Alternative Health Care Systems Research Articles

Network pharmacology- and molecular docking-based exploration of the molecular mechanism underlying Jianpi Yiwei Recipe treatment of gastric cancer.

Traditional Chinese medicine (TCM) is widely used as an important complementary and alternative healthcare system for cancer treatment in Asian countries. Network pharmacology, which utilizes various database platforms and computer software to study the interactions between complex drug components in vivo, is particularly useful for studying the pharmacodynamic mechanisms of multi-pathway and multi-target Chinese medicines. To explore the potential targets and function of Jianpi Yiwei Recipe treatment of gastric cancer (GC) through network pharmacology and molecular docking. Data on the components of Jianpi Yiwei Recipe (Radix Astragali, Radix Codonopsis, Agrimonia eupatoria, Atractylodes macrocephala Koidz., Poria cocos, stir-baked rhizoma dioscoreae, Amomum villosum Lour., fried Fructus Aurantii, pericarpium citri reticulatae, Rhizoma Pinelliae Preparata, and Radix Glycyrrhizae Preparata) were collected and screened by using the TCM systems pharmacology database and analysis platform (TCMSP). Then the targets of these compounds were predicted. GC-related targets were screened using the GeneCards database. Venn diagram was used to identify common targets. An active ingredient-core target interaction network and a protein-protein interaction (PPI) network were built. Moreover, we performed gene ontology (GO) functional annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses on the core targets and validated them by molecular docking. TCMSP screening revealed 11 active components and 184 targets, whereas GeneCards found 10118 disease-related targets, with 180 shared targets between them. Topology analysis of the PPI network identified 38 targets, including ATK1, TP53, and tumor necrosis factor, as key targets for the treatment of GC by Jianpi Yiwei Recipe. Quercetin, naringenin, luteolin, etc., may be the main active components of Jianpi Yiwei Recipe. GO enrichment analysis identified 2809, 1218, and 553 functions related to biological process, molecular function, and cellular component, respectively. KEGG pathway enrichment analysis revealed 167 related pathways, mainly involved in cancer, endocrine resistance, and AGE-RAGE signaling in diabetic complication. Validation with molecular docking analysis showed docking of key active components with core targets. Jianpi Yiwei Recipe plays a therapeutic role in GC through multiple components, targets, and pathways. These findings form a basis for follow-up exploration of Jianpi Yiwei Recipe in the treatment of GC.

Deep Insights into Herbal Plants with Potential Anti-diarrheal Drug

Millions of people throughout the globe rely on traditional medicines as part of their alternative health care systems. In contrast to contemporary pharmaceuticals, which are single molecules that have undergone extensive testing, structural optimization, and toxicological clearance, traditional herbal remedies are multi-constituent treatments whose safety and effectiveness is dependent on the experiences of practitioners. More than 80% of today’s pharmaceuticals come from natural sources (plants, bacteria, cells, etc.), either as the original molecules or as synthetic versions of the original chemicals. Diarrhea and similar gastrointestinal diseases are treated using a wide variety of medicinal herbs used in traditional medicine. The effectiveness of several of these plants in treating diarrhea in animal models has been shown by science. Unfortunately, only a small fraction of these have been subjected to rigorous clinical trial testing. Several traditional anti-diarrheal medicinal herbs are discussed, and their effectiveness in in-vivo models is highlighted. While a small number of active phytomolecules have been isolated from these plants, their potential therapeutic use and safety have not been thoroughly investigated. The prospective herbal extracts that might be researched for the discovery of new active molecules against diarrhea and other gastrointestinal illnesses are also described in this study. The development of innovative, effective, and safe phyto-medicines for fighting diarrhea and related illnesses will need rigorous clinical studies of lead plants/phyto-molecules.

