The focus of the present study is on the ways in which storybooks communicate cultural ideals about achievement orientation, and in particular, the role of effort, perseverance, and hard work in fostering successful outcomes. Sixty preschool children's books from Indonesia, Japan, and the United States (20 from each country) were examined for the presence of achievement-oriented themes. These countries were chosen due to previously documented cultural differences in models of learning and individualist/collectivist tendencies that could have some bearing on achievement outcomes. Texts were assessed for (1) the frequency with which “challenge events” appeared in the narratives, (2) whether these events derived from sources internal or external to the main character, and (3) whether solutions relied on the main character individually or included the assistance of others. Results show that Japanese storybooks contained significantly more challenge events than Indonesian storybooks. Compared with Japanese storybooks, American storybooks tended to include a greater proportion of challenges derived from internal qualities of the main character as opposed to external factors. Compared with American storybooks, Japanese storybooks contained a significantly greater proportion of challenges that were solved with individual efforts as opposed to efforts involving the assistance of others. Findings from this study contribute to our understanding of how storybook contexts can provide a rich source of information for young children learning about culturally valued qualities and behaviors related to achievement. These countries were chosen due to observed cultural differences in models of learning and individualist/collectivist tendencies that could have some bearing on achievement outcomes. Previous research has pointed to the tendency for Japanese students to attribute success to hard work and failure to lack of effort, in contrast to Anglo American children, who attribute success to a range of factors including luck and ability along with effort  targeted for 3- to 4-year-olds was included in the study . Books from the United States and Japan were chosen using guidelines from previous research by Dyer et al. ; Dyer-SeAll of the storybooks in the study sample were written in the original languages . In order to avoid confounds involving the coders' native language, their countries of origin, and personal values regarding effort and achievement, we decided to have the books from Japan and Indonesia translated into English and have a single, native English-speaking coder (who was blind to our hypotheses) complete the coding of all books. The translators were Japanese-English and Indonesian-English bilingual speakers who were also blind to the study hypotheses.In each storybook, our analysis focused on the main character, which was determined by several criteria. First, the main character is usually stated in the title . Second, the main character is mentioned or described more than other characters in the book. Third, the main “character” could be considered to be more than one individual , but only when there is no more detailed description of one character over another, or no one individual is mentioned more than another. Finally, the main character could be an entire group of individuals, as long as these individuals are mentioned as a unit.challenge episode is where the main character encounters an obstacle or difficulty that could prevent him/her from achieving a goal. We then coded each challenge episode along several dimensions. First, we determined the source of the challenge: Internal or External. An Internal source is where the challenge comes from some quality or behavior of the main character him/herself. For example, Betsy stopped singing because she got sick; Michael decided not to join his friends on the basketball court because he believes he is too small. An External source is when the challenge comes from the environment, a situation, or other characters outside of the main character. For example, Betsy stopped singing because her parents didn't allow her to sing anymore; Michael didn't play basketball because someone took his ball. Second, we identified the solution for the challenge: Individual or Social. An Individual solution is when the main character overcomes the challenge by her/himself. A Social solution is when the main character receives help from another character to overcome the challenge. Finally, at the end of each book, we determined whether the main character achieves his/her goal (Success or Failure). If the main character is successful, we also identified who gets the benefit of the solution in the end: only the main character , an(other) character(s) (Other benefit), or both (Shared benefit). To assess the reliability of this coding, another native English-speaking coder  scored a randomly selected set of 10 American storybooks in the sample. The inter-rater reliability between these coders was 0.78.Once the main character was established, we identified challenge episodes. A Based on the coding scheme described above, we analyzed the data by comparing the three countries in terms of the number of challenge events, the sources/types of challenges and their solutions, and the nature of the overall outcome.F = 7.324, p = 0.001. Post-hoc analyses indicated that Japanese and American storybooks did not differ significantly from each other in length . However, Indonesian storybooks were significantly lower in length compared to storybooks from Japan and the United States .To examine whether the lengths of the books were equivalent for the three countries in the sample, we counted the total number of sentences for each book from Indonesia, Japan, and the United States. A One-Way ANOVA on this measure showed a significant effect of country, F = 3.91, p = 0.026. Post-hoc analyses showed that Japanese books had significantly more challenge events than Indonesian books  and that American books had a greater number of challenge events than Indonesian books, although the difference was only marginally significant . There was no significant difference in the mean number of challenge events for Japanese and American books.For each book, we tallied the number of challenge events present in the textual information in the narratives. Most of the books in our sample included at least one challenge event . A One-Way ANOVA conducted on the total number of challenge events as a function of country yielded a significant effect of country, These findings, of course, need to be tempered by the fact that book lengths for the Indonesian sample were shorter compared to Japan and the United States. There is less opportunity for challenge events to appear if books have less content. However, if the Indonesian books can be considered to represent the typical storybook experience for preschool children in that