Traditional Chinese medicine has a long history of using plants therapeutically including multiple species of the genus Rubus (Rosaceae). Fruits and other parts of Rubus plants have had a significant effect on human health and nutrition in both ancient and modern times. The pharmacological effects of Rubus include anti-inflammatory, antibacterial, anti-stress, anti-cancer and anti-aging properties. One of the current challenges limiting further development of Rubus resources in traditional Chinese medicine is a poor understanding of phylogenetic relationships among Rubus species in general and especially among Asian species, and also the need for additional studies of phytochemicals. Several confounding factors are frequent hybridization, polyploidy, and highly variable morphology due in part to diverse ecological conditions across species’ distributions. The goal of this study was to elucidate phylogenetic relationships among Rubus species in the predominantly Asian subgenera Idaeobatus and Malachobatus emphasizing species valued in traditional Chinese medicine. Sequences of six noncoding (plus matK) chloroplast DNA regions totaling 8,276 aligned characters were analyzed for 35 Rubus species using maximum parsimony (MP) and maximum likelihood (ML). Both analytical approaches yielded topologically identical phylogenies except for one additional grouping in the ML tree. The phylogeny has nearly complete resolution and divides the species into two primary clades; one comprises R. geoides (representing the Southern Trans-Pacific clade), R. nivalis (subg. Chamaebatus) and R. trivialis (representing subg. Rubus) and the other is composed largely of R. arcticus and R.saxatilis (subg. Cylactis), and the large subgenera Idaeobatus (raspberries) and Malachobatus. Within the latter, principally Asian clade, three unresolved lineages exist (four using MP) precluding an improved understanding of the relationships among them. However, three major subclades containing Asian species have good support. Two contain subg. Idaeobatus species only, and the third comprises members of the exclusively polyploid subgenera Malachobatus and Dalibardastrum. Examination of the presence of biochemically active terpenes reveal that triterpenes are common among subg. Idaeobatus species with diterpenes reported only in R. pungens and R. chingii (not sampled). Subg. Malachobatus species have not been as thoroughly investigated so triterpenes may also be common in these species. From these results, multiple subg. Idaeobatus and subg. Malachobatus species may be good candidates for terpene analysis as members of their respective clades possess triterpenes. Moreover, five species not currently used in traditional Chinese medicine should be evaluated as they also occur in China, and may possess medicinal value.

Research regarding use of complementary and alternative medicine (CAM) among all populations in America is needed to understand what seems to be an increasing trend. Education has been shown to be a significant determinant of CAM use, therefore, college students are likely to be CAM users. Little research has addressed the prevalence and predictors of CAM use among this population, so the purpose of this study was to: (1) measure the prevalence and type of CAM use among a sample of college undergraduates; and (2) test the significance of select social-cognitive constructs and demographics as predictors of CAM use. A random sample of undergraduate students within the Texas A&M University System was solicited via email to complete a web-based survey. Findings show high rates of CAM use. Gender, attitude toward CAM, outcome expectancies regarding the health care encounter, and social network use of CAM were shown to be significant predictors of CAM use. Results can inform health care and health education professionals interested in improving health care processes and addressing positive and negative issues related to CAM use.

The inflammatory process is a critical component of the repair and regeneration of skeletal muscle following injury. The influx of innate immune cells following injury is intricate, and temporal nature. Although required for proper repair and regeneration, the inflammatory process has been shown to exacerbate initial damage, prolonging the healing process. Complementary Alternative Medicine (CAM) treatments, such as massage therapy, are a promising substitute for pharmaceutical modulation of the inflammatory response, and recent studies into the efficacy of massage have begun to report the physiological benefits of massage application following injury. Nonetheless, there is a significant lack of sound mechanistic investigations into massage application and its effects on unperturbed tissue. To gain insight to its potential influences on healthy skeletal muscle, massage was applied at three different magnitudes of load in vivo. Using a custom fabricated device for cyclic compressive loading, Wistar rats receiving massage had an increased expression in genes associated with the immune response; a significant change in the macrophage populations within the muscle tissue; and demonstrated a systemic effect marked by the increase of immune cells in the non-massaged limb. Further elucidating the systemic and immunomodulatory effects of massage, Long Evans rats receiving non-constrained eccentric exercise followed by a single 30minute bout of massage, displayed a significant crossover effect just 6 hours post exercise through the modulation of inflammatory cells in the non-massaged limb. Together these investigations suggest that mechanotransductive properties of massage can promote modulation of the immune response absent of pharmaceuticals.

