Doctor of Philosophy / This thesis analyses the concept of indigenous peoples’ right to self–determination within the international human rights system and explores viable avenues for the fulfilment of indigenous claims to self–determination through the design, implementation and evaluation of development policies. The thesis argues that development policy plays a crucial role in determining the level of enjoyment of self–determination for indigenous peoples. Development policy can offer an avenue to bypass nation states’ political unwillingness to recognize and promote indigenous peoples’ right to self–determination, when adequate principles and criteria are embedded in the whole policy process. The theoretical foundations of the thesis are drawn from two different areas of scholarship: indigenous human rights discourse and development economics. The indigenous human rights discourse provides the articulation of the debate concerning the concept of indigenous self–determination, whereas development economics is the field within which Amartya Sen’s capability approach is adopted as a theoretical framework of thought to explore the interface between indigenous rights and development policy. Foundational concepts of the capability approach will be adopted to construct a normative system and a practical methodological approach to interpret and implement indigenous peoples’ right to self–determination. In brief, the thesis brings together two bodies of knowledge and amalgamates foundational theoretical underpinnings of both to construct a normative and practical framework. At the normative level, the thesis offers a conceptual apparatus that allows us to identify an indigenous capability rights–based normative framework that encapsulates the essence of the principle of indigenous self–determination. At the practical level, the normative framework enables a methodological approach to indigenous development policies that serves as a vehicle for the fulfilment of indigenous aspirations for self–determination. This thesis analyses Australia’s health policy for Aboriginal and Torres Strait Islander peoples as an example to explore the application of the proposed normative and practical framework. The assessment of Australia’s health policy for Indigenous Australians against the proposed normative framework and methodological approach to development policy, allows us to identify a significant vacuum: the omission of Aboriginal traditional medicine in national health policy frameworks and, as a result, the devaluing and relative demise of Aboriginal traditional healing practices and traditional healers.

Background. Traditional plant use was studied in Lao PDR. Research focused on medicinal plant use by the Brou, Saek and Kry ethnic groups, traditional plant repellents against parasitic arthropods and leeches, and the phylogeny and biogeography of the medicinally-important snake gourd genus (Trichosanthes, Cucurbitaceae).  Methods. The ethnobiology research used a combination of structured interviews, village surveys, botanical collecting, hydro-distillation, GC-MS analysis, literature studies, and laboratory experiments. The plant systematics research used a combination of morphological studies, molecular biology laboratory work, and phylogenetic, dating and biogeographical analysis.  Results. Informants reported the use of close to 100 species to repel arthropods and leeches, many of which have constituents with documented efficacy.  Brou, Saek and Kry informants use over 75 plant species for women’s healthcare, mainly during the postpartum period for steam sauna, steam bath, hotbed, mother roasting, medicinal decoctions and infusions, and postpartum diet.  A molecular phylogeny of Trichosanthes and Gymnopetalum using a broad sampling of ~60% of their species and 4756 nucleotides of nuclear and plastid DNA shows that Gymnopetalum is nested within Trichosanthes. Fossil-calibrated Bayesian molecular dating of the Trichosanthes phylogeny reveals an early Oligocene origin of the genus, and many of the extant sections originating and diversifying during the Miocene. Biogeographical analysis shows a likely East or South Asian origin of Trichosanthes, with lineages diversifying and spreading throughout Australasia from the early Pliocene to the Pleistocene.  Discussion. Traditional plant use in Lao PDR is common and widespread. The presence among the repellent species of economical alternatives to costly synthetic repellents is tenable, and the subject of ongoing studies.  Postpartum traditions and medicinal plant use are essential parts of childbirth and postpartum recovery in these ethnic groups, and many other groups in Lao PDR. Efforts to improve maternal healthcare and reduce maternal and infant mortality need to integrate these traditions with modern notions of healthcare to achieve wider adoption. Documenting all possible uses of commonly used medicinal plant species shows that similarity in use between these ethnic groups is relatively low considering that they share, and have shared for many generations, the same environment and resources. A lack of effective cures leads to a process of continuous innovation, where effective cures are shared between cultures, but remedies of only cultural importance, or those under evaluation are culture-specific.  The Trichosanthes phylogeny implies the merging of Gymnopetalum into Trichosanthes, and this is done using available names or new combinations. A synopsis of Trichosanthes, the new combinations, and a revision of the species in Australia, are made and presented.  Conclusions. Traditional plant use is widespread in Lao PDR, and of significance to many people as a source of primary healthcare and inexpensive repellents. The important medicinal plant genus Trichosanthes includes Gymnopetalum, and has a complex biogeographic history with multiple colonization events of Australasia.

<p>This investigation focused on Rhoicissus tomentosa, belonging to the family, Vitaceae in an attempt to assess the phytochemistry of this plant which is widely used by traditional healers in South Africa to ensure the safe delivery during pregnancy and childbirth (Hutchings et al., 1996).</p>

Seventeen Cree anti-diabetic herbal medicines and eight Traditional Chinese Medicines have been examined for their potential to cause interactions with drugs, which is considered as a major reason for adverse drug effects. Specifically, the effect of these natural health products was examined on major Phase I drug metabolism enzymes including cytochrome P450, human carboxylesterase-1 and flavin-containing monooxygenases. Several of these natural health products have the potential to cause adverse drug effect through the inhibition of major drug metabolism enzymes. The results indicated that 7 Cree medicines plant extracts inhibited CYP3A4 activity, and 3 of them have been proven to cause potent mechanism-based inactivation of CYP3A4. Seven of eight Traditional Chinese Medicines have been identified as strong CYP3A4 inhibitors; the ethanol extract of Goji has identified as a potent inhibitor for CYP2C9 and 2C19. Goji juice showed universal inhibitory effects on most of the tested enzymes except flavin-containing monooxygenases 3.