Traditional and Herbal Medicines: Opportunities and Challenges

Pharmacognosy Research,2022,14,2,107-114.DOI:10.5530/pres.14.2.15Published:April 2022Type:Review ArticleAuthors:Sachin Saggar, Prince Ahad Mir, Nishant Kumar, Apporva Chawla, Jasreen Uppal, Shilpa, and Anmoldeep Kaur Author(s) affiliations:Sachin Saggar1, Prince Ahad Mir2,*, Nishant Kumar3, Apporva Chawla4, Jasreen Uppal5, Shilpa6, Anmoldeep Kaur7 1Department of Pharmaceutics, Amritsar Group of Colleges, Punjab, INDIA. 2Department of Pharmacognsoy and Phytochemistry, Khalsa College of Pharmacy, Punjab, INDIA. 3Department of Pharmaceutics, Khalsa College of Pharmacy, Punjab, INDIA. 4Department of Pharmacology, Khalsa College of Pharmacy, Punjab, INDIA. 5Department of Pharmaceutical Chemistry, Khalsa College of Pharmacy, Punjab, INDIA. 6Department of Pharmaceutical Chemistry, Amritsar Group of Colleges, Punjab, INDIA. 7Department of Pharmacology, Amritsar Group of Colleges, Punjab, INDIA. Abstract:Background: Since ancient times natural herbs were extensively used for the treatment and prevention of various ailments and in past few decades, due to an extensive research in traditional system of medicine various herbal medicines have been developed for the prevention and treatment of diseases, which are environmentally, organically safe and inexpensive. Indian sub-continent has a good capability to tackle the task of meeting the worldwide demand for such products due to its rich wealth in case of herbal medicine. Historically, Indian people conventionally played a vital role in the development and management of these biological sources and also preserve their pertinent data that were accumulated via trial and error over centuries. Objectives: Due to tremendous global resurgence in traditional and alternative healthcare systems, the market for herbal medicines has grown at an impressive rate and therefore has great economic importance. However, the primary barriers to the expansion of herbal medicine include biodiversity loss, over-exploitation and improper use of medicinal plants, industrialization, biopiracy, and a lack of regulation and infrastructure. For the expansion of herbal medicine usage in the twenty-first century, conservation, proper research based on traditional knowledge, quality control of herbal medicine, and correct documentation are required. Methods: The desired and encouraging testifying items for systematically evaluated reviews and meta-analysis (PRISMA) standards were opted. A literature exploration was accomplished utilizing SCIENCE DIRECT, SCOPUS and GOOGLE SCHOLAR to locate articles for the present scenario about traditional and herbal medicines. Conclusion: The availability and type of conventional medicine safety and effectiveness data are far from sufficient to fulfil the requirements required to support its use globally. This review paper examines the restrictions and issues associated with conservation, science and technology, regulatory constraints, potential usage of herbal medicines, the drug production industry, safety and efficacy, and the prospects for traditional remedies on a nationally and internationally scale. Key words: Traditional medicines, Herbal medicines, Healthcare system, Regulatory constraints, Traditional Knowledge, Quality control. View:PDF (205.35 KB)

Healthcare in Metaverse: A Survey on Current Metaverse Applications in Healthcare

The COVID-19 pandemic has revealed several limitations of existing healthcare systems. Thus, there is a surge in healthcare innovation and new business models using computer-mediated virtual environments to provide an alternative healthcare system. Today, digital transformation is not limited to virtual communication alone but encompasses digitalizing the network of social connections in the healthcare industry using metaverse technology. The metaverse is a universal and immersive virtual world facilitated by virtual reality (VR) and augmented reality (AR). This paper presents the first effort to offer a comprehensive survey that examines the latest metaverse developments in the healthcare industry, which covers seven domains: telemedicine, clinical care, education, mental health, physical fitness, veterinary, and pharmaceuticals. We review metaverse applications and deeply discuss technical issues and available solutions in each domain that can help develop a self-sustaining, persistent, and future-proof solution for medical healthcare systems. Finally, we highlight the challenges that must be tackled before fully embracing the metaverse for the healthcare industry.