Music is a powerful modality that can bring about changes in individuals of all ages. This research employed both an experimental and quasi-experimental design to identify the effects of music as it influenced psychological well-being, memory, and cognition among older adults. Specifically, it addressed three aims: (a) To determine to what extent learning to play a music instrument later in life influenced psychological well-being and cognitive function of non-institutionalized healthy seniors, (b) To determine the effects of the amount of music involvement on psychological well-being and cognitive function (c) To determine the benefit of music for those with limited/no music experience. For the first aim, it was hypothesized that individuals in the experimental music group would maintain and/or improve psychological well-being, memory, and cognitive function more than those assigned to the wait-list control group. For the second aim, it was hypothesized that participants with extensive music involvement would have higher scores on cognitive ability measures and experience greater psychological well-being than those who had not been actively involved in music throughout their life. For the third aim, it was hypothesized that the participants with limited/no music involvement throughout their life would have a larger change on the psychological well-being measures and cognitive assessments than those who had more music involvement. For the experimental portion (Aim 1), the study employed a 6-week music intervention with non-institutionalized older adults. The quasi-experimental portion (Aims 2 & 3) divided participants according to their amount of time involved in music and then looked at psychological well-being and cognitive function. This dissertation did not show a strong connection between music, memory, and cognition so it did not achieve the desired overall results. However, the findings did suggest that music may modify some areas of cognitive function (verbal learning, memory, and retention) and psychological well-being but did not influence other areas (playing a music instrument for any length of time). Therefore, the findings of this dissertation can be a basis upon which future research relating to music, cognitive functioning, psychological well-being and involvement in music can build.

Although most “alternative” medical practices have existed far longer than conventional healthcare, modern allopathic continues to be the dominant system of medicine used in the United States. Herbal medicine is one of the oldest healing practices known to humankind and continues to be practiced today despite the numerous challenges modern society poses. As Julie Stone and Joan Mathews illuminate in Complimentary Medicine and the Law, “Plant-based remedies have been the principal source of medicines in healing traditions around the world and, as the World health Organization is at pains to remind us, 80 percent of the world’s population still depends primarily on plant medicine." Another statistic cited by Larry Dossey in Reinventing Medicine illustrates, “…researchers have found that adverse reactions to drugs kill over 100,000 people a year in US hospitals. That is the equivalent of a passenger jet crashing everyday. If this level of death were seen in any other field, it would probably be considered a national scandal." These facts reveal that American citizens have come to believe in a form of healthcare that is not widely accepted by the rest of the world, and that has some surprisingly dangerous characteristics hidden within. The question thus arises as to why biomedicine continues to be the standard form of healthcare in the US, and why alternative forms of medicine are devalued and failed to be justifiably recognized and incorporated into treatment strategies.