country, these data suggest that Indonesian children receive less exposure to characters that repeatedly attempt to overcome obstacles than children in Japan and the United States.F = 2.52, p = 0.089. American books depicted more Internal challenge events  than Indonesian books , which in turn depicted more Internal challenge events than Japanese books . Further analysis showed that the contrast between means for American vs. Japanese books approached significance (p = 0.079).In order to obtain a better understanding of the types of challenges encountered by characters in the storybooks, we tallied the proportion of challenge events that were coded as Internal to the main character in their origin for each book. A One-Way ANOVA on this measure indicated a marginally significant effect of country, F = 3.62, p = 0.033. Post-hoc analyses showed that Japanese storybooks had a greater proportion of Individual solutions to problems compared to American books . The mean proportion of Individual solutions for Indonesian books  was not significantly different from the two other groups.In addition, the proportion of solutions to challenge events that were coded as Individual in nature was obtained for each book. A One-Way ANOVA on this measure showed a significant effect of country, 2(4) = 6.00, p = 0.199. Most outcomes were directed toward the main characters themselves or shared between main characters and others. In no instance were others the sole beneficiaries of the problem resolution.We hypothesized that collectivist vs. individualist themes might be revealed by the types of outcomes evidenced in the resolution of the overall dilemma or challenge presented in the narratives being examined. First, the overwhelming majority of books depicted successful resolution of the overall challenge depicted in the book. Only 2 or fewer out of the 20 books in each country presented a failure to achieve success. For the successes, outcomes coded as having an Individual, Other-oriented, or Shared (between self and other) benefit were analyzed to see if patterns varied by country. A chi-square test showed no significant differences in how these outcome scores were distributed across the three countries, χThe current study examined storybooks targeted for preschoolers from Indonesia, Japan, and the United States for the presence of achievement-oriented themes. The books were analyzed in terms of the number of challenge events, the source of each challenge, and the type of solution for the challenge. The results revealed several interesting findings, as discussed below.First, while Japanese storybooks were similar to American storybooks in the number of challenge events, these groups differed in terms of the source of the challenge and the solution for the challenge. The challenges depicted in American storybooks tended to be due to internal qualities of the main character, but the solutions for the challenge were mostly external in nature . The somewhat greater emphasis on internal sources of challenge in American storybooks is consistent with previous observations that American children tend to exhibit ability beliefs (vs. effort beliefs)  or more enjoyable “opportunities to learn.” More detailed analyses on the language by which these messages are framed could be informative.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Hydronephrosis, reflux and renal failure are serious complications that occur in patients with neurogenic bladder associated with myelomeningocele. When the bladder compliance is lost, it is imperative to carry out surgery aimed at reducing bladder storage pressure. An ileocystoplasty, and for patients not suitable for intermittent catheterization, using the Mitrofanoff principle to form a continent stoma and the subsequent closure of the bladder neck, can be used. We report here, for the first time to the best of our knowledge, an association between two previously described techniques (the Mitrofanoff principle and the technique of Monti), that can solve the problem of a short appendix in obese patients.2O) while still maintaining normal renal function. A bladder augmentation (ileocystoplasty) with continent derivation principle (Mitrofanoff) was performed. During surgery, we found that the patient's appendix was too short and was insufficient to reach the skin. We decided to make an association between the Mitrofanoff conduit and the ileal technique of Monti, through which we performed an anastomosis of the distal stump of the appendix to the bladder . Later, the proximal stump of the appendix was anastomosed to an ileal segment of 2.0 cm that was open longitudinally and reconfigured transversally (Monti technique), modeled by a 12-Fr urethral catheter, and finally, the distal stump was sutured at the patient's navel.A 33-year-old male Caucasian patient with myelomeningocele and neurogenic bladder developed low bladder compliance  and a Foley catheter (10 Fr) through the continent conduit were left in place. The patient had recovered well and was discharged on the tenth day after surgery. He remained with the Foley catheter (through the conduit) for 21 days and cystostomy for 30 days. Six months after surgery he was continent with good bladder compliance without reflux and fully adapted to catheterization through the navel.The unpublished association between the Mitrofanoff and Monti techniques is feasible and a very useful alternative in urologic cases of derivation continent in which the ileocecal appendix is too short to reach the skin . The development of hydronephrosis, vesicoureteral reflux and renal scarring with subsequent progression to renal failure are feared and serious complications that can occur in patients with neurogenic bladder associated with myelomeningocele. Such patients should be treated starting in childhood with clean and intermittent catheterization along with anticholinergics in the presence of detrusor overactivity. In severe cases , there are greater risks of renal failure. When irrespective of the treatment, a patient has an unsatisfactory development and loss of bladder compliance, it is imperative to avoid future renal failure by surgeries aimed at reducing bladder storage pressure. Our service routinely uses ileocystoplasty and, for patients unable or not adapted to intermittent catheterization, Mitrofanoff's principle . We then proceed with closure of the bladder neck.2O) and grade II left vesicoureteral reflux. Although his renal function was still preserved, bladder augmentation (ileocystoplasty) was indicated.A 33-year-old male Caucasian patient with myelomeningocele and neurogenic bladder had an unsatisfactory clinical progression despite treatment with intermittent catheterization and anticholinergics. Not suitable for catheterization, the patient developed low bladder compliance (4.0 mL/cm H2O) and no urethral reflux, and he is well adapted to intermittent catheterization