Introduction In the past two decades, the United States has experienced a rapid growth in the Hispanic population – increasing 233% since 1980 to reach a total of 37 million Spanish-speakers by 2012. A logical effect of this increase in population has been an increase in the use of Spanish in every service industry, of which health and human services is no exception. However, despite the significant diversity found inherent to this incoming population – which represents various countries, regions and backgrounds – many of the medical Spanish courses treat these immi- grants as a homogeneous group. Indeed, oftentimes in these courses, and in much of the learning and reference materials, the colloquial re- gister, which is not only the most common language register but also the one that takes into account this diversity, is absent. In contrast to the abundant information available on both standard and technical Spanish in the medical setting, it is quite difficult to find any materials that include or describe Latin American dialect variants. In this chapter, the variants that arise in the clinic setting and the impact that these can have on doctor-patient communication will 218 Ashley Bennink be described. Then, the communicative competence necessary to converse effectively in the medical interview given the appearance of these terms will be outlined along with a discussion of the challenges that they present to the attainment of this quality communication. However, it should be noted that the intention in this chapter is not to offer solutions to these problems but instead to create awareness around the issue of Spanish lexical variants in the United States medical setting. Spanish lexical variants in the United States medical setting In 2013, a preliminary study was conducted by Bennink (2013a) to research the presence and frequency of Spanish lexical variants in the medical setting in southeastern United States. The study was inspired, on one side, by her previous work with Latinos and with other bilingual professionals in healthcare clinics within that region and, on the other, by the fact that, prior to that study, there were no lists of frequent variants in the field of health and wellness. With the goal of starting to fill that gap, questionnaires were sent to clinics and medical interpreter organizations in order to collect data on which variants were encountered and at what frequency. It should be noted that in that study the denomination lexical variant was used to refer to words or phrases used by patients that were neither the technical term nor the ‘standard’. The responses received not only confirmed the extent to which lexical variants are employed in the healthcare setting, recovering a list of around 242 distinct variants, but also demonstrated a surprising diversity in terms of origin. The variants recorded in the survey by respondents as ‘lexical variants’ included ones with origins in other languages, including indigenous languages – such as cuate from the Nahua cóatl, meaning ‘twin’ – or the English language – for example, raite to mean ‘a ride as a form of transportation and rifill to mean a Dialect Variation and its Consequences on In-Clinic Communication 219 ‘medication refill’. However, it should be noted that most diatopic variants were found to be from Mexico, with high numbers also from El Salvador, Guatemala and parts of South America (Colombia and Peru). This concentration of variants from a handful of countries seems to reflect the composition of the non-English speaking Latino population in that region, which seems to logically imply that the variants most frequently employed are determined, in part, by the most common countries of origin for the Hispanic population in that region, leading us to hypothesize that care should be taken in generalizing these results to other sectors of the United States. Impact on care Given the presence and diversity of these variants in the clinic setting, the question is then raised as to if they have any impact on care. In early 2014, I met with groups of Spanish for healthcare professors, Spanish-speaking medical professionals and medical interpreters while conducting part of a larger study.
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There are at least two approaches that might do so Genes may be regarded as nodes in a network purchase 5 mg bisoprolol overnight delivery blood pressure and pregnancy, with – one a great deal less obvious than the other – inputs being proteins such as transcription factors discount bisoprolol 10mg visa arteria peronea magna, involving nutritional (biochemical) and structural and outputs being the level of gene expression buy bisoprolol 10mg cheap blood pressure 6080. Masi (2000) has presented an integrative physiopatho- genetic perspective of hormonal and immunological Hard wired? This model buy cheap bisoprolol 10 mg on line heart attack 36, which reso- modification as follows (Bland 1999, Martin 2001): 48 Naturopathic Physical Medicine Functional genomics derived out of the human genome cell is located have been shown unequivocally to project, in which it was thought that by dissecting the modify its ability to process nutrients normally, or to code of life in our 23 pairs of chromosomes people express itself genetically (Ingber 2003). This has pro- would be able to understand how they were going to found implications for physical medicine in general, die. They would see locked in their genes heart disease, and for naturopathic physical medicine in particular. Ingber (2003) reports: day, and what disease, they would finally fall prey