There remains a high degree of scepticism about acupuncture since its theoretical basis has no clear reference in Western medical and scientific terms, making any associations between neurophysiology and specific acupuncture concepts difficult to determine. Using neuroimaging and engineering approaches to understand its physiological basis may engender greater acceptance of and improvement in the clinical application of acupuncture. Research into the efficacy of acupuncture has raised a number of difficult methodological issues, particularly in relation to the selection of appropriate controls. Separating specific effects from non-specific effects is complex because acupuncture is a physical, invasive, manual procedure involving time and ritual. Sham acupuncture results show only the difference between sham and real acupuncture not the real affect of acupuncture, and other controls may produce distinct subjective and objective effects. Point injection (the injection of a small amount of a substance at an acupoint), a recent innovation of traditional acupuncture, aims to enhance and prolong the stimulation effect in a standardised, reproducible manner. By providing precise, measurable acupoint stimulation applied incrementally in a specifically designed paradigm, an acupoint could act as its own control. This firstly requires injection to be validated against traditional needling. Aims 1. To develop an instrument for reproducible saline delivery at an acupoint. 2. To cross-validate saline acupoint injection (PI) with traditional needle acupuncture (TA). 3. To demonstrate central nervous system (CNS) effects of acupuncture both in health and chronic pain. Hypothesis The primary hypothesis is that stimulation of specific acupoints with linearly incremental saline injection produces differential effects within the CNS observable with functional magnetic resonance imaging (fMRI) allowing investigation of acupuncture in health and chronic pain. Novelty As neuroimaging has not yet clearly defined the brain structures that may be modulated by acupuncture, this project is exploratory in nature. It is expected that acupuncture effects can be robustly imaged with fMRI in healthy subjects and those suffering chronic pain. The demonstrated effects will result from the acupuncture process of progressive point stimulation by tissue distension rather than needle insertion or biological noise. It is proposed to examine the putative modulation of pain by acupuncture within the extensively mapped neuromatrix of cortical and subcortical regions, including the somatic, insula, and limbic cortices, and thalamus. Detailed information regarding differences in brain response between acupuncture in normal and diseased states will expand understanding of acupuncture as a clinical tool. The dilemma of sham stimulation or arbitrary controls will be addressed by confirming PI as a valid, reproducible stimulation method. Methods and Results A series of empirical experiments was designed and conducted to determine the effects of stimulation of different acupoints. 1. Chapters 1 and 3 outline the current understanding of acupuncture in the Western milieu and a review of the neuroimaging literature respectively. 2. In Chapter 2, the report of PI tested against TA in healthy volunteers to determine equivalence of physiological effect demonstrates no statistically significant differences between the methodologies. 3. Chapter 4 reports the design and validation of a task specific microprocessor controlled syringe driver. 4. Four differing acupoints were tested during an fMRI experiment described in Chapter 5; different activation areas were demonstrated across the acupoints providing early support for the hypothesis that different acupoints may have different effects. A subset of brain areas recognised within the pain neuromatrix was delineated, congruent spatially and directionally with those reported in pharmacological analgesia studies. 5. As outlined in Chapter 6, heart rate variability can be measured rapidly in a stressful environment to provide meaningful data on the response of the autonomic nervous system to acupuncture stimulation. 6. The hypothesis of different acupoints having different effects was tested in subjects suffering chronic pain by contrasting an accepted and a neutral acupoint, the results being reported in Chapter 7. Conclusion Despite a long history of clinical usage, appropriate scientific studies have not yet addressed the basic effectiveness and efficacy of acupuncture. This thesis presents a series of empirical studies designed to address a number of the questions arising in the literature and provides converging evidence of the manner in which different acupoints modulate the CNS, specifically within the pain neuromatrix.