of the umbilicus.We used 15 cm of ileum, 20 cm from the ileocecal valve, that was opened longitudinally and reconfigured into a "U" shape, with continent derivation (Mitrofanoff's principle). During surgery, we found a short ileocecal appendix that was insufficient to reach the skin. Then it was decided to make an association between the Mitrofanoff's principle and the Monti's technique of ileal conduit by which we performed an anastomosis of the distal stump of the appendix to the bladder with an antireflux valve. Then, the proximal stump of the appendix was anastomosed to an ileal segment of 2.0 cm that was open longitudinally and reconfigured transversally (Monti technique), modeled by a 12-Fr urethral catheter, and finally, the distal stump was sutured at the patient's navel  is isolated on its mesentery in the standard fashion. If simultaneous augmentation or a neobladder creation is being performed, the Monti segment should be harvested from an adjacent section, eliminating the need for an additional bowel anastomosis  and who have an appendix that is too small to reach the skin.Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.The authors declare that they have no competing interests.MFC wrote the article and was the surgeon of the case. AAR had the idea and helped with the surgery. ST, AJC and ACPM performed the literature review. RBR wrote the discussion and literature review. HJS discussed the case and revised the article. All authors have read and approved the final manuscript.


Global Assessment of Functioning (GAF) is a scoring system for the severity of illness in psychiatry. It is used clinically in many countries, as well as in research, but studies have shown several problems with GAF, for example concerning its validity and reliability. Guidelines for rating are important. The present study aimed to identify the current status of guidelines for rating GAF, and relevant factors and gaps in knowledge for the development of improved guidelines.A thorough literature search was conducted.Few studies of existing guidelines have been conducted; existing guidelines are short; and rating has a subjective element. Seven main categories were identified as being important in relation to further development of guidelines: (1) general points about guidelines for rating GAF; (2) introduction to guidelines, with ground rules; (3) starting scoring at the top, middle or bottom level of the scale; (4) scoring for different time periods and of different values ; (5) the finer grading of the scale; (6) different guidelines for different conditions; and (7) different languages and cultures. Little information is available about how rules for rating are understood by different raters: the final score may be affected by whether the rater starts at the top, middle or bottom of the scale; there is little data on which value/combination of GAF values to record; guidelines for scoring within 10-point intervals are limited; there is little empirical information concerning the suitability of existing guidelines for different conditions and patient characteristics; and little is known about the effects of translation into different languages or of different cultural understanding.Few studies have dealt specifically with guidelines for rating GAF. Current guidelines for rating GAF are not comprehensive, and relevant points for new guidelines are presented. Theoretical and empirical studies, and international expert panels would be valuable, as well as production of a manual with more information about scoring. Computerised assessment may well be the future. Reliable assessment of the problems patients face is important. With regard to the assessment instruments, guidelines for their use are also important -5. Work In psychiatry, the severity of illness can be scored by Global Assessment of Functioning (GAF). GAF is known worldwide and it is Axis V of the internationally accepted Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR) . The GAFAn advantage of GAF is its simplicity , but proIn general, psychiatric evaluation is too dependent on subjectivity, as assessors may rate psychiatric impairments according to their own experience and attitudes . Rating In the present study, guidelines are defined as written instructions that give guidance or recommendations for scoring and consist of some steps that are accepted by clinicians and the scientific community.Guidelines are important for quality assurance of the assessment , and resThe aims of the present study were to identify the current status of guidelines for rating GAF, points that are relevant for new guidelines, and gaps in knowledge that are of interest for the development of improved guidelines. Gaps in knowledge are defined as points concerning guidelines for scoring GAF where no, or little, research has been done and where it is likely that further development would play a role for improved scoring.Acta Psychiatrica Scandinavica, American Journal of Psychiatry, Applied Psychological Measurement, Archives of General Psychiatry, BMC Psychiatry, British Journal of Psychiatry, Comprehensive Psychiatry, European Journal of Psychological Assessment, European Psychiatry, Evidence-Based Mental Health, International Journal of Testing, Journal of Psychiatric Research, Psychiatric Bulletin, Psychiatric Services, Social Psychiatry and Psychiatric Epidemiology, and Journal of Clinical Psychiatry); (c) thorough hand searching: after identification of publications by steps (a) and (b), their reference lists were hand searched for more literature and, by reading total publications, a search for citations to other studies was also conducted.A literature review -47 was cEach time a relevant publication was identified, the same search for new literature was performed. After several rounds of such hand searching, new relevant references became difficult to find and the search proceeded to steps (d) to (i): (d) search in PubMed, which used experiences from research on search strategies ,49. A seThe final two steps were as follows: (j) the contribution of each selected publication to the knowledge base for the present study was summarised . EmphasiThe literature review identified seven main categories, with a number of points  considered important in relation to further development of guidelines: (1) general points about guidelines for rating GAF; (2) introduction to guidelines, with ground rules; (3) starting at the top, middle or bottom level of the scale; (4) scoring for different time periods and of different values ; (5) the finer grading of the scale; (6) different guidelines for different conditions; and (7) different languages and cultures.Where the presentation of problems concerning guidelines does not require any distinction between the single-scale and dual-scale GAF, no remarks are made about this. Guidelines for scoring single-scale and dual-scale GAF can