Ancient Practice Research Articles

Foucault's Epicureanism: Parrhēsia , Confession, and the Genealogy of the Self

Abstract: This paper addresses the apparent absence of a systematic analysis of Epicureanism in Foucault's exploration of ancient philosophy. By considering Pierre Hadot's remark concerning Foucault's problematic neglect of the Epicurean notion of hēdonē , it revisits Foucault's work in search of traces of his engagement with Epicureanism. It then goes on to analyze the genesis of the notion of parrhēsia in Foucault's work, showing how it first appears and is developed in a series of analyses of the "philosophy of the garden," first in a reading of Epicurus's view on the study of nature in the Vatican Sayings , second in his study of Philodemus's Peri Parrhēsias . It is precisely in a series of readings of the Epicurean school that Foucault finds one of his key theoretical resources guiding his study of ancient philosophical practices in the 1980s. More importantly, the paper seeks to articulate the ways in which the analysis of parrhēsia —and of the Epicureans in particular—is situated in a broader genealogy of confession, which connects Foucault's studies of ancient philosophy to his readings of Christianity and the formation of the modern technologies of power and veridiction, defining aspects of the earlier project of a History of Sexuality , as announced in the Will to Knowledge . Finally, the paper articulates a possible view on the critical import of parrhēsia in this broader genealogy of confession.

Illness, Pain, and Health Care in Early Christianity

Illness, Pain, and Health Care in Early Christianity

Traditional Birth Attendant in the Maternal and Child Health Space in Nigeria: Ancient Practices and Modern Recommendations

Background: Arguments on the usefulness of Traditional Birth Attendants (TBAs) in maternal and child health care and the reduction of maternal and child morbidity and mortality indices or not, persist. This paper sought to explore the ancient practices of TBAs and to strike a balance to portray modern recommendations that would contribute to improved maternal and child health status. Methods: The method used was review of relevant literatures from open-access journals and google scholar data base, as well as research reports on variables of the subject in developing countries. Results: Findings revealed that the overlapping root of TBAs’ practice burden include poor social amenities, inadequate health facilities and services in rural areas where over 70% of the population reside. While evidencebased report showed that even when 93% of rural women registered for Ante-Natal Care, 49% were delivered at home by TBAs and 73% has sought help from them for retained placenta with bleeding. Also, 41% of women of child bearing age indicated that maternal and child infection is a risk associated with the patronage of TBAs, whereas 32.8% indicated that bleeding during and after delivery were equally risks associated with TBA-provided maternal health services. Such circumstances of service were associated with harmful practices with attendant health and medical complications to recipient mother and child. However, helpful ancient practices of TBAs include; home visiting to promote well-being of mother and child (9.84%), sitz bath (17.20%), encouraging breastfeeding up to 2years (18.90%) etc. The modern recommendations, x-rayed the remedial actions on the harmful practices and associated negative consequences to improving maternal and child health indices in Nigeria. Conclusion: For reasonable and sustainable reduction in the burden associated with the practices of TBAs in maternal and child health care in Nigeria, contextual focused training and continuous mentoring is a necessity.

Mindfulness-Based Cognitive Therapy: A Review

Mindfulness, an ancient Buddhist practice, is not just recognizing and living in the present moment. It is a way of welcoming things by recognizing them right now. Mindfulness is an approach about gently bringing attention, which tends to go to the past and future, back to the present and accepting what is perceived. It includes intentional and nonjudgmental attention in the present moment. Before thought, which is always one step ahead or behind the present moment, there is awareness in the present moment. In fact, mentally healthy individuals who are able to distinguish between the real and the unreal think about the question of "Is this the case or am I perceiving it this way?". For this reason, how the person perceives is more important than events/situation. The most important determinant on the way to awareness is the way of welcoming individually perceived events/situations. Attitudes as a form of welcoming events and situations are staying in the moment, compassion, noticing judgments, acceptance, beginner’s mind, patience, letting things go. Many factors may cause students stress in nursing education. Academic and clinical stressors are experienced by many nursing students enrolled in a nursing education program. When these stressors are not managed well, mental problems such as depression and anxiety disorder may ocur. This review aimed to analyze the mindfulness-based cognitive therapy program.