There remains a high degree of scepticism about acupuncture since its theoretical basis has no clear reference in Western medical and scientific terms, making any associations between neurophysiology and specific acupuncture concepts difficult to determine. Using neuroimaging and engineering approaches to understand its physiological basis may engender greater acceptance of and improvement in the clinical application of acupuncture. Research into the efficacy of acupuncture has raised a number of difficult methodological issues, particularly in relation to the selection of appropriate controls. Separating specific effects from non-specific effects is complex because acupuncture is a physical, invasive, manual procedure involving time and ritual. Sham acupuncture results show only the difference between sham and real acupuncture not the real affect of acupuncture, and other controls may produce distinct subjective and objective effects. Point injection (the injection of a small amount of a substance at an acupoint), a recent innovation of traditional acupuncture, aims to enhance and prolong the stimulation effect in a standardised, reproducible manner. By providing precise, measurable acupoint stimulation applied incrementally in a specifically designed paradigm, an acupoint could act as its own control. This firstly requires injection to be validated against traditional needling. Aims 1. To develop an instrument for reproducible saline delivery at an acupoint. 2. To cross-validate saline acupoint injection (PI) with traditional needle acupuncture (TA). 3. To demonstrate central nervous system (CNS) effects of acupuncture both in health and chronic pain. Hypothesis The primary hypothesis is that stimulation of specific acupoints with linearly incremental saline injection produces differential effects within the CNS observable with functional magnetic resonance imaging (fMRI) allowing investigation of acupuncture in health and chronic pain. Novelty As neuroimaging has not yet clearly defined the brain structures that may be modulated by acupuncture, this project is exploratory in nature. It is expected that acupuncture effects can be robustly imaged with fMRI in healthy subjects and those suffering chronic pain. The demonstrated effects will result from the acupuncture process of progressive point stimulation by tissue distension rather than needle insertion or biological noise. It is proposed to examine the putative modulation of pain by acupuncture within the extensively mapped neuromatrix of cortical and subcortical regions, including the somatic, insula, and limbic cortices, and thalamus. Detailed information regarding differences in brain response between acupuncture in normal and diseased states will expand understanding of acupuncture as a clinical tool. The dilemma of sham stimulation or arbitrary controls will be addressed by confirming PI as a valid, reproducible stimulation method. Methods and Results A series of empirical experiments was designed and conducted to determine the effects of stimulation of different acupoints. 1. Chapters 1 and 3 outline the current understanding of acupuncture in the Western milieu and a review of the neuroimaging literature respectively. 2. In Chapter 2, the report of PI tested against TA in healthy volunteers to determine equivalence of physiological effect demonstrates no statistically significant differences between the methodologies. 3. Chapter 4 reports the design and validation of a task specific microprocessor controlled syringe driver. 4. Four differing acupoints were tested during an fMRI experiment described in Chapter 5; different activation areas were demonstrated across the acupoints providing early support for the hypothesis that different acupoints may have different effects. A subset of brain areas recognised within the pain neuromatrix was delineated, congruent spatially and directionally with those reported in pharmacological analgesia studies. 5. As outlined in Chapter 6, heart rate variability can be measured rapidly in a stressful environment to provide meaningful data on the response of the autonomic nervous system to acupuncture stimulation. 6. The hypothesis of different acupoints having different effects was tested in subjects suffering chronic pain by contrasting an accepted and a neutral acupoint, the results being reported in Chapter 7. Conclusion Despite a long history of clinical usage, appropriate scientific studies have not yet addressed the basic effectiveness and efficacy of acupuncture. This thesis presents a series of empirical studies designed to address a number of the questions arising in the literature and provides converging evidence of the manner in which different acupoints modulate the CNS, specifically within the pain neuromatrix.

This research investigated the transformative and extraordinary experiences of nurse healers. The broad aim of the research was to promote the role of the healer in nursing by providing data on the experiences specific to nurse healers’ evolution as healers. The research was theoretically informed by van Manen (1990, 1984) and utilised hermeneutic phenomenology. Van Manen’s emphasis on writing as the key element of phenomenology in lived experience research was employed to bring forth a sense of lived immediacy and aesthetic colour essential to phenomenological understanding. The thesis was also theoretically aligned with the conceptual model of nursing as a caring-healing profession, developed by Jean Watson (1999, 1990a, 1988, 1985a). In particular, this research drew on Watson’s explicit connection of nursing with healing and nursing practice with transformational, transpersonal and esoteric insights. There were eleven nurse (nine women and two men) participants in the study. All participants identified strongly as healers. Selection was based on how long, and important to the individual was their commitment to being a healer. The data collection method used was semi structured interview with a predominant focus on storytelling. The overarching theme of ‘Walking Two Worlds’ was identified, and within that five essential themes were uncovered: (1) Belonging & Connecting; (2) Opening to Spirit; (3) Summoning; (4) Wounding & Healing Journey; and (5) Living as a Healer. Implications for nursing discussed include the need for the profession to provide support to nurse healers as they encounter challenging experiences and to allow for ontological flexibility regarding the esoteric aspects of human/spiritual experience revealed by this research. Further the need to extend the understanding invoked by healing beyond the obvious and opening vistas into experience which have been previously repudiated by domineering, narrow and spirit-denying powers in our society is also discussed.