be quite similar. When the single scale is used, 'whichever is the worse' of the symptom and functioning values is the single value recorded  .Brief guidelines for rating GAF exist, but their lack of depth is likely to result in subjectivity in rating . They arIn practice, experienced clinicians operate by forming initial hypotheses and testing them through assessment , but theWhen assessment instruments are developed, study of the assessment process should be a standard procedure , but theIn the historical development of GAF, there has been little research on existing guidelines. Few studies have compared the effect of using different existing guidelines for rating and the effect of systematically varying guidelines. We do not know which norms for the guideline are best or whether changed and extended guidelines would improve rating.The introduction to guidelines should give raters a basic understanding of the guidelines' other specifications and what to look for when scoring GAF. However, existing guidelines for rating GAF have different introductions ,12,50,51The introductory paragraph in a guideline for rating GAF could start by explaining the purpose of rating GAF, for example to score the overall level of functioning or severity of illness  and why In the second paragraph, a definition of what GAF is can be given  and an iIntroductions to guidelines have been given little attention in international literature. Ground rules for rating have been little analysed and there is little information about how they are understood by different raters. It is not known what the result would be if international consensus panels of experts worked with ground rules.It is known from methodology studies of questionnaire design that the ordering of response categories is a problem. Studies show a tendency to choose the both first listed response category ('primacy' effect) and the last listed response option ('recency' effect). Primacy effects are more likely in self-completion surveys . A similIt may be hypothesised that starting from the top results in higher values than starting from the bottom and it is known that with questionnaires even seemingly minor changes can have a major impact . An alteInformation concerning the effects of starting the rating process at top, middle or bottom level is difficult to find.In psychiatry, symptoms can change over time, for example over 24 h . AccordiThe score for the last week may conflict with the patient's previous mental health, and fluctuations in the patient's condition may need to be scored several times over a longer period of time . If thisKnowledge of the course of different conditions over time is essential ; for somWhen the effect of treatment is being studied, GAF should be scored both before and after treatment ; scoringThe longitudinal dimension of using different GAF scores for different disorders has been little explored and existing guidelines give little instruction. There is little research data available about the time period that should be used for GAF rating or the criteria for choosing a specific time period. It is not known whether scoring should be done for the same time period for the GAF-S and GAF-F scales, whether scoring should be done for different time periods for the higher and lower ends of each GAF scale, or whether scoring should be done for different time periods for different anchor points.The aim of scoring should be to give a true image of the patient's mental health that will be useful for clinicians and research. As the severity of illness can vary over time, the question of which GAF value to record becomes relevant. Simple alternatives are the lowest, highest or average GAF for a time period. According to scoring instructions for GAF, when the current level of functioning is scored, the lowest score for the last week should be used; the lowest level of functioning is chosen because of its clinical relevance . Rating However, assigning the lowest GAF score is not without problems. It may give a wrong impression of both the overall mental situation and the present status ; the higIf the patient is not well described by either the highest or the lowest GAF for the last week, a solution may be to use more scores; for example, scores such as highest and lowest for the last year, the highest and lowest the patient has ever had, or scores for when the patient is symptomatic and asymptomatic. Rating of average functioning has also been proposed ,50, for Internationally, both the single-scale and dual-scale GAF are in use. For the single-scale GAF, according to the manual for DSM-IV-TR  only oneIn the clinical setting, comments can be added to a GAF score on why a particular score was chosen, which may be important when others take over treatment. It may also have an educational effect, add meaning to the scores, and improve inter-rater reliability . HoweverIt is difficult to find empirical research aimed at finding the right GAF value , or combination of GAF values, to record for different applications. The potential applications for GAF scoring are wide ranging and include different diagnostic categories, the chronic and acutely ill, treatment decisions, prediction or measurement of outcome, choice of level of care, and measurement of case mix. Little is known about which score gives the best inter-rater reliability and validity, and it is not known whether separate GAF-S and GAF-F, or the lower of the two scores is best for treatment decisions and measurement of outcome, or how much weight should be given to GAF-S versus GAF-F for such applications.The DSM-IV-TR, Veterans Administration and Norwegian guidelines have instructions for scoring within 10-point intervals, but instructions are limited ,12,13,51It is possible that more detailed verbal instructions would result in more accurate scores. An alternative to having more anchor points is to use categorical scales for scoring within the 10-point intervals, in which case the anchor points (with key words and examples of symptoms and functioning items) should be graded ,75. BothIn the history of GAF, systematic work to improve scoring within 10-point intervals is limited and it is not known how to best score within 10-point intervals. This also applies to the use of categorical scales for scoring, which requires considerations concerning the nature and number of categories.There can be a vast difference between the mental states of different patients. However, a dual-scale GAF scoring uses two straight lines , which may not reflect this complexity. The answer to the problem is not necessarily to have more scales covering different aspects of, for example functioning, as this would require a more complex scoring process . HoweverPanels of experts aided by empirical data could develop norms with ranges of relevant GAF values. The comprehensibility of anchor points (with key words and examples) for