Traditional Healer’s Medicinal Practice Survey and Clinical Evidence Assessment of “YIKI”: An Antimalarial Phytomedicine Recipe from Bobo-Dioulasso, Burkina Faso

YIKI is an antimalarial phytomedicine used by a traditional healer to treat malaria in Bobo-Dioulasso. However, there is no scientific evidence to support its use by local populations. The aim of this study was to identify the medicinal practices of the healer holder of YIKI and assess the clinical evidence of its phytomedicine in the uncomplicated malaria treatment. Ethnomedical survey based on a semi-structured and open questionnaire was conducted from October to December 2019 with the healer. Malaria knowledge and diagnosis methods, patient treatment and monitoring, and recipe formulation steps were surveyed. Moreover, thick and thin blood smears were taken, haemoglobin levels and temperature of consenting patients were measured before treatment, mid-treatment and at the end of treatment. The survey revealed that the healer has a good knowledge of malaria symptoms and his diagnosis is based on observation and physical examination of patients. The healer’s malaria diagnosis was rudimentary and had accuracy problems, with only 62.79% of malaria cases confirmed by microscopy. The formulation of YIKI and its use to treat malaria follow a standard process for plant harvesting, powder quantities and posology, but do not use any reproducible parameters for dose adjustment. Forty-three patients diagnosed and treated by the healer participated in the study. Laboratory results revealed 27 Plasmodium falciparum infection cases, including 2 with parasitaemia ≥ 200,000 p/µl blood. 25 patients were selected for therapeutic evidence assessment. There was a 48% elimination of parasites, a 28% parasitaemia decrease without complete cure, with gametocytogenesis in some patients, and a 24% parasitaemia increase. Haemoglobin and temperature results suggested that YIKI was not cytotoxic and reduced fever. Encouraging preliminary results have been obtained, but in view of the low number of patients, further YIKI efficacy and toxicity studies will be necessary for patient safety.

Traditional agroecological knowledge and practices:The drivers and opportunities for adaptation actions in the northern region of Ghana

Agroecological practices are promoted as a more proactive approach than conventional agriculture to achieving a collective global response to climate change and variability while building robust and resilient agricultural systems to meet food needs and protect the integrity of ecosystems.There is relatively limited evidence on the key traditional agroecological knowledge and practices adopted by smallholder farmers,the factors that influence smallholder farmers’decision to adopt these practices,and the opportunities it presents for building resilient agricultural systems.Using a multi-scale mixed method approach,we conducted key informant interviews(n=12),focus group discussions(n=5),and questionnaire surveys(N=220)to explore the traditional agroecological knowledge and practices,the influencing factors,and the opportunities smallholder farmers presented for achieving resilient agricultural systems.Our findings suggest that smallholder farmers employ a suite of traditional agroecological knowledge and practices to enhance food security,combat climate change,and build resilient agricultural systems.The most important traditional agroecological knowledge and practices in the study area comprise cultivating leguminous crops,mixed crop-livestock systems,and crop rotation,with Relative Importance Index(RII)values of 0.710,0.708,and 0.695,respectively.It is reported that the choice of these practices by smallholder farmers is influenced by their own farming experience,access to market,access to local resources,information,and expertise,and the perceived risk of climate change.Moreover,the results further show that improving household food security and nutrition,improving soil quality,control of pest and disease infestation,and support from NonGovernmental Organizations(NGOs)and local authorities are opportunities for smallholder farmers in adopting traditional agroecological knowledge and practices for achieving resilient agricultural systems.The findings call into question the need for stakeholders and policy-makers at all levels to develop capacity and increase the awareness of traditional agroecological knowledge and practices as mechanisms to ensure resilient agricultural systems for sustainable food security.