This thesis is about the contemporary challenges facing herbal medicine. Specifically it concerns the difficulties faced by Australian herbalists in their attempts to maintain authority over the knowledge base of their craft and a connection with traditional understandings of the uses of plant medicines, while at the same time engaging with biomedicine and the broader Australian healthcare system. It contributes to the study of the nascent field of qualitative studies in contemporary western herbal medicine by making three main arguments.Firstly, Australian herbal medicine is characterised by its origins as a European colonial practice and its history of professional marginalisation during most of the 20th century. Secondly herbal practitioners have been unable to capitalise significantly on a surge of public popularity in the closing years of the 20th century which brought with it the interest of industry, the scrutiny of regulators and the renewed attention of biomedicine. Herbalists continue to struggle for recognition in the face of these more powerful interests. Thirdly it is argued that herbalists are attempting to gain legitimacy and acceptance as a healthcare profession through a process of underpinning their knowledge base with science, which is replacing their traditional philosophical basis. This has the effect of weakening the ability of herbalists to maintain their identity as an independent profession and makes its knowledge base vulnerable to appropriation by other healthcare professions.Gross’ model of the cultural location of traditions in contemporary societies is used to clarify the situation of herbalists and to identify problems consequent to the political choices they have made or which have been forced upon them. Gross suggests that traditions which place themselves close to power have difficulty in maintaining their own character and integrity, but that other cultural locations are also problematic and limit full participation in society. vi It is argued that there are compelling reasons to move beyond Gross’ analysis and to find ways to strengthen the independence of the herbal profession. Given the financial problems facing the current healthcare system in Australia and the looming ecological challenges, radical changes to the current system are required. The central concepts of herbal practice, in particular vitalism and holism, lead to approaches to healthcare which are potentially both costeffective and ecologically sustainable. A robust and independent profession of western herbalists, with their philosophy articulated and restored, could provide a valuable and sustainable contribution to Australian healthcare.

This thesis is about the contemporary challenges facing herbal medicine. Specifically it concerns the difficulties faced by Australian herbalists in their attempts to maintain authority over the knowledge base of their craft and a connection with traditional understandings of the uses of plant medicines, while at the same time engaging with biomedicine and the broader Australian healthcare system. It contributes to the study of the nascent field of qualitative studies in contemporary western herbal medicine by making three main arguments.Firstly, Australian herbal medicine is characterised by its origins as a European colonial practice and its history of professional marginalisation during most of the 20th century. Secondly herbal practitioners have been unable to capitalise significantly on a surge of public popularity in the closing years of the 20th century which brought with it the interest of industry, the scrutiny of regulators and the renewed attention of biomedicine. Herbalists continue to struggle for recognition in the face of these more powerful interests. Thirdly it is argued that herbalists are attempting to gain legitimacy and acceptance as a healthcare profession through a process of underpinning their knowledge base with science, which is replacing their traditional philosophical basis. This has the effect of weakening the ability of herbalists to maintain their identity as an independent profession and makes its knowledge base vulnerable to appropriation by other healthcare professions.Gross’ model of the cultural location of traditions in contemporary societies is used to clarify the situation of herbalists and to identify problems consequent to the political choices they have made or which have been forced upon them. Gross suggests that traditions which place themselves close to power have difficulty in maintaining their own character and integrity, but that other cultural locations are also problematic and limit full participation in society. vi It is argued that there are compelling reasons to move beyond Gross’ analysis and to find ways to strengthen the independence of the herbal profession. Given the financial problems facing the current healthcare system in Australia and the looming ecological challenges, radical changes to the current system are required. The central concepts of herbal practice, in particular vitalism and holism, lead to approaches to healthcare which are potentially both costeffective and ecologically sustainable. A robust and independent profession of western herbalists, with their philosophy articulated and restored, could provide a valuable and sustainable contribution to Australian healthcare.