This thesis examines how traditional medicine workshops offered by an Aboriginal health centre contribute to capacity re-building through self-care in two local communities in Manitoulin Island, Ontario. Health disparities that exist between Aboriginal people and the rest of the population have prompted a need to better understand health determinants that are of relevance in these communities including the importance of culture, tradition, and self-determination. A variety of qualitative methods were employed in this work including in-depth interviews, focus groups and “art voice.” The use of art voice on Manitoulin Island advances decolonizing methodologies by emphasizing how the incorporation of locally and culturally relevant methods or “methods-in-place,” is an effective way to engage communities in the research process. Results show the need to approach traditional teachings, health programs, and research from an Aboriginal worldview and indicate that more frequent workshops are required to empower youth and adults to practice and share traditional knowledge. Furthermore, a continuum exists in which the interest in language, culture, and tradition increases with age. Capacity can therefore be re-built over time within communities promoting autonomy and self-determination through self-care. Findings can be expected to further inform the traditional programming in participating communities, enhance existing Aboriginal determinants of health models by including traditional medicine as an element of self-care, and can act as a springboard for the inclusion of unique place-based methods into community-based research projects in the future.

Seventeen Cree anti-diabetic herbal medicines and eight Traditional Chinese Medicines have been examined for their potential to cause interactions with drugs, which is considered as a major reason for adverse drug effects. Specifically, the effect of these natural health products was examined on major Phase I drug metabolism enzymes including cytochrome P450, human carboxylesterase-1 and flavin-containing monooxygenases. Several of these natural health products have the potential to cause adverse drug effect through the inhibition of major drug metabolism enzymes. The results indicated that 7 Cree medicines plant extracts inhibited CYP3A4 activity, and 3 of them have been proven to cause potent mechanism-based inactivation of CYP3A4. Seven of eight Traditional Chinese Medicines have been identified as strong CYP3A4 inhibitors; the ethanol extract of Goji has identified as a potent inhibitor for CYP2C9 and 2C19. Goji juice showed universal inhibitory effects on most of the tested enzymes except flavin-containing monooxygenases 3.

Thesis (M.Sc.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Master of Science in Population Health, School of Public Health. Title from pdf file main screen (viewed on March 18, 2010). Includes bibliographical references.

Achieving complete health requires a deep understanding of complementary cultural competency sensitivity between physician and patient. This may include but is not limited to access to preventative health care resources, access to health educational resources and access to cultural healing resources, for example, shamans, Ayurvedic physicians, and herbal healers. Advocates of cultural competency emphasize great importance on knowledge of the patients' cultural background; however, the transcendence of this knowledge can be explained further through complementary cultural competency sensitivity. This is when the cultures of the physician and patient complement each other in terms of understanding what is in the patients' best interest in the overall goal of healing and complete health for the patient. The explanation of this concept revolves around the idea that health is not just found within body wellness physically, but also mentally and emotionally. The tragedies of poor health outcomes we face have psychological repercussions with a significant social determinant that bio-medical medication cannot and should not solve. The purpose of research includes theoretical discussions that address questions of: What roles do Evidence Based Results play for Medical Anthropologists? How will having knowledge of socioeconomic status, cultural practices and determinants of environmental insult and structural violence as experienced by the individual patient influence the facilitation of the process of creating a positive health outcome for the patient? How can "End of Life" issues be better addressed? How does language influence health? Does a positive dialogue between health professionals and patients contribute to better health outcomes? Research will emphasize the idea that Ethnomedicine (traditional medicine) and Western Bio-medicine complement each other within the model of complementary cultural competency sensitivity. The Holistic Complementary Structure of Western Bio-medicine and Traditional Healing is a multifaceted mean by which the manifestations of complete and positive health results occur. The methods of research used in the research include ethnographic interview content discussions, primary and secondary literature sources, and research of bio-statistical data. The interview discussions consist of dialogue with Medical Anthropologists, a Nurse Practitioner, a Global Health Studies Ph.D. professor and an Africana Studies Ph.D. professor. In order to prove the hypothesis, explanations through examples of Ethnomedicine (traditional medicine) and Western Bio-medicine working together, show how the combination of the two modalities along with the factors of complementary cultural competency sensitivity between patient and physician contribute to positive health outcomes.

This thesis explores the ontological content of the integration of complementary and alternative medicine (CAM) in biomedical education, through a critical exploration of “CAM" policy related documents from the World Bank, the World Health Organization and Health Canada, as a means of contextualizing "CAM" in biomedical education. It also interrogates curriculum documents from a project that seeks to standardize “CAM” in biomedical education. This thesis suggests that there are ontological parallels to the colonial era conversion of indigenous medicine evoked in the contemporary 'integration' of CAM in biomedical education.

<p>This investigation focused on Rhoicissus tomentosa, belonging to the family, Vitaceae in an attempt to assess the phytochemistry of this plant which is widely used by traditional healers in South Africa to ensure the safe delivery during pregnancy and childbirth (Hutchings et al., 1996).</p>