The Antimicrobial Activity of Red Palm (Cyrtostachys renda) In Leaf Ethanolic Extract Against Staphylococcus aureus

Medicinal plants are a rich source of secondary metabolites and been utilized since time immemorial as powerful drugs in traditional or alternative healthcare systems. In the light of this marvel, Cyrtostachys renda (Red Palm) is known to possess phytochemicals such as flavonoids, tannins, and steroids. Previous phytochemical studies on Cyrtostachys renda has revealed, the presence of steroids, tannins and flavonoids but none have tested its antimicrobial capabilities. In this study, the researchers used the red palm tree (Cyrtostachys renda) leaves extract as a viable antimicrobial concoction against Staphylococcus aureus. The determination of the Minimum Inhibitory Concentration (MIC) as well as the Zone of Inhibition (ZI) was highlighted in this study for the researchers to assess the overall capability of the Red Palm leaf ethanolic extract as a viable antimicrobial concoction. Apart from the Red Palm ethanolic extract, the researchers had used the ampicillin vial as their positive control and distilled water as their negative control in order to have a point of comparison and synthesis. This study utilized a post test experimental design with three treatments and three repetitions following a complete randomized design format (CRD) to ensure the validity and integrity of the experimental process. Results had shown that Red Palm (Cyrtostachys renda) showed potential viability as an antimicrobial extract as there was a notable presence of Minimum Inhibitory Concentration of (30 mm) using a 30 ml solution and a Zone of Inhibition with a mean of 9.33 mm. The researchers recommend to venture out different species of Palm for comparison of its potential antimicrobial viability.

Mental health nursing and conscientious objection to forced pharmaceutical intervention.

This paper attempts a critical discussion of the possibilities for mental health nurses to claim a particular right of conscientious objection to their involvement in enforced pharmaceutical interventions. We nest this within a more general critique of perceived shortcomings of psychiatric services, and injustices therein. Our intention is to consider the philosophical and practical complexities of making demands for this conscientious objection before arriving at a speculative appraisal of the potential this may hold for broader aspirations for a transformed or alternative mental health care system, more grounded in consent than coercion. We consider a range of ethical and practical dimensions of how to realize this right to conscientious objection. We also rely upon an abolition democracy lens to move beyond individual ethical frameworks to consider a broader politics for framing these arguments.

Assess the Knowledge and Attitude Regarding Alternative System of Medicine among the Adults in Rural Community Area

Introduction: The folk medicine which is available such as herb, flora, found and minerals. The people taking some treatment for improving health and treat the person which lies in ancient times. Some of the people of the alternative system such as homeopathy, Ayurveda, Siddha, Unani, naturopathy and yoga. The alternative system of medicine is widespread. This leads to improving knowledge regarding the alternative system of medicine in the rural community area.
 Background: The present study has been designed to capture the knowledge and attitude towards the Alternative health care system of medicine in its user and non-users to compare the differences in its source of knowledge among the rural community people. Knowledge regarding the alternative therapies that are living in the rural community area. The person has some knowledge regarding alternative health such as naturopathy, homeopathy, yoga, Unani and Siddha. The people will have known about alternative therapies.
 Objective: To assess the knowledge of adults in rural community areas regarding the alternative system of medicine. To assess the attitude towards an alternative system of medicine among rural community areas. 
 Methods: The sample size is 100 among the adults in the rural community area.
 Results: In the present study 98% of the adults were having a positive attitude and only 2% of them had a negative attitude. Association of knowledge score and attitude score with the selected demographic variables there is a significant in the gender and not significantly associated with education, occupation, caste regarding the alternative system of medicine and significant association between attitude score the gender and not significantly associate with education, occupation, caste regarding the alternative system of medicine.
 Conclusion: This study revealed that in wardha city, there is relatively high public interest in complementary and alternative medicine and a significant number has a produce good awareness attitude toward complementary and alternative medicine.

From Mental Health Industry to Humane Care. Suggestions for an Alternative Systemic Approach to Distress.