Traditional Agrodiversity Management:A Case Study of Central Himalayan Village Ecosystem

Environmental, biological, socio-cultural and economic status variation existing in the Central Himalaya have led to the evolution of diverse and unique traditional agroecosystems, crop species and livestock, which facilitate the traditional mountain farming societies to sustain themselves. Indigenous agroecosystems are highly site specific and differ from place to place, as they have evolved along divergent lines. For maintenance of traditional agrodiversity management the farmers of the Central Himalaya have evolved various types of crop rotations in consonance with the varied environmental conditions and agronomic requirements. In irrigated fiat lands two crops are harvested in a year with negligible fallow period but in rainfed conditions if a cropping sequence is presumed to be starting after winter fallow phase then four major cropping seasons can be identified namely first kharif season （first crop season）, first rabi season （second crop season）, second kharif season （third crop season） and second rabi season （fourth crop season）. Highest crop diversity is present in kharif season in comparison to rabi season. Traditionally the fields are left fallow after harvest of the second kharif season crop. Important characteristics of agrodiversity management are the use of bullocks for draughtpower, human energy as labour, crop residues as animal feed and animal waste mixed with forest litter as organic input to restore soil fertility levels. Women provide most of the human labour except for ploughing and threshing grain. The present study deals with assessment of traditional agrodiversity management such as （i） crop diversity, （ii） realized yield under the traditional practices and （iii） assess the differences of realized yields under sole and mixed cropping systems. It indicated that crop rotation is an important feature of the Central Himalayan village ecosystem which helps to continue the diversity of species grown, as are the distribution of crops in the growing period and the management of soil fertility. The cropping diversity existing and the sequences practiced by the traditional farmers seems to have achieved high degree of specialization and thus even when the yield/biomass variations are about 6o%, the farmers continue to practice these sequences as they need to maintain diversity and synergistic relationships of crops in addition to manage the food and labour requirements for crop husbandry. Crop yields are generally higher in irrigated systems than rainfed systems and in sole cropping as compared with mixed cropping. However, gross biological and economic yields are higher in mixed cropping than sole cropping systems.

Changes in Agricultural Biodiversity: Implications for Sustainable Livelihood in the Himalaya

Himalayan mountain system is distinguished globally for a rich biodiversity and for its role in regulating the climate of the South Asia. Traditional crop-livestock mixed farming in the Himalaya is highly dependent on forests for fodder and manure prepared from forest leaf litter and livestock excreta. Apart from sustaining farm production, forests provide a variety of other tangible and intangible benefits, which are critical for sustainable livelihood of not only 115 million mountain people, but also many more people living in the adjoining plains. Extension of agricultural land- use coupled with replacement of traditional staple food crops by cash crops and of multipurpose agroforestry trees by fruit trees are widespread changes. Cultivation of Fagopyrum esculentum, Fagopyrum tataricum, Panicum miliaceum, Setaria italica and Pisum arvense has been almost abandoned. Increasing stress on cash crops is driven by a socio-cultural change from subsistence to market economy facilitated by improvement in accessibility andsupplyofstaplefoodgrainsatsubsidizedpriceby the government. Farmers have gained substantial economic benefits from cash crops. However, loss of agrobiodiversity implies more risks to local livelihood in the events of downfall in market price/demand of cashcrops,terminationofsupplyofstaplefoodgrains at subsidized price, pest outbreaks in a cash crop dominated homogeneous landscape and abnormal climate years. Indigenous innovations enabling improvement in farm economy by conserving and/enhancing agrobiodiversity do exist, but are highly localized. The changes in agrobiodiversity are such that soil loss and run-off from the croplands have dramatically increased together with increase in local pressure on forests. As farm productivity is maintained with forest-based inputs, continued depletion of forest resources will result in poor economic returns from agriculture to local people, apart from loss of global benefits from Himalayan forests. Interventions including improvement in traditionalmanureandmanagementofon-farm trees, participatorydevelopmentofagroforestryindegraded forestlandsandpoliciesfavoringeconomicbenefitsto local people from non-timber forest products could reduce the risks of decline in agricultural biodiversity and associated threats to livelihoods and Himalayan ecosystems.

Clinical Practice Guideline of Traditional Medicine for Primary Osteoporosis

BACKGROUND Primary osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue,leading to enhanced bone fragility and a consequent increase in fracture risk. Primary osteoporosis is particularly common in senile persons and in postmenopausal women.It ranks the fifth of diseases in the modern society.

Traditional Chinese Practice,A Promising Integrative Intervention for Chronic Non-Infectious Disease Management

The number of people with chronic diseases rises rapidly in recent years worldwide. Except for drug medication, mind-body exercises are indispensable for chronic disease management. Traditional Chinese practice （TCP）, as an integrative intervention, is known as an effective means to keep in good health and fitness, as well as help regulate emotion. This paper introduces the domestic and overseas studies on effectiveness of TCP for chronic diseases, and explores the key action links from three aspects, including functional training of multiple-joint guided by consciousness, relieving psychological risk factors, improving respiratory and digestive function, blood and lymph circulation through respiratory training, and regulation of nerve, metabolic, and immune system. Finally, the authors discussed how to integrate TCP in the chronic disease management, and put forward that the practice methods and evaluation standard should be assessed academically.