different diagnostic group should be considered and it would be helpful to include examples of patients scored and not scored in each decile ,77. The If different GAF values are expected for different ages and sexes, this should be noted in the guidelines, but there is little information available about this. Different norms of functioning can represent different baselines against which the patient is evaluated, so, for example, instruments should be adapted to assessing older patients, to include scoring of dementia and happiness at the end of life . GuideliGAF should score impairment due to mental condition, but the effect of somatic and mental impairment can be interrelated and it can be difficult to distinguish between them . The GAFThere is limited empirical information concerning the suitability of existing guidelines for different conditions, different groups of patients and patients with several other characteristics. The effect of adapting guidelines to these variations is not known. Having different guidelines for symptoms and functioning has been little explored.GAF has been translated into many languages, but languages encode meaning in different ways. Instruments should be adapted to different cultures and languages ,40,73,78People from different cultures can answer in different ways when questions are asked, for a number of reasons ,79, and Language differences may also present problems; a patient may be clearly psychotic when interviewed in their own language, but not when interviewed in a foreign language . When trLittle is known about the importance of translation and culture for GAF guidelines. The safety of international comparisons should be questioned. Meta-analyses based on data from countries with different languages and cultures may be influenced by these differences.We are a long way from having a comprehensive set of heuristic guidelines that could support the assessor in executing the scoring process , but proWhen designing a norm for the scoring process, it is important to consider which process can best achieve the aims. It is essential to first define the purpose of a scoring system. For example, a system that is mainly intended for clinical use should be viewed by clinicians as sensible and easy to use. However, having a short version of the guidelines for the clinic and more detailed guidelines for research could result in scores that are not directly comparable; evidence-based treatment is, by definition, based on research and this could pose a problem for its implementation.A manual with more information about GAF and scoring of GAF could also be developed alongside the guidelines . The reqComputerisation of assessment may well be the future. Assigning scores could begin with a visible GAF scale on the screen, where placing the cursor at different places along the scale reveals different windows with information about the criteria for scoring; clicking the mouse in one of these windows could make even more detailed information available in another window. The use of electronic patient records represents a possibility for new quality assurance methods. Some diagnoses are not combinable with high GAF scores; if such a diagnosis has been given, a warning could pop up on the screen if a GAF score that is too high is given. If a low GAF-S is given, a warning could pop up if a high GAF-F is given. A reminder may come up if the psychiatric record is completed for a new patient without having entered a GAF score. When a GAF score has not been given for an outpatient for the last 3 months, a reminder could pop up on the screen. Computer-based scoring of GAF can give high correlation with scoring based on clinical impression , but difWork with a scoring instrument is not complete without testing or pilot study ,95. AlteLiterature reviews can play a role in development of guidelines . The preAn encompassing hand search of literature was done because it was considered that some relevant publications were likely not to be included in computerised databases. A combination of searching reference lists and reading publications has been considered the most thorough way of hand searching . PubMed The literature review identified the state of knowledge for GAF guidelines and a review of this type can be valuable in work to develop better guidelines. In the history of GAF, limited focus has been given to development of guidelines and currently available guidelines are short. In the clinic, the primary goal of the assessment process is to contribute to the solution of a person's problems . A generA scoring system must be robust enough to allow for scorer bias and more random errors of measurement. If GAF is not good enough, a given change in GAF value would not necessarily reflect a corresponding change in severity. Subjectivity in scoring should be kept to a minimum; some scorers can be unwilling to give a low score because of the negative labelling of clients  and clinThe aim of better guidelines is to make scores more reliable, to improve comparability of scores (for example across organisations and from different studies), to make combination of scores in meta-analysis safer, help in assigning more accurate scores , to provide more accurate information for the choice of intervention and evaluation of treatment results, and to be of help in the education and training of assessors. However, it is not a matter of course that new guidelines will give much better GAF scores.The clinical situation is not just about having a perfect scoring system; it is equally important to earn the respect and trust of the patient . New guiThe present review has focused on guidelines for rating GAF, but other factors can also play a part in the choice of GAF value. Factors that have not been treated include: (1) characteristics of the patient interview and the importance of collecting information from different sources; (2) characteristics of the rater, i.e. professional background, training and motivation, groups, or individuals score; and (3) properties of GAF (discussed in a previous study) ,102-105.The guidelines that are currently available for rating GAF are not the result of a sophisticated development, but guidelines are important for reliable assessments. There are few published studies dealing specifically with guidelines for rating GAF. This study presents a number of points that are relevant for new guidelines and show a significant potential for development.International panels of experts have a role to play, and a manual for GAF can be developed. Computerisation of the scoring process can offer advantages for rating. In light of the current situation, care should be exercised when comparing outcomes across facilities and also with international comparison, and meta-analyses. More work is needed to develop improved guidelines for rating GAF.The author declares that he has no competing interests.