The article proposes a rough outline of an alternative systemic approach to mental health issues and of a more humane mental health care system. It suggests focusing on understanding mental distress as stemming from problems in living, using medications as agents facilitating psychotherapy, or as a last resort and short-term help, according to the principles of harm reduction. It argues that understanding drugs as psychoactive substances and studying the subjective effects they produce could lead to better utilization of medications and improvements in terms of conceptualizing and assessing treatment effects. Qualitative research could be particularly useful in that regard. It also advocates a radical departure from current diagnostic systems and proposes a synthesis of already existing alternatives to be used for both research and clinical purposes. Accordingly, a general idea for an alternative mental health care system, based on a combination of Open Dialogue Approach, Soteria houses, individual and group psychotherapy, cautious prescribing, services helping with drug discontinuation, peer-led services and social support is presented. The proposition could be seen as a first step towards developing a systemic alternative that could replace the currently dominating approach instead of focusing on implementing partial solutions that can be co-opted by the current one.

Green Care as Alternative Therapy: The Situation in Ghana

Green care, an alternative healthcare system that involves the use of nature, is proven to be useful in the management of organic and psychological disorders worldwide. There are various forms of Green care including Animal-Assisted Therapy (AAT), a type where animals play pivotal roles in the healing process and is widely used in many developed countries. We assessed the level of awareness and attitude towards Green care among medical students of Ghana. Using a cross-sectional study design and a semistructured questionnaire designed on Google Forms, data were collected from randomly selected 4th-, 5th-, and 6th-year medical students of the University for Development Studies, Tamale, Ghana. The data submitted by 206 of the students were analyzed using Statistical Package for the Social Sciences, Version 25, and the results were presented as frequencies, percentages, and charts. The association between sociodemographic characteristics of respondents and awareness about Animal-Assisted Therapy (AAT) was considered significant at p < 0.05 . The study found that only 7 (3.4%) of the medical students had ever heard of Green care while a higher number of 36 (17.5%) were aware of AAT mostly through movies and television. However, the majority, 122 (59.3%), had a positive attitude towards the introduction of AAT, into their medical training curriculum. Up to 146 (70.9%) of the respondents suggested lectures and practical sessions as their preferred way of acquiring knowledge and skills on AAT. Only the sex of the respondents was significantly associated with awareness of AAT, with females having a better awareness of AAT (28.6% vs. 11.0%, p = 0.003 ). We conclude that awareness of Green care practices among medical students in Ghana was highly inadequate, but the desire of the majority of them to acquire knowledge and skills in this proven alternative therapy makes its future use in Ghana promising.

Abandoning the Term "Voodoo" in Medicine.

* Abbreviation: EBM — : evidence-based medicine Spend enough time around medical practitioners here in the United States and you will definitely hear the word “voodoo.” In medicine, the term is used to denote an absence of evidence or a superstitious practice, either as an apology for one’s own medical choices in the face of limited or contentious evidence or often as a disdainful dismissal of the medical choices of others. When my medical career began in the mid-to-late 90s, the term was already in use. I suspect it had been in use for some time, but it took on particular relevance in the evidence-based medicine (EBM) era. In the EBM context, it often signifies practices that lack sufficient evidence by EBM standards.1 I suggest we abandon this use of the term “voodoo” to refer to medical practices of unsure or poor quality of evidence. The problem with the use of the term “voodoo” in this dismissive or derogatory way is that Voodoo, also written Vodou, Vodun, or Vodu, is a religion. This religion grew out of the inheritances, beliefs, and experiences of mostly West African people who were enslaved and brought to the island of Quisqueya, present-day Haiti and the Dominican Republic, as well as from the dynamic experiences of their descendants as they navigated a changing world of colonial power, slavery, revolution, occupation, and dictatorship. Voodoo has direct connections to several West African and Central African religious systems and practices, including the Vodun practices of the Fon people of Benin, Togo, … Address correspondence to Nathan Luna, MD, Department of Pediatrics, Kaiser Permanente Oakland Medical Center, 3600 Broadway, Oakland, CA 94611. E-mail: nathan.luna{at}kp.org