Assessing the Quality of the First Batch of Evidence-Based Clinical Practice Guidelines in Traditional Chinese Medicine

Objective: To assess the quality of the first batch of Chinese evidence-based clinical practice guidelines (CPGs) in Traditional Chinese Medicine (TCM) using the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument. Methods: Evidence-based CPGs in TCM supported by the World Health Organization Western Pacific Regional Office (WHO/WPRO) and whose development was organized by the China Academy of Chinese Medical Sciences were identified and manually retrieved. CPGs were assessed using the AGREE instrument, and the data in each CPG were analyzed in terms of the six domains in the AGREE instrument: scope and purpose, stakeholder involvement, rigor of development, clarity and presentation, applicability, and editorial independence. Results: Twenty-eight CPGs were identified, of which 26 were included in the study. The AGREE instrument rated the 26 CPGs in terms of the six domains. The assessment results showed the following average scores: for editorial independence, 84.16%; for rigor of development, 80.95%; for scope and purpose, 79.96%; for clarity and presentation, 70.88%; for stakeholder involvement, 61.28%; for applicability, the average score was only 27.09%. In summary, nine CPGs were rated as "strongly recommended", six as "recommended with provision or alternation", and 11 as "unsure". Conclusion: Most of the first batch of Chinese evidence-based CPGs in TCM had significant shortcomings in applicability. It is suggested that special attention be paid to enhancing the quality of applicability when developing evidence-based CPGs in TCM.

Improving Clinical Practice Guideline Development in Integration of Traditional Chinese Medicine and Western Medicine

Integration of traditional Chinese medicine （TCM） and Western medicine （WM）, or called as integrative medicine （IM） in China, came into being in 1950s as a new form of medicine. IM emphasizes the combination of both conventional WM and TCM alternative approaches to address all aspects of health and illness.（1） The major practice in IM includes the integration of disease diagnosis in WM and pattern classification （or syndrome differentiation） in TCM, and the integration of WM interventions and TCM interventions.

The Igbo Art and Cultural Heritage： Changing Time, Changing Form

The Igbo artists of all generations, from the pre-colonial to the post-colonial period, and from her traditional to contemporary art practices, have demonstrated the ability to express the material, as well as spiritual world of the lgbo cultural society. The fear of the unknown, uncertainties of the forest, river, mountain, seas, oceans, lightening, thunder, and the changing weather, brings her artists in constant contact with their spirituality. Over time, these artists have demonstrated their inherent ability to perceive, through their various art practices, the unseen, speak the unspoken, revere and share in the silent salient world of their ancestors, as well as preserve it for posterity. This paper presents an insight into the Igbo cultural society with reference to her indigenous and contemporary art practices. It identifies the trajectories of her art and cultural developments toward contemporary and global acceptance, and in addition attempts to identify her visual creative frontiers.

Toward sustainable development： Lessons from vernacular settlements of Sri Lanka

From modern urban perspectives, indigenous housing practices are regarded as undeveloped, backward, and require improvements. They may be valid for measuring on the basis of standards alien to the communities. However, these perceptions have obfuscated the appreciation and potential adoption of hotistic, culturally relevant, and traditionally tested approaches to planning and housing that have sustained communities for centuries. Sri Lankan indigenous settlements have been founded on principles and understanding acquired through the wisdom of Buddhism. For the Sri Lankan indigenous, sustainability has been an intrinsic accompaniment to everyday life, unlike articulated modern discourses. However, these traditions exert minimal benefits to recent housing practices, and researchers are Looking etsewhere to develop mechanisms to infuse sustainability as a recently discovered issue of significance. The present study examines the principles underlying several indigenous settlements in Sri Lanka through dose observations supported by documented evidence and demonstrates their validity and appropriateness for contemporary planning practices. This study argues that approaches to sustainabitity shoutd be generated hotisticatty from within rather than from the outside and offers several propositions that can redirect the contemporary housing and planning practices.