Smallpox eradication is one of humankind’s greatest accomplishments, but like all great successes, it was the result of many individual efforts. For >3,500, years smallpox (variola major strain of the virus) had killed, scared, or blinded most inhabitants of the world. In the past century, it killed more than half a billion persons, and death was dreadful. In large cities, it was a childhood disease infecting almost every child and killing 30% of them. In isolated smaller communities, the disease would strike periodically, killing one third of those who had not previously had smallpox. When introduced into the Western Hemisphere, it killed >80% of the native population. Smallpox changed history, impacted monarchies, and affected outcomes of wars. Its detailed history is told in Smallpox and Its Eradication by Fenner et al., and is available on the World Health Organization (WHO) website  would not send vaccine to continue uninterrupted immunizations, Foege stole vaccine from their warehouse. These 2 books describe dedicated, creative, and capable persons working in many countries and overcoming unpredictable obstacles.The original plan was for mass vaccination of >80% of the population in any country that had smallpox cases. When Foege was beginning his work in Nigeria, he heard from missionaries communicating by short wave radio that there were outbreaks of smallpox in several villages. He did not have enough vaccine for mass vaccination of the region. Instead, he went to each village whose inhabitants had smallpox infections and vaccinated the inhabitants of only that village and perhaps 1 or 2 nearby villages that had frequent contact. This procedure was called surveillance and containment. As he pursued this approach, smallpox seemed to be cleared from eastern Nigeria. The civil war between the eastern and western regions caused him to evacuate for >1 year. When he returned, eastern Nigeria was still free of smallpox. This amazing result was shared with programs from other nations but met with mixed acceptance. Mass vaccination had been the accepted way.Foege’s final proof of the effectiveness of surveillance and containment came when he was assigned as advisor to the most challenging state in India. The surveillance system there was far more complex than relying on shortwave radio reports of missionaries from isolated communities. In addition, the density and mobility of the population meant that containment had to be more rigorous. As improved surveillance detected more cases, the Indian Minister of Health wanted to return to mass vaccination, but a young, brave health officer pointed out that when a house is on fire, you pour water on that house, not in the neighborhood (thus the book title). That simple argument saved the program. On the basis of the increasing number of reported cases, the Communist Party in India accused the United States of spreading the disease. Foege had to convince Ambassador Daniel Patrick Moynihan to allow the program to continue. The last case of smallpox in India occurred in a homeless beggar on May 18, 1975. She had spent 4 days on the platform of a railroad station potentially infecting thousands. While she was there, 4,500 tickets had been sold to persons traveling to stations throughout India, prompting an intensive widespread search. Fortunately, no additional cases were detected.Henderson tells the story of the mixed role of the USSR. Few persons realize the key role the USSR played in eradicating smallpox. The USSR was the original force behind the proposal to WHO to eradicate smallpox and provided free vaccine to much of the world. It is unlikely that eradication would have been achieved without the contributions of the USSR. Conversely, the last chapter in Henderson’s book, entitled Smallpox as a Biological Weapon, documents the inhumane posteradication activities of the USSR to produce 50–100 tons of smallpox virus per year for use as a biological weapon. The story of how this information came to light, and the subsequent response of our government to protect our nation, needs to be more widely known.These 2 books tell the story of humankind’s most remarkable achievement, the eradication of the most dreaded infectious disease in history. I have never understood how the Nobel Prize Committee has avoided recognizing this achievement. Two men played the 2 most critical roles. Foege showed that surveillance and containment worked. Henderson helped create and then direct the program and overcame seemingly insurmountable obstacles. Perhaps the greatest obstacle was the “knowledge” that eradication was impossible, but as Foege said, “Something must be believed to be seen.” Although hundreds of thousands of persons were involved in the eradication of smallpox, Henderson provided the leadership to get it completed and Foege showed how it should be conducted, even in the most challenging of settings. It is time for their contributions to be recognized!