ASSESSMENT OF PREVALENT PERCEPTIONS REGARDING EFFICACY OF VARIOUS COVID’19 TREATMENTS IN THE POPULATION OF PUNJAB, PAKISTAN

Coronavirus disease or COVID’19, caused by SARS-CoV-2, was the most recent pandemic in world history. The total cases worldwide exceeded 547M with global death toll exceeding 6.34M. The unprecedented infection rates were coupled with panic and misinformation that altered public perceptions regarding treatment options. The present study was aimed at assessing the factors that modulated public reliance on various treatments, ranging from non-pharmaceutical, herbal options to modern medicines and vaccines. The methodology employed was of qqualitative analysis using survey tool and SPSS, focusing on perceived efficacy, safety, availability, cost-effectivity and immune modulation of treatments. The results exhibit a trend within responders in favor of vaccines and herbal medicines. Moreover, a general hesitation has been expressed in regards to pharmaceutical treatment. The results indicate the highest positive perceptions in people regarding efficacy of herbal treatments (56.3 % in agreement), safety (59.4% in agreement), availability (63.2% in agreement), cost effectiveness (47.2% in agreement) and immunity-boosting activity (63.9% in agreement). Such an indication can be attributed to ancient Ayurvedic practices that serve as a recourse, during emergency situations. Moreover, the least positive perceptions were indicated for pharmaceutical drugs regarding efficacy, safety, availability, cost-effectivity and immune modulation activity. The trends observed in this resource can be utilized to design policy, with enhanced understanding of people’s beliefs and norms. Moreover, the communications and awareness endeavors during a global pandemic can be catered to existing biases and uncertainties in Pakistani population.

Management of essential hypertension through Basti Karma: A case study

Stroke, myocardial infarction, vascular disease, and chronic renal disease are some of the most severe complications that can arise from hypertension. High blood pressure is defined as a systolic reading of 140 mm Hg or more, a diastolic reading of 90 mm Hg or more, or the need for antihypertensive medicine to control either reading. Primary/essential hypertension has no known aetiology, and secondary hypertension, which occurs due to another disease process, are the two main categories into which hypertension can be placed. Hypertension incidence and prevalence look very different in underdeveloped and developed nations. Hypertension in India has increased between three and six-fold among urban dwellers and ten and thirty-fold among rural dwellers. It is estimated that 600 million people are affected worldwide. Hypertension can be correlated with a vata prakopa janya vyadhi involving hridaya, rasavaha srotas, raktavaha srotas etc. Basti karma is the primary treatment for vata dosha. This case study demonstrates the efficacy of basti karma in management of vital hypertension by considering vata dosha, hridaya and rasa-rakta vaha srotas. The present case report emphasizes the potential of Basti Karma, as a supplementary therapeutic approach for the management of critical hypertension. This statement highlights the significance of personalized treatment strategies and comprehensive methodologies in improving patient outcomes and overall quality of life. Additional investigation and expanded clinical studies are necessary to authenticate the results and prove the effectiveness and safety of Basti Karma in the therapy of hypertension. Incorporating ancient practices such as Basti Karma into contemporary medical procedures can enhance the comprehensiveness and efficacy of hypertension therapy approaches.

Yoga studio websites: are they an accurate first glance at the studio’s mission, values, and resources?

BackgroundYoga, as an ancient and modern practice, increases physical, mental, emotional, spiritual, and social health. Yoga studio websites serve as a dissemination channel for studios to express their offerings, whom they employ, and whom they seek as clientele. Public health workers, physicians, researchers, and clinicians, can refer to existing studios to increase health among their patients or clients. The degree to which these websites can provide relevant information to these various stakeholder groups has yet to be defined.MethodsA pragmatic, sequential mixed-methods study was employed with quantitative data extraction, summarized as means and proportions, to score the studio websites (N = 28), and semi-structured interviews (n = 6) analyzed using the rigorous and accelerated data reduction (RADaR) technique, to confirm website content and staff intention. To explore urban and rural characteristics, yoga studios in southwest Virginia and Los Angeles were selected for inclusion.ResultsOverall, community-based yoga studios websites included information on the type, duration, cost, and COVID mitigation strategies. The most common class duration was 60 min. Rural Southwest Virginia studios offered 8.5 classes per week whereas those in urban Los Angeles offered 24.2 classes per week. All studios used iconography and images to invite racial, ethnic, age, and body type and ability diversity. While studios in both areas specified that there were 200- and 500-hour registered yoga teachers, many of the instructor biographies did not include information on their training. Although only preliminary, the interviews (n = 6) confirmed that the websites generally represented the feel, intention, and offerings of the studio and that the primary purpose of the studio was to build relationships and ensure people felt comfortable in the space.ConclusionWebsite information was related to studio offerings and values; however, discussion with management or visiting the studio may provide a richer picture of the yoga practices offered in the space. Further suggestions for website content are provided.

