Integrative Skin Care: Dermatology and Traditional and Complementary Medicine.

Skin problems and diseases are extremely common globally and, due to their visibility, often result in severe distress and stigma for sufferers. Traditional (i.e., indigenous or local) and complementary health systems are widely used and incorporate many treatment modalities suitable for skin care, and a body of evidence for their efficacy and safety has built up over many decades. These approaches are often used as part of a broader "integrative medicine" (IM) approach that may also include, for example, nutrition and mind-body approaches. This article presents an overview of current knowledge about traditional and complementary medicine (T&CM) and IM principles and practices for skin health; reviews published epidemiologic studies, clinical trials, and wider literature; and discusses the challenges of conducting research into T&CM and IM. It also highlights the need for an innovative research agenda-one which is congruent with the principles of IM, as well as taking policy and public health dimensions into consideration.

Reconceptualizing 'effectiveness' in environmental projects: can we measure values-related achievements?

There have been recent calls for a shift to an evidence-based paradigm in environmental management, grounded in systematic monitoring and evaluation, but achieving this will be complex and difficult. Evaluating the educational components of environmental initiatives presents particular challenges, because these programs often have multiple concurrent goals and may value 'human outcomes', such as value change, which are intangible and difficult to quantify. This paper describes a fresh approach based on co-creating an entirely new values-based assessment framework with expert practitioners worldwide. We first discuss the development of a generic framework of 'Proto-Indicators' (reference criteria constituting prototypes for measurable indicators), and then demonstrate its application within a reforestation project in Mexico where indicators and assessment tools were localized to enhance context-relevance. Rigorously derived using unitary validity, with an emphasis on relevance, practicability and logical consistency from user perspectives, this framework represents a step-wise advance in the evaluation of non-formal EE/ESD programs. This article also highlights three important principles with broader implications for evaluation, valuation and assessment processes within environmental management: namely peer-elicitation, localizability, and an explicit focus on ethical values. We discuss these principles in relation to the development of sustainability indicators at local and global levels, especially in relation to post-2015 Sustainable Development Goals.

Field trials of a novel toolkit for evaluating 'intangible' values-related dimensions of projects.

A novel toolkit has been developed, using an original approach to develop its components, for the purpose of evaluating 'soft' outcomes and processes that have previously been generally considered 'intangible': those which are specifically values based. This represents a step-wise, significant, change in provision for the assessment of values-based achievements that are of absolutely key importance to most civil society organisations (CSOs) and values-based businesses, and fills a known gap in evaluation practice. In this paper, we demonstrate the significance and rigour of the toolkit by presenting an evaluation of it in three diverse scenarios where different CSOs use it to co-evaluate locally relevant outcomes and processes to obtain results which are both meaningful to them and potentially comparable across organisations. A key strength of the toolkit is its original use of a prior generated, peer-elicited 'menu' of values-based indicators which provides a framework for user CSOs to localise. Principles of participatory, process-based and utilisation-focused evaluation are embedded in this toolkit and shown to be critical to its success, achieving high face-validity and wide applicability. The emerging contribution of this next-generation evaluation tool to other fields, such as environmental values, development and environmental sustainable development, shared values, business, education and organisational change is outlined.

Do ethnobotanical and laboratory data predict clinical safety and efficacy of anti-malarial plants?

BACKGROUND: Over 1200 plant species are reported in ethnobotanical studies for the treatment of malaria and fevers, so it is important to prioritize plants for further development of anti-malarials. METHODS: The "RITAM score" was designed to combine information from systematic literature searches of published ethnobotanical studies and laboratory pharmacological studies of efficacy and safety, in order to prioritize plants for further research. It was evaluated by correlating it with the results of clinical trials. RESULTS AND DISCUSSION: The laboratory efficacy score correlated with clinical parasite clearance (rs=0.7). The ethnobotanical component correlated weakly with clinical symptom clearance but not with parasite clearance. The safety component was difficult to validate as all plants entering clinical trials were generally considered safe, so there was no clinical data on toxic plants. CONCLUSION: The RITAM score (especially the efficacy and safety components) can be used as part of the selection process for prioritising plants for further research as anti-malarial drug candidates. The validation in this study was limited by the very small number of available clinical studies, and the heterogeneity of patients included.

Citizen's choice of preferred system of healthcare as a fundamental human right.

Fundamental rights are preconditions for any human to act with sufficient freedom and to be allowed sufficient choice to realize their potential. The right to indigenous medicine must be recognized as a fundamental human right for indigenous peoples. In accordance with the principles of Evidence-Based Medicine, every citizen should be allowed to benefit from the placebo effect. It constitutes an essential aspect of treatment, which is rightfully theirs on the basis of payment for health care - regardless of whether the payment is made out of pocket, or from public finance. It then follows that, the right of citizens to access the medical system of their choice should be formally acknowledged. That choice should be regarded as a Fundamental Human Right, which should under no circumstance be denied them - not for reasons of scientific prejudice, nor commercial ambition.

HIV/AIDS: Traditional systems of health care in the management of a global epidemic.

Cultural preference and the high cost and unavailability of anti-HIV drugs for people living with HIV/AIDS in the developing world leads many to turn to traditional (indigenous) medicine to manage HIV-related illness. Traditional health practitioners can play an important role in delivering an AIDS prevention message and some may be able to offer treatment for opportunistic infections. In industrialized countries, approximately half or more of those with AIDS use complementary medicines in conjunction with their antiretroviral therapy. A growing body of research highlights the immunomodulatory and antiviral potential of plant-based medicines. There are also concerns about unsafe practices and a growth in claims of traditional cures for AIDS. Partnerships between the modern and traditional/complementary health sectors in research, policy, and practice are essential in building comprehensive HIV/AIDS control strategies.