SCIENTIFIC RATIONALITY, ADOPTION AND PERCEIVED EFFECTIVENESS OF ETHNOMEDICAL PRACTICES ON BITE REMEDIES IN IDUKKI, KERALA

The study was carried out among tribal farmers of Idukki district, Kerala. Forty gramapanchayats were selected for the study. A total of 90 tribal healers cum age-old farmers and 452 tribal farmers were the respondents of this study. The study recorded sixty eight EMPs on bite remedies. The prevalent categories of EMPs expertise were on poisonous bites (48.55%), snake bites (22.05%), scorpion bites (16.17%), spider bites (10.29%), and dog bites (2.94%). Of the sixty eight EMPs, seventeen were assessed for their scientific rationality and adoptions of which sixteen were studied for their perceived effectiveness among tribal farmers. Of the seventeen practices, fourteen were found to be rational, while the rest three were irrational. In this study, the scientific rationale behind fourteen rational EMPs was also explained. Sixteen practices were adopted by 51.32 to 83.18 percent of the respondents. Of the sixteen EMPs studied for effectiveness, all were perceived as effective by the tribal farmers, and this revealed that many EMPs on bite remedies were both rational and effective. This requires more clinical and pharmacological interference to validate and standardize EMPs, which will consecutively pave way for the development of low cost and effective alternative health care system.

Evidence-Based Medicine and the Potential for Inclusion of Non-Biomedical Health Systems: The Case for Taijiquan.

Many traditional and complementary and alternative healthcare systems or practices, such as Traditional Chinese Medicine, taijiquan, or acupuncture, are easily found in many North American and European cities. For the most part these practices are not accredited, and their validation remains limited. This is primarily the result of the lack of modern scientific research. Additionally, the studies that are performed rely on evidence and research designs that often negate the true features of these practices with a loss of authenticity. Is it possible or even desirable for these systems to acquire accreditation and inclusion? If so, given the apparent, subjective nature of these practices, can a pluralistic approach to healthcare that retains the Western values of science and medicine be developed that yet respects the diversity of different concepts about life, health and services while permitting these practices to maintain their authenticity? And is it possible to develop a regulatory framework that practitioners can use? The current paper examines questions concerning the uses of non-Western healthcare practices without the loss of their authentic nature. The process of integration is here examined using the inclusion of taijiquan as a health-promoting martial art as the model.

Caregivers' and parents' explanatory models of intellectual disability in Khayelitsha, Cape Town, South Africa.

Post-apartheid, understanding and management of intellectual disability remain poor in South Africa, complicated by various contextual and cultural explanations used to describe and conceptualize this condition. We conducted 20 semi-structured interviews with primary caregivers and parents of children with intellectual disability residing in Khayelitsha, a low-income setting in Cape Town, South Africa. We used Kleinman's Explanatory Models (EMs) of illness to explore terms used to describe and conceptualize this condition. Carers' explanatory models included biomedical causes, injuries during pregnancy or birth, as well as spiritual causes. It was reported that there were significant difficulties in accessing services and support, and difficulties with coping in the context of extreme poverty and deprivation. Current findings highlight a need for collaboration between the biomedical and alternative healthcare systems in educating carers and parents regarding intellectual disability.

Cytotoxic and genotoxic action of Tagetes patula flower methanol extract and patuletin using the Allium test

