Traditional medicine use by cancer patients in Thailand

Ethnobotanical relevance Cancer patients commonly use traditional medicines (TM) and in Thailand these are popular for both self-medication and as prescribed by TM practitioners, and are rarely monitored. A study was conducted at Wat Khampramong, a Thai Buddhist temple herbal medicine hospice, to document some of these practices as well as the hospice regime. Materials and methods Cancer patients (n=286) were surveyed shortly after admission as to which TMs they had previously taken and perceptions of effects experienced. They were also asked to describe their current symptoms. Treatment at the hospice is built upon an 11-herb anti-cancer formula, yod-ya-mareng, prescribed for all patients, and ideally, its effects would have been evaluated. However other herbal medicines and holistic practices are integral to the regime, so instead we attempted to assess the value of the patients׳ stay at the hospice by measuring any change in symptom burden, as they perceived it. Surviving patients (n=270) were therefore asked to describe their symptoms again just before leaving. Results 42% of patients (120/286; 95% CI 36.4%, 47.8%) had used herbal medicines before their arrival, with 31.7% (38/120; 95% CI 24%, 40.4%) using several at once. Mixed effects were reported for these products. After taking the herbal regime at Khampramong, 77% (208/270 95% CI; 71.7%, 81.7%) reported benefit, and a comparison of the incidence of the most common (pain, dyspepsia, abdominal or visceral pain, insomnia, fatigue) showed statistical significance (χ2 57.1, df 7, p<0.001). Conclusions A wide range of TMs is taken by cancer patients in Thailand and considered to provide more benefit than harm, and this perception extends to the temple regime. Patients reported a significant reduction in symptoms after staying at Khampramong, indicating an improvement in quality of life, the aim of hospices everywhere. Based on this evidence, it is not possible to justify the use of TM for cancer in general, but this study suggests that further research is warranted. The uncontrolled use of TMs, many of which are uncharacterised, raises concerns, and this work also highlights the fact that validated, robust methods of assessing holistic medical regimes are urgently needed.

Understanding the resurgence of traditional authorities in post-apartheid South Africa

Drawing their power not from the ballot box but from a supposedly ancient wellspring of power, hereditary traditional authorities in postcolonial Africa have frequently posed challenges for incoming ‘democratic’ governments. The situation in post-apartheid South Africa is no different. However contentious their role under the colonial and apartheid systems of government was, the Constitution of the new South Africa (1996) recognised traditional authorities and afforded them opportunities for a political resurgence. This paper reviews the changing status of traditional authorities in the Eastern Cape Province over the twenty years since 1994. It explores the resurgence of the chiefs in relation to the consolidation of both democratic processes and of emergent, neo-patrimonial modes of government. It briefly considers the role of traditional authorities in three key and closely related spheres, namely the institution of the Eastern Cape House of Traditional Leaders, the question of how gender is handled by and within traditional institutions, and the continuing challenges of land administration and development in rural areas. In all these spheres, and in the face of real opposition, the voice and influence traditional authorities have emerged stronger than ever. We conclude by suggesting that as they are drawn deeper into governance and have to play a formal role in addressing the myriad institutional challenges, new questions will and should be asked about the status and influence of traditional authorities, and their substantive contribution to democracy in South Africa.

Different strategies for improving summer thermal comfort in heavyweight traditional buildings

In order to exploit the passive energy potential of the building envelope, it is important to provide a right combination of insulation thickness, heat capacity and night-time ventilation. In this paper, this issue will be tackled with reference to an historic building in Catania (Southern Italy). The building was built at the end of the XIX century, and its opaque envelope is entirely made with lava stones, which is typical of traditional architecture in this area. Starting from the current configuration of the building, many hypotheses for refurbishment are considered, combined with different strategies for passive cooling, such as night-time ventilation, use of shading devices and adoption of highly-reflective coatings. The effectiveness of each solution in terms of summer thermal comfort is evaluated through dynamic thermal simulations carried out with EnergyPlus. The results show the synergic effect of these strategies, as well as their individual impact, and allow to draw some general conclusions about the behaviour of heavyweight buildings under moderately hot weather conditions.

Assessing how retrofit of traditional buildings impacts indoor environment and occupant’s thermal comfort

Buildings consume a large amount of energy, in both their use and production. Retrofitting aims to achieve a reduction in this energy consumption. However, there are concerns that retrofitting can cause negative impacts on the internal environment including poor thermal comfort and health issues. This research investigates the impact of retrofitting the façade of existing traditional buildings and the resulting impact on the indoor environment and occupant thermal comfort. A Case building located at the University of Reading has been monitored experimentally and modelled using IES software with monitored values as input conditions for the model. The proposed façade related retrofit options have been simulated and provide information on their effect on the indoor environment. The findings show a positive impact on the internal environment. The data shows a 16.2% improvement in thermal comfort after retrofit is simulated. This also achieved a 21.6% reduction in energy consumption from the existing building.