Agni: The Eternal Flame Guiding Indian Life and Spirituality

This opinion delves into India's profound connection with Agni, exploring its significance as a symbol of divinity, transformation, and guidance. The ancient practice of Yagya, a ritual centered around Agni, has evolved through time, maintaining its relevance in modern India. Agni's teachings are reflected in Vedic mantras and are interwoven into the fabric of daily life through rituals like Balivaishya Yagya. The manuscript discusses Agni's role in 16 Sanskaras, guiding individuals through life's stages while promoting values and virtues. It also explores Agni's metaphysical dimension, manifested as sacred eternal flames or lamps, revered by Yogis and the masses alike. The spiritual essence of Agni is emphasized through practices like Yogagni, Pranagni, and Mantragni. Additionally, Maharshi Aurobindo's perspective unveils Agni's deep symbolism in Vedic hymns as a bridge between humanity and divine realms. Ultimately, the opinion underscores that Agni is not a mere concept, but an integral thread woven into the tapestry of Indian life, continuing to inspire generations to embrace wisdom, virtue, and spiritual growth.

Lessons From India: A Narrative Review of Integrating Yoga Within the US Healthcare System.

The ancient practice of yoga has gained worldwide popularity as a way for people to improve their overall health and well-being. This manuscript reviews and examines the history of yoga, its physical and mental health benefits, its incorporation into the Indian healthcare system, and the public perception of yoga in India. Many initiatives for yoga exist, including promoting research on yoga, providing education and information on its benefits, and developing evidence-based standardized yoga therapy guidelines. With this in mind, this narrative review article explores the potential benefits of incorporating yoga into the United States (US) healthcare system and the possible challenges of doing so. It also provides valuable insights for policymakers and healthcare professionals.

Application and Impacts of Mulch Installation Techniques on Indian Horticulture: An In-depth Review

Mulching, an ancient agricultural practice, has emerged as a critical tool in modern horticulture due to its numerous benefits. This review examines the application and impacts of mulch installation techniques on Indian horticulture, with a focus on understanding different mulch types, traditional and modern techniques, advantages, potential impacts on crop growth and yield, and environmental implications. The introduction elucidates the definition and historical importance of mulching in horticulture and sets the objective of the review: to comprehensively assess various mulch installation techniques and their impacts on Indian agriculture. The subsequent sections delve into the different types of mulches used in Indian horticulture, categorizing them into organic, inorganic, and biodegradable materials. Each type is discussed in detail, including its benefits and concerns, providing a holistic understanding of the materials available to farmers. Traditional mulching techniques, such as hand-spreading and the use of simple tools, are explored, highlighting local adaptations and indigenous practices that have been prevalent in Indian agriculture for generations. Modern mulching techniques, like automated mulch spreaders, plastic film laying machines, and mulch mats/sheets, are then examined, emphasizing their potential to enhance efficiency and productivity in contemporary agriculture. The review goes on to explore the advantages of mulching techniques, including soil moisture retention, weed growth reduction, temperature regulation, erosion control, and organic matter addition in the case of organic mulches. These benefits underscore the vital role of mulching in sustainable and resource-efficient farming. The potential impacts of mulching on crop growth and yield are analyzed, focusing on improved germination and early growth, reduced water requirements, enhanced pest and disease resistance, and increased yield and quality of produce. The effects on different crop types, such as fruits, vegetables, and flowers, are also explored, elucidating the versatility of mulching techniques across diverse agricultural contexts. Furthermore, the review investigates the environmental impacts of various mulch materials, emphasizing benefits such as soil structure improvement, reduction in water runoff, and carbon sequestration. Simultaneously, concerns, including plastic pollution from inorganic mulches, decomposition rate and residues from organic mulches, and impacts on local biodiversity, are discussed. Finally, recommendations for future research and practice are proposed. These include exploring new biodegradable mulch options, developing cost-effective installation techniques, implementing training programs for farmers and horticulturists, and formulating policies and guidelines for sustainable mulching practices. By addressing these challenges, the potential of mulching in contributing to sustainable and productive agriculture can be fully realized.