Tagetes patula is used to treat cancer patients in alternative healthcare systems. However, its cytotoxic and genotoxic effects have not been reported. Therefore, themethanol extract of T. patula flower, the ethyl acetate fraction, and the pure compound patuletin were evaluatedusing the Allium test.The methanol extract and fraction contained ~3% and ~36% patuletin, respectively, with ~98% purity. The methanol extract caused inhibition of Allium root growth displaying an IC50 value of ~500 µg/mL, while the fraction and patuletin were more potent by ~2 and ~5 times, respectively. The Allium root tips demonstrated a decline in prophase, metaphase, anaphase, and telophase stages with concomitant decrease in percent mitotic index in the methanol extract (~5.64), fraction, and patuletin (~4) as compared to the control (~7.61). However, in only methanol extract-treated root tips, an increase in metaphase stage was noted. In addition, the methanol extract predominantly induced c-type, misaligned, and multipolar chromosomal abnormalities while the fraction and patuletin displayed fragments and sticky chromosomes. The fraction and patuletin also produced micronuclei (~2%). In conclusion, T. patula flower methanol extract and ethyl acetate fraction are cytotoxicand genotoxic, which most likely could be due to the patuletin. Further preclinical and clinical studies are required to justify its clinical use.

Catalyzing development of Best Practice Guidelines for Community-managed health Programs: Case study of a Community-Academic Partnership

Background. There is a need to standardize community health practices, while still adhering to principles of community involvement, to ensure social acceptability and equitable access to health services. A set of Best practice guidelines (BPGs) were thus developed through a community-academic partnership (CAP) between the Integrative Medicine for Alternative Healthcare Systems Philippines, Inc. and its affiliated community-managed health programs (CMHPs), the University of the Philippines, and Bicol University.
 Objective. This study aimed to report the process and insights gained from the crafting of the BPGs.
 Methods. The BPGs were developed using a community-based participatory research approach and focused on top ten (10) diseases based on local prevalence and experiences of its CMHPs.
 Results. BPGs were developed for eight (8) communicable diseases (common cold/cough, influenza, measles, pulmonary tuberculosis, acute gastroenteritis, amebiasis, scabies, and intestinal parasitism); and two (2) noncommunicable diseases (diabetes and hypertension), which also provided information on signs and symptoms, initial referral criteria, management, and, where appropriate, specific use of medicinal plants, acupressure, and traditional massage. Emerging issues from this project include how community involvement led to the development of BPGs, the need to update its content, its potential application as a model for costing public health interventions, its anticipated benefits to health workers, the state of local health service delivery, and how the project epitomizes the ideal concept of community-academic partnerships.
 Conclusion. As a CAP project, this process holds promise as a catalyst for stakeholder engagement and health service delivery improvement. Further studies are necessary to map out other potential challenges and success factors, especially the socio-cultural, political, and health impact of CAPs.

Ghanaian traditional and faith healers' explanatory models for epilepsy

Epilepsy is the most common neurological condition in sub-Saharan Africa. A significant number of people with epilepsy in low- and middle-income countries do not receive formal biomedical care. They utilize the services of various traditional and alternative medicine practitioners. However, there is relatively little information about the beliefs and methods of alternative healthcare providers about epilepsy in many African countries. Using explanatory models of illness framework, we interviewed thirty-six traditional and faith healers in Ghana on their beliefs and perceptions about epilepsy, as well as how they would treat epilepsy. The healers' beliefs about the nature of epilepsy were reflected in the labels they assigned to the condition. These indicated a belief in the influence of the moon in epilepsy. Furthermore, the participants held multiple, simultaneous explanatory models of causes for epilepsy, including biological, social, and supernatural causes. Epilepsy was also considered to have serious social implications for patients, especially for women. Finally, their treatment methods involved a range of herbal and spiritual practices. These varied based on the identified cause of the condition, as well as the orientation of the healer. We discuss these findings with reference to their implications for potential collaboration between biomedical and alternative healthcare systems.