Ritual and religious uses of plant-derived smoke are widespread throughout the world. Our research focuses on Southwest China, where the use of incense is very common. This study aims to document and analyze contemporary ritual plant uses by the Bai people of Shaxi Township , including their related ethnobotanical knowledge, practices, and beliefs.The present study builds on previous ethnobotanical research in Shaxi, which started in 2005. Interviews focusing on ritual plant use and associated beliefs were carried out with a total of 44 Bai informants in September 2009 and May and June 2010. The results are supplemented with information on the local religion collected from June to December 2010. All documented species were vouchered, and are deposited at the herbaria of Kunming Institute of Botany (KUN) and the University of Zurich (Z/ZT).Cupressus funebris Endl., Gaultheria fragrantissima Wall., and Ligustrum sempervirens (Franch.) Lingelsh. are the most important incense species. Others serve as substitutes or are used to stretch incense powders.A total of 17 species have been documented for use in incense. They are always used in mixtures and are either burned in the form of powders in a censer or as joss sticks. The smell of the smoke is the main criterion for the selection of the incense plants. Incense is burned for communication with spiritual entities at graves, temples, and cooking stoves, as well as for personal well-being. In Shaxi the use of incense mixtures at the household and community level is regularly practiced for communication with ancestors, ghosts, and deities and in some cases to strengthen self-awareness. Some of the documented species are widely used in central Asia and Europe, hinting at the well documented knowledge exchange that occurred in Shaxi, which was a major hub along the influential Southern Silk Road. Ritual plants can be used in ritual healing , as hallDianella ensifolia (L.) DC as incense in the context of Torajanese funeral ceremonies in South Central Celebes . In Yunnan, where "ethnic minorities" account for one-third of the total population, the Bai, after the Yi, form the second largest group comprising around 1.5 million residents . The offThe term "China's Three Great Religions" is commonly used to refer collectively to Buddhism, Confucianism and Daoism and many temples throughout China are dedicated to all three religions. In Shaxi, statues depicting Confucian or Daoist gods or immortals can be observed in principally Buddhist temples or the other way around.Ancestor worship is also practiced throughout rural China and is loosely associated with both Daoism and Confucianism. In the early 20th century, ancestor worship was practiced daily by the Bai people of Dali [28:94] and the importance of these practices in Shaxi are evidenced by the fact that in almost every household there is a shrine reserved for the worship of family ancestors.Benzhu Cult is often considered the religion of the Bai people and used as a defining character of this ethnic group. Benzhu has been referred to as "patron god worship", as many of the deities have a connection to local history, and each village has its own Benzhu in a specific temple, which is responsible for the village's safety [24:16]. Many of the Benzhus of the Shaxi valley, however, have their origin in Buddhism and Daoism.The Benzhu Cult. Tudigong (Earth God) and his wife Tudipo, for example, are worshipped for matters related to agriculture, Shanshen (Mountain God) is worshipped before venturing into the hills, and Longwang (Dragon King) is worshipped for water related issues. Shrines dedicated to these local gods are omnipresent in the valley bottom as well as in agricultural fields in the lower hills, bridges, in the vicinity of water sources, and at the edges of villages. Additional deities are worshipped at home, such as the Zaojun (Kitchen God) and the Menshen (Gate Gods).There are a number of locally worshipped deities in Shaxi, which are neither part of an institutionalized religion nor of the The present study builds on our previous ethnobotanical studies in Shaxi, which started in 2005 ,22. ReseInformants were chosen using the complementary strategies of snowball, purposive, and convenience sampling [29:186-194]. Informal conversation, unstructured, semi-structured, and structured interviews were carried out in Chinese with the help of an interpreter, who was familiar with the research area and fluent in English and Mandarin. All participants were fluent in Mandarin. Participant observation was undertaken to complement the interview data.The interviews were carried out with a total of 44 Bai informants from Sideng (20), Changle (9), Shibaoshan (3), Silian (3), Diantou (2), Dongnan (2), Aofeng (1), Bailongtan (1), Shaping (1), Xinan (1), and Zongdeng (1). The average age of all informants was 56 years, 25 were female (50.3 ± 22.4 years), and 19 were male (64.1 ± 15.9 years).The interviews covered questions on the topics of incense plant knowledge, uses, and associated beliefs. Structured interviews were carried out using representative parts of mentioned species that had been bagged in transparent plastic jackets. These were shown to the informants, who were then asked to tell the plant's name, its uses, the used parts, and how they are used. The local names of the species were recorded on tape and can be provided upon request. The recordings were performed with the help of three Bai persons of different ages and both sexes.Use reports, listing the informant's name, species name, plant part