Clinicians have come to recognize the importance of to. Exploration egg, were these strengths and weaknesses that we of basic physiological mechanisms, such as sound call the recessive and dominant characteristics of sensation, motion recognition and gravity detection, inheritance that we could not get out from under. If we had the genes for heart disease we for manipulating and probing individual molecules would die of heart disease. It turns out that the human and cells has revealed the importance of the physical genome project has discovered that the genes that we nature of the biochemical world. Within our genes are multiple motors (Mehta et al 1999); cells exert tractional forces messages, and the message that is expressed at any on micro-particles greater than those that can be moment – that’s in our phenotype – is a consequence applied by optical tweezers (Schmidt et al 1993); and of the environmental messages including diet, lifestyle, behaviours required for developmental control, environment, that wash over our genes to give rise to including growth, differentiation, polarity, motility, different expression paths of the genes. How we change chemical activities inside the cell and control exercise, how we work, what our stress patterns are. The answer, says Ingber, lies in Research by Ames et al (2002) has now shown that molecular biophysics and to a large extent in the these concepts are indeed accurate, and that gene tensegrity format on which cellular architecture is expression can often be dramatically modified by based (Chen & Ingber 1999, Ingber 1991, 1997, 1999). Ames and colleagues have listed It seems that when a distending force is applied to more than 50 genetic diseases, successfully treated cell surface adhesion receptors, the mechanical load is with high doses of vitamins and other nutrients, most transferred to linked cytoskeletal elements that form of them rare inborn metabolic diseases due to defec- the tensegrity framework of the cell. If the cytoskeletal filaments and associated regula- tory molecules distort, without breaking, then some Modifying gene expression or all of the molecules that make up these structures effectively change shape, and when the shape of a mol- biomechanically ecule is altered, its biophysical properties change. The But there exists another – possibly surprising to some resulting changes affect intracellular biochemistry by – factor that can modify gene expression: the state of altering thermodynamic parameters locally in living structural adaptation of the cells themselves. These structural adaptations can be seen to influ- Ingber (2000) explains further: ence, and indeed determine, the way cells express themselves genetically. Put at its simplest, structural In contrast to existing paradigms that look for modification to cell shape, warping or distortion of explanations in terms of specific soluble and insoluble the cytoskeleton, and the environment in which the factors and linear signaling pathways, the functional Chapter 2 • Adaptation and the Evolution of Disease and Dysfunction 49 state of the cell appears to ‘self-organize’ as a result of derives from the processes of structural compensation the architecture and dynamics of its underlying and adaptation that occur in response to aging, envi- regulatory network. Here manipulation) should enhance metabolic function, we see a picture of complex structural adaptations health and gene expression (Ingber 2003). Pulling of collagen and/or elastic What seems clear is that given a structurally modified fibers and deformation of extracellular matrix during context (tissues that are, for example, fibrotic, contracted, needle manipulation may have powerful and long- distorted, hypertonic or even in spasm), the best nutrition in lasting effects on local cells, including synthesis and the world would have difficulty being utilized adequately. Such changes in this clearly places structural normalization at the fore- matrix composition in turn potentially can modulate front of naturopathic therapeutic requirements. The results of this research highlight the potentially Structure and function: the important role of interstitial connective tissue in adaptation cycle neuromodulation: Leaving aside the obvious link between structure and Subcutaneous connective tissue forms a continuous function on the musculoskeletal (muscle, joint, back tissue plane throughout the body. These connective that emerge from a background of adaptation and tissue planes also constitute the ‘milieu’ surrounding compensation. Techniques expression as suggested by Ingber’s (1993) studies – such as acupuncture may act not simply via neural 50 Naturopathic Physical Medicine Langevin’s more recent research (Langevin et al Box 2. In 1991, Ruff described how the colder the climate, Cytoskeleton-dependent changes in cell shape are well- the wider the body structure appeared to be. He established factors regulating a wide range of cellular explained that: functions including signal transduction, gene expression and matrix adhesion. Although the The very broad pelvis of small early hominids has importance of mechanical forces on cell shape and previously been interpreted in obstetrical and function is well established in cultured cells, very little biomechanical terms. However, neither of these is known about these effects in whole tissues or in considerations can explain the subsequent vivo. In this study we have used ex vivo and in vivo decrease in maximum pelvic breadth relative to models to investigate the effect of tissue stretch on stature in larger more recent hominids. Tissue