Evidence based validation of Indian traditional medicine – Way forward

Evidence based validation of the ethno-pharmacological claims on traditional medicine (TM) is the need of the day for its globalization and reinforcement. Combining the unique features of identifying biomarkers that are highly conserved across species, this can offer an innovative approach to biomarker-driven drug discovery and development. TMs are an integral component of alternative health care systems. India has a rich wealth of TMs and the potential to accept the challenge to meet the global demand for them. Ayurveda, Yoga, Unani, Siddha and Homeopathy (AYUSH) medicine are the major healthcare systems in Indian Traditional Medicine. The plant species mentioned in the ancient texts of these systems may be explored with the modern scientific approaches for better leads in the healthcare. TM is the best sources of chemical diversity for finding new drugs and leads. Authentication and scientific validation of medicinal plant is a fundamental requirement of industry and other organizations dealing with herbal drugs. Quality control (QC) of botanicals, validated processes of manufacturing, customer awareness and post marketing surveillance are the key points, which could ensure the quality, safety and efficacy of TM. For globalization of TM, there is a need for harmonization with respect to its chemical and metabolite profiling, standardization, QC, scientific validation, documentation and regulatory aspects of TM. Therefore, the utmost attention is necessary for the promotion and development of TM through global collaboration and co-ordination by national and international programme.

Reasons and circumstances for the late notification of Acute Flaccid Paralysis (AFP) cases in health facilities in Luanda.

IntroductionAs the polio eradication effort enters the end game stage, surveillance for Acute Flaccid Paralysis in children becomes a pivotal tool. Thus given the gaps in AFP surveillance as identified in the cases of late notification, this study was designed to explore the reasons and circumstances responsible for late notification of AFP and collection of inadequate stools (more than 14 days of onset of paralysis until collection of the 2nd stool specimen) of AFP cases in health facilities equipped to manage AFP cases.MethodsEleven AFP cases with inadequate stools were reported from January 2 to July 8, 2012 - Epidemiological Weeks 1-27. The families of these cases were interviewed with an in-depth interview guide. The staff of the seven health units, where they later reported, was also enlisted for the study which used in-depth interview guide in eliciting information from them.ResultsIgnorance and wrong perception of the etiology of the cases as well as dissatisfaction with the health units as the major reasons for late reporting of AFP cases. The first port of call is usually alternative health care system such as traditional healers and spiritualists because the people hold the belief that the problem is spiritually induced. The few, who make it to health units, are faced with ill equipped rural health workers who wait for the arrival of more qualified staff, who may take days to do so.ConclusionAn understanding of the health seeking behavior of the population is germane to effective AFP surveillance. There is thus a need to tailor AFP surveillance to the health seeking behavior of the populations and expand it to community structures.

Constructing and Evaluating “as-is” and “to-be” OPM Models for the Healthcare Sector for Adoption of Vscan

Current healthcare systems are no longer sustainable; governments around the world have come to realise that the rapidly growing demand for healthcare cannot be matched by sufficient financial resources, and that improving efficiency and cutting costs is not enough. System-wide changes that include people, products, processes, and services are required. All the relevant stakeholders need to get involved in developing alternative healthcare system models and be able to understand and interact with models of such systems in order to accelerate the adoption and diffusion of changes. This paper presents a systems approach to developing affordable business models based on the specific case example of novel portable ultrasound scanning device – the GE Vscan – for use in primary care. We investigated whole system changes required for adopting Vscan. Systems engineering principles are applied to represent alternative business models around this technology. Object Process Methodology (OPM) is utilized to visualise the conceptual models in order for subject matter experts to successfully participate in the development and validation of alternative healthcare systems. The paper concludes with a discussion on wider implications of adopting systems engineering methods and techniques.

The traditional belief system in relation to mental health and psychiatric services in Sudan

Traditional healers' centres may constitute community resources for people with a mental illness. Many low-income countries are seeking to integrate mental health into their mainstream health services and primary healthcare, so as to decrease the duration of untreated illness. Traditional healers can help to meet these needs. A series of four studies has been conducted in central Sudan. In-patients with mental disorders undergoing treatment with traditional healers were recruited, as well as some of the healers themselves. The resulting observations should help practitioners trained in Western psychiatry to better understand traditional healing as an alternative healthcare system. The results should contribute to current debates on whether or not traditional healers in Africa should be officially recognised as healthcare providers. They should also deepen social scientists' understanding of the role of culture in mental health and help policy makers to improve mental health services.