Seeing the Biblical World of Sodom-Mamre Through Surveillance

Abstract Genesis depicts a world of tension and collaboration among the groups and families that constitute the stories of the formation of early Israel. The obedience and behaviour of characters within the narrative determine covenantal inclusion or exclusion. The narrative of Sodom-Mamre can be interpreted as a story of surveillance, wherein characters observe each other and act based on their desire for knowledge and control. Though surveillance promises omniscience, knowledge ultimately remains limited. The divine character yearns to witness human experience, while the human characters act as mirrors to this impulse. Lot’s wife highlights the chasm between the desire to see and know and the limits of a gaze. Ultimately, this desire begets violence as the surveillant gaze produces cognitive dissonance and narcissism. This essay references surveillance studies, critical biblical scholarship, psychoanalytic and philosophical traditions concerning desire, particularly the desire of the eyes, the gaze, and ancient imperial surveillance practices.

A Systematic Review on Prospects and Barriers of Silk in Bangladesh

Sericulture is an ancient agricultural practice and silk production has economic as well as historical importance in Bangladesh. The study has reviewed the prospects and barriers of silk compiling the production to industry level. In the last five years, silk production has decreased from 46 to 41 metric tons. As the total demand for silk in Bangladesh is 300 metric tons, it created import pressure, accounting for an average of 393.73 metric tons. Bangladesh produced 1099 kg silk yarn which contributed to the 4.43million USD export return and made the emergence of light more than in previous years. This paper shows that 75% of the total rural population lived in rural areas, and more than 60% of the total population directly or indirectly depended on agricultural activities where majority of employees were women, accounting for 60%. Bangladesh has achieved the honor of becoming the second largest exporter of Readymade Garments (RMG) which employed 4.4 million people and exported 81.16 million dollars, contributing about 18% of the total GDP. But the condition stagnated regarding the proper timing of raw materials procurement, temperature fluctuation, the Covid-19 outbreak, and others. Bangladesh Sericulture Development Board, Bangladesh Sericulture Research and Training Institute, and other non-government organizations support are required for its further growth.
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Vipassana Meditation an Indigenous Approach for Good Self-Esteem and Self-Efficacy

Vipassana is one of the most ancient techniques of mindful meditation found and practiced in India. History of vipassana can be traced back to 2500 years ago, when Gautama Buddha rediscovered this ancient Indian practice. Buddha taught vipassana as a universal remedy for all illness. Vipassana is self-transformation technique through self-observation that brings deep awareness about mind and body interconnection. The present study aimed to compare the level of self-esteem and self-efficacy of adults who practice vipassana and also those who do not practice vipassana. The research was conducted on 32 number of adults, among them 16 adults practiced vipassana and the rest 16 did not have awareness about the practice. Questionnaire survey and interview method was utilized in the collection of data. Generalized Self-Efficacy Scale (GSES) and Rosenberg self-esteem scale was used in the research. To analyse the data mean, SD and t-test was used. The research emphasized the relevance of vipassana in today's modern world for better mental health.

Isolation and Identification of L-asparaginase Producing Bacteria from Soils of Different Agroclimatic Zones of Jammu (J&K), India

A milestone was set in the field of medicine with the discovery of L-asparaginase present in the serum of guinea pig responsible for action against the acute lymphoblastic leukemia. Since then, the use of L-asparaginase as a potential anti-cancer drug has been a great success in the field of modern oncology. Despite its varied sources, new sources are continuously being explored to obtain a high therapeutic index drug. The study aims to isolate potential L-asparaginase producing microorganisms from environmental niches of Northwestern Himalayas. The climatic conditions of the region and ancient agricultural practices which are still being followed in these areas, add up to the diverse microbial repository and a potential habitat which can be explored to obtain a potent asparaginase producing microbial source. In the study, soil samples from different regions of Jammu were collected aseptically. From the isolation studies, a total of 44 bacterial isolates were obtained. Pure cultures were then screened for asparaginase activity both qualitatively as well as quantitatively using agar plate and nesselerization method. Screening studies resulted in the isolation of a potent L-asparaginase producer isolated from black gram soil sample of Rajouri, Jammu showing an enzyme activity of 9.14 U/ml. Based on biochemical and molecular approaches, the isolate was identified as Enterobacter aesburiae strain R16C1 / No. MT93543. The study resulted in the isolation of a pure bacterial culture from the soils of Northwestern Himalayas possessing anti-cancer asparaginase activity. Further, optimization studies can help in considerably increasing the enzyme activity which can be tested against different human cancer lines for its anti-cancer efficacy.