absolute body breadth should remain constant despite differences in body height. Variation among stretch in vivo for 30 minutes had effects that modern humans supports the prediction: paralleled those ex vivo. In fibroblasts to changes in tissue length have important contrast, populations living in colder climates have implications for our understanding of normal absolutely wider bodies, and thus lower surface movement and posture, as well as therapies using area/body mass, regardless of stature. Additionally, Stock (2004) has demonstrated that the • Cell behavior – including metabolic functions, relative strength of distal limb bones, such as the tibia, handling of nutrients, gene expression and shows a stronger correlation with habitual activity even cell death – is ‘shape dependent’, patterns than does the relative strength of proximal powerfully influenced by structural changes limb bones, such as the femur, which shows a (resulting from the adaptational effects of the stronger correlation with climate. More recently, Ruff et al (2006) pointed out that • Amongst its many other functions, connective another way to explain these same features is that the tissue acts as an important signaling structure of proximal limb bones is influenced by body mechanism with body-wide influences, the shape, which itself is in large part determined by efficiency of which is also ‘shape dependent’, adaptation to climatic demands (Ruff 1994). In being positively affected by methods such as contrast, it seems that the structure of distal limb acupuncture needling and manual methods. Stating the obvious At first glance the naturopathic concepts as outlined in this chapter – of attention to cause, doing no harm, stimulation, but also by producing changes in the encouraging self-regulation, etc. These connective tissue changes may be sense, and to possibly be indistinguishable from the long lasting, which may explain claims that primary beliefs and practices of many other health acupuncture can have prolonged effects. Chapter 2 • Adaptation and the Evolution of Disease and Dysfunction 51 However, on closer examination, differences should Beal M 1983 Palpatory testing of somatic dysfunction become apparent, most notably the incorporation into in patients with cardiovascular disease. Journal of clinical reasoning of all of these features, overlaid onto the American Osteopathic Association 82(11): a perspective that observes whatever symptoms are 73–82 evident to be part of ongoing (often adaptational) Beal M 1985 Viscerosomatic reflexes review. Journal processes, rather than seeing them as stand-alone of the American Osteopathic Association 85:786– entities. Pain cal therapy, massage and other ‘bodywork and 65:259–264 movement therapy’ settings conforms to many of these naturopathic principles – but as will become Bennet C 1952 Physics. Barnes & Noble, New York clear in discussions in later chapters, by no means Berczi I 1986 Immunoregulation by pituitary hormones. Analgesic Neuroimmunomodulation 1:201–216 and anti-inflammatory medication – while useful in extreme conditions – hardly deals with cause or Berczi I 2005 Stress and disease: the contributions of encourages self-regulation. Department of In the next chapter an historical overview of naturo- Immunology, Faculty of Medicine, University of pathic physical medicine is presented to allow the Manitoba, Winnipeg context out of which modern naturopathic physical Berczi I, Nagy E 1991 Effects of hypophysectomy medicine has emerged to be better understood. Academic Press, San Diego Berczi I, Nagy E 1994 Neurohormonal control of References cytokines during injury. Cambridge Ames B, Elson-Schwab I, Silver E 2002 High-dose University Press, Cambridge vitamin therapy stimulates variant enzymes with decreased coenzyme binding affinity Bevan S 1999 Nociceptive peripheral neurones: cellular (increased Km): relevance to genetic disease and properties. Keats Publishing, Andrews J, Harrelson G, Wilk K 1998 Physical Los Angeles, p 116–118 rehabilitation of the injured athlete, 2nd edn. In: Chaitow L concentration and glutathione metabolism in (ed) Positional release techniques, 3rd edn. Journal of Rheumatology 24:941–944 back pain: a questionnaire measuring the daily use and loading of the spine. Journal of Manipulative and Chaitow L 2003a Fibromyalgia syndrome: a Physiological Therapeutics 26(4):226–232 practitioner’s guide to treatment.
These diseases can have a considerable to severe impact on the 38 overall quality of life generic bisoprolol 5 mg on-line heart attack cafe chicago. If the 48 treatment results are unsatisfactory proven bisoprolol 10mg blood pressure natural remedies, more potent preparations can be 49 50 9 purchase 10mg bisoprolol visa hypertension 33 weeks pregnant. Standardized ginkgo biloba leaf extracts 11 can be used when a nootropic preparation is desired buy bisoprolol 5mg fast delivery prehypertension examples. The bitter taste 18 stimulates specific taste buds of the tongue and, through them, a 19 number of reflexes that increase the secretion of saliva and gastric juic- 20 es. This, in turn, increases the secretion of enzymes and digestive juices, 21 improves the utilization of nutrients, and stimulates motility through- 22 out the entire gastrointestinal tract. It is not always necessary to start 23 treatment with the most potent herbal remedy. Bile secretion can be stimulated using the herbal 28 choleretics fumitory and celandine (see p. Because patients tend to accept herbal remedies more readily than their 34 synthetic alternatives, they are an excellent choice for treating the above- 35 