From Tradition to Science: Unravelling the Mysteries of Wet Cupping Therapy for Modern Healthcare

Background. Wet cupping therapy (WCT) is an ancient therapeutic practice involving suction cups and controlled incisions. It is widely used in traditional and complementary medicine systems for treating diverse conditions. This narrative review aimed to summarize the current evidence on the effects of WCT and provide an overview of its therapeutic potential. Methods. A comprehensive literature search was conducted using PubMed, Embase, and Scopus databases to identify studies published from January 2000 to March 2023, evaluating the therapeutic effects of WCT in various health conditions. The retrieved studies were critically reviewed and analyzed to identify key findings. Results. The findings suggest that WCT has potential therapeutic effects across different health conditions. It has been reported to alleviate pain, reduce inflammation, modulate the immune response, improve blood circulation, and enhance overall well-being. Efficacy of WCT has been demonstrated in managing musculoskeletal disorders (e.g., low back pain, rheumatoid arthritis), respiratory conditions (e.g., asthma, chronic obstructive pulmonary disease), and mental health issues (e.g., anxiety, sleep quality). Additionally, WCT has shown promise as a complementary therapy for metabolic disorders, cardiovascular diseases, and infertility. Conclusion. WCT exhibits potential benefits as a traditional therapeutic modality. Accumulated evidence suggests it can provide symptomatic relief, improve quality of life, and complement conventional treatments. However, it is important to acknowledge the limitations of the reviewed studies. The absence of a standardized cup placement protocol hinders determining optimal placement for specific health conditions. Further investigation considering anatomical descriptions and individual variations is necessary to enhance treatment effectiveness. Moreover, the underlying mechanisms of WCT's therapeutic effects are still hypothetical, warranting more direct and accurate evidence. Future research should focus on elucidating these mechanisms to establish a comprehensive understanding of WCT's effects.

A Review on Chlorination of Harvested Rainwater

The supply of safe drinking water to rural communities has always been challenging, unlike in most large cities where government authorities have constructed central water supply systems. In many rural areas, primary water sources such as surface water and groundwater are at risk of contamination with rapid agricultural and industrial growth and climate change-related issues. Rainwater harvesting is an ancient practice for rural communities, and the momentum around its use is continually growing in recent years. However, the lack of sustainable treatment facilities on a small scale encourages dwellers to consume harvested rainwater (HRW) without any treatment even though drinking untreated HRW may have multiple health impacts in many cases. There are several methods of treating HRW. While chlorination is extensively used to disinfect water in large volumes, e.g., central drinking water supply systems), it has not been widely adopted for treating water on a small scale. We present a scoping review to explore whether chlorination could be a viable option for disinfecting HRW at a domestic level. It is found that inadequate treatment prior to chlorine disinfection could produce chlorine disinfection byproducts (DBPs). Limited data on DBP concentrations in HRW are available to assess its health implications. Based on this review, it is argued that chlorination could be an option for treating HRW at a domestic level when limitations associated with this method (such as safe storage, appropriate sustainable technology, and lessening DBPs by lowering total organic carbon before chlorination through other treatment methods) are resolved.

Ancient catechumenate

In this article the development of the ancient liturgical-didactic practice of the catechumenate is explored by making use of both primary and secondary liturgical-historical sources. The aim is to sketch a liturgical-historical overview regarding the rise, the flourishing, and the demise of the catechumenate; describing what the catechumenate involved, why it existed as well as reasons for changes to this Christian practice from the late fourth century AD onwards. The description commences in the first decades of the history the Christian Church and ends in the later medieval period and before the onset of the Reformation when what was known as the catechumenate ceased to exist and disappeared as Christian liturgical practice of initiation. In conclusion, the potential value of this ancient practice for current day liturgical praxis is summarised.