mentioned adaptive and functional disorders of aging. Ginkgo presumably does this by stimulating the adaptive capacity 44 of the still-intact neuron complexes. By various mechanisms (calcium an- 45 tagonism, gene induction to promote stress hormone production), it also 46 protects neurons from injurious effects of energy metabolism and trans- 47 mitter metabolism or damage due to a deficient blood supply. Good treat- 48 ment results can most easily be achieved in patients with mild to moderate 49 dementia-related diseases, primary degenerative dementia, vascular de- 50 mentia, and mixed forms of these diseases. In the above indications, treatment 34 should be continued for no less than 8 weeks. After 3 months of treatment, 35 the patients should be given a questionnaire to help the therapist deter- 36 mine and document whether continuation of treatment is justifiable. These include eating healthy foods, getting enough 11 sleep, learning to relax, avoiding stress, and building up one’s resistance to 12 disease (e. The herbal remedy was found to have a beneficial effect 33 on the severity and course of catarrhal disorders and seems to be successful 34 in fighting concomitant infections during chemotherapy. Ginseng root con- 42 tains a large number of compounds, and those responsible for the individ- 43 ual therapeutic effects have not yet been identified. Clinical studies have 44 shown that treatment is able to improve psychophysical performance and 45 various parameters of cardiovascular and pulmonary function. Siberian ginseng was found to improve the stress resistance of ex- 3 perimental animals. Extracts of the herb have hormonelike effects that bene- 4 ficially modulate the axis of the adrenal cortex and anterior pituitary lobe. These herbal remedies have immunomodula- 20 tory and antiviral effects and inhibit bacterial hyaluronidase. Solid forms (lozeng- 39 es, tablets, capsules): Take 1 to 2 single doses, 3 times a day or as directed 40 by the manufacturer. The herbal remedy can be continued after a 23 break in treatment (the optimal length of the treatment-free interval is 24 not known). Therefore, only high- 26 quality, standardized products or whole roots (for tea) should be pur- 27 chased. Most qualified 13 health care practitioners prefer to inject the herbal remedy into the upper arm 14 or leg. Injection into irradiation fields or areas proximal to the tumor should be 15 avoided. Temporary remission or alleviation of 20 symptoms (palliative therapy) is all that can be achieved in the remaining 21 patients. Secondary plant 24 chemicals such as conjugated isoflavones from soybeans or phytoestrogens 25 may soon play an important role. Most of the available clinical studies do 37 not conform with modern scientific standards. Moreover, the researchers 38 tended to use different methods of manufacture and dilution and use ma- 39 terial obtained from different host trees, making it impossible to compare 40 the data. Extensive clinical studies are therefore being conducted to assess 41 the effects of mistletoe extract on tumor progression and recurrence, me- 42 tastatic spread, cytostatic-induced side effects, and quality of life. In North America, a1:10 mistletoe tincture(20 to 40 drops, 48 3 times a day) is recommended by herbal and naturopathic practitioners, 49 though no clinical trials showing efficacy are available. Owing to the lack of ad- 11 equate study data, mistletoe extracts should not be used by children under 12 12 years of age. Liquid oral preparations are 19 commonly recommended by herbalists and naturopaths in North Amer- 20 ica for similar purposes because injectable preparations are not ap- 21 proved in North America. Should not be 38 used during the first trimester of pregnancy unless the expected benefits 39 clearly outweigh the potential risks. These substances maintain joint 8 inflammation and promote the production of enzymes that destroy the car- 9 tilage. Inflammatory processes also occur in arthrosis, but are induced by 10 mechanical irritations due to malposition. In many cases, 12 improvement or worsening cannot be reliably attributed to any definite 13 therapeutic measure. Most treatment 15 strategies still do not achieve very satisfactory long-term results, especially 16 in rheumatic inflammatory diseases. After transdermal absorption, vis- 25 cerocutaneous reflexes convey the effects of the oils to the internal organs. These are pillows 32 filled with dried flowers of hay, commercially available in Germany. In North 34 America, baths with ginger tea added to the bathwater and, as topical treat- 35 ment, ginger compresses are used instead. Also, adding essential oils (coni- 36 fer oil) to the bathwater is a possible treatment. Adjunctive treatment 42 with the recommended herbs makes it possible to reduce the dose frequen- 43 cy and level of nonsteroidal antirheumatics. Various 35 compounds in willow bark, ash bark, and aspen leaf and bark have anti- 36 pyretic, antiphlogistic, and/or analgesic effects. Salicin is converted in vivo 37 to salicylic acid, a substance that mainly inhibits cyclooxygenase and re- 38 duces the prostaglandin concentration in inflamed tissues without causing 39 gastrointestinal side effects. This helps to protect cartilage 3 and connective tissues from the destructive effects of cytokines. Indian 4 frankincense is an inhibitor of 5-lipoxygenase and cyclooxygenase, which 5 are key enzymes for tissue hormones involved in inflammatory processes 6 (prostaglandins and leukotrienes). The root of the devil’s claw plant contains harpagoside, a substance 8 that inhibits prostaglandin synthesis.