Effectiveness of visceral fascial therapy targeting visceral dysfunctions outcome: systematic review of randomized controlled trials

BackgroundFascial Therapy is an ancient and widespread practice throughout the world. These approaches are very common in osteopathic practice and taught in workshops for professionals from different areas of health care, including Physiotherapy. This type of treatment is quite specialized and centered on the therapist. However, there is a lack of high-quality and low-risk bias studies that justify the use of this practice. Despite this, there is little scientific evidence about the effectiveness of Fascial Therapy to treat some visceral disorders. The purpose of this study was to critically appraise the scientific literature concerning the clinical efficacy of techniques used in Fascial Therapy targeting the visceral system.MethodsThis systematic review included randomized controlled trials in any language or date of publication. All primary outcomes reported were included. The methodological quality and statistical reporting of each eligible trial were evaluated using the version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). This systematic review provided a synthesis of current evidence on the effects of Fascial Therapy in patients with visceral disorders and/or pain. A total of 11 studies were included, with five of them covering gastrointestinal dysfunction, two covering cardiorespiratory dysfunction, two covering musculoskeletal dysfunction, and two covering urogenital dysfunction.ResultsFascial Therapy targeting the visceral system has been shown to be effective in reducing pain over the long term in people with low back pain when combined with standard physical therapy and effective in reducing gastroesophageal reflux symptoms over the short term. Considering the overall bias, six studies were at high risk of bias, two studies had some concerns and only three studies were at low risk of bias. Of the three studies with a low risk of bias, only two showed positive results and were effective in improving the studied outcome.ConclusionThis systematic review shows that currently, there is poor evidence for the efficacy of the techniques used in Fascial Therapy targeting the visceral system, and this information can help healthcare professionals in decision-making related to the use of Fascial Therapy targeting the visceral system in patients with visceral disorders and/or pain.

Ancient restoration practices in the Monumental Nymphaeum at Tripolis ad Maeandrum (Turkey): multi-analytical approach on Roman and Byzantine bonding mortars

The study of ancient architectural restoration has recently gained attention in the field of archaeometry thanks to a new sensitivity for the long biographies of human artifacts. The paper focuses on ancient repairs documented in the column shafts of the Monumental Nymphaeum of Tripolis ad Maeandrum (Denizli, Turkey). Bonding mortars used to hold the ancient patches in place were sampled and analysed according to a multi-analytical protocol, coupling mineralogical and petrographic investigation (XRPD and OM) together with FT-IR and chromatographic and mass spectrometric techniques (i.e. Py–GC–MS, GC–MS, HPLC-MS) for the characterisation of the inorganic and organic components. For the inorganic part, medium and fine-grained crystals of calcite are used as aggregates. As for the organic fractions, three different ingredients have been detected: egg, beeswax and Pinaceae resin. These multi-ingredient recipes detected in Tripolis are discussed with reference to ancient literary sources and the results of scientific investigations previously performed on ancient architectural repairs in the nearby city of Hierapolis of Phrygia, to highlight functional and chronological differences.

Complementary Therapies: Tai Chi in the Prevention and Management of Cardiovascular Disease.

Cardiovascular disease has remained the top contributor to global mortality for decades, necessitating research into the most effective methods of its prevention and treatment. Simultaneous with an immense amount of discovery and innovation in the field of cardiology, certain therapies with traditional Chinese origins have become progressively more popular in the West in recent decades. Specifically, ancient meditative mind-body practices such as Qigong and Tai Chi may lower cardiovascular disease risk and severity through a focus on movement and meditation. Such practices are generally low-cost and modifiable, with few adverse effects. Studies have shown higher quality of life in patients with coronary artery disease and heart failure after participation in Tai Chi, as well as a positive impact on cardiovascular risk factors such as hypertension and waist circumference. Most studies in the field have various limitations, such as small sample size, lack of randomization, and inadequate control; however, these practices show potential as an adjunct in the prevention and treatment of cardiovascular disease. Patients unable or unwilling to partake in traditionally aerobic activities may benefit greatly from such mind-body therapies. Nonetheless, more studies are warranted for more definitive answers to the question of Tai Chi and Qigong's effectiveness. In this narrative review, we discuss the current evidence surrounding the effects of Qigong and Tai Chi on cardiovascular disease, in addition to the limitations and difficulties in conducting such studies.