used, and specific uses were compiled for the analysis of information about relevant plant species. All species were vouchered, and specimens were identified, following the nomenclature of the Flora of China , by the Research was conducted according to the Convention on Biological Diversity (CBD), including the Bonn guidelines on Access and Benefit-sharing (ABS). Field research took place in agreement with the responsible local authorities of Sideng and Kunming and in prior informed consent with all informants. To meet the fair and equitable Benefit-sharing guidelines, a set of labeled specimens together with summarizing descriptions of their uses were prepared to form part of an exhibition in the context of a medicinal plant garden project in Shaxi .In total, 369 use reports of 20 plant species in 14 botanical families were documented. The collected information includes the names, the uses, and the habitats of the used species (Table Cupressus funebris Endl. is the species with the highest agreement ratio (90%), indicating that most of the informants agreed on its use as a ritual plant. On the contrary, the use of Cinnamomum glanduliferum  Meisn. (23%) as ritual plant is controversial, as some informants questioned its ritual use.Knowledge of specific ritual plants differed considerably among the informants. To quantify the degree of agreement among the informants on whether specific species are used as ritual plants, an agreement ratio was calculated for all species with five or more use reports Figure . OverallA total of 17 species are used as incense and for joss stick production. They belong to 12 different families, 4 species in the Cupressaceae family, and comprise shrubs (7 spp.), trees (6 spp.), and herbs (4 spp.). The parts of the plant used are the leaves (9 spp.), branches (2 spp.), tubers (2 spp.), wood (2 spp.), shoot axes (2 spp.), roots (1 sp.), and aerial parts (1 sp.). The species are always used as mixtures and are either burned in the form of powders in a censer or as joss sticks. According to most informants, the smell of the smoke is the main criterion for the selection of incense plants.Juniperus squamata Buch.-Ham. or Cupressus funebris wood are placed on an incense heap. Then, a dried ball of Artemisia sp1 is lit and added to ignite both powder and wood  Miq. or Basella alba L.  per bunch of 20 sticks at the local weekly market  Bedd., Lyonia ovalifolia  Drude, Ligustrum sempervirens, and Cinnamomum glanduliferum can indeed be used to stretch or fake the powders. However, it was also claimed that because of increasing pressure resulting from the large number of incense producers, people were compelled to use the materials that are available. As a result of this pressure, there are many species combinations.Both the joss-stick and the censer-use mixture compositions vary. Although eleven species were named to be used as incense, only five were mentioned as compounds of the collected incense powders. Why the remaining six species do not occur in the mixtures is uncertain. Possible explanations are that the informants who provided the mixtures did not know the exact composition, or that they pretended not to know in order to keep the details of their mixtures secret. Other potential explanations are that species which are not present in the mixtures are of facultative use  or that they are used intentionally to stretch incense. Opinions among informants differed on this issue. It was mentioned that The contexts of the documented incense uses are diverse and include aspects of meaning, purpose, time, and place. In interviews, informants mentioned various reasons for burning incense. Usually, incense is burned to communicate with spiritual entities and for fumigations that enhance personal well-being. The communicative act with spiritual entities was the most frequently mentioned reason for fumigations. The locations where incense is burned for these communicative acts include graves, shrines, temples, and kitchen stoves. Each place is connected to a unique myth about the spirits that can be called there. These places and spirits are described below.In almost all documented contexts, it was not the type of incense burned that was deemed to be significant but rather that it was burned at all. Although no fundamental difference between sticks and powders was found, certain differences in their practical functionality were observed. Sticks were usually preferred for outside use because they are less affected by weather and because expensive censers are not needed. On the contrary, powders tend to be used inside houses and temples, where the necessary censers are available.Guijie , Chunjie , Duanwujie , Qingmingjie (Tomb Sweeping Day), and Jiuyuejiu . For a detailed description of the festivals and the plants used see Appendix 1.The household use of incense takes place on a daily or periodical basis, usually in the form of burning incense sticks. The timing of fumigations varies, and can take place in the morning before breakfast, at noon before lunch, and in the afternoon. During the fieldwork, fumigations were never observed in the evening. Typical days of usage are traditional holidays like the Zaojun (Kitchen God), can be worshiped. It was mentioned that the same altar is also a place for ancestors to meet the household members and to enjoy a meal. Incense is thus burned to invite the ancestors into the home.The most conspicuous place for incense burning is at the entrance gates of a house, where incense sticks are placed in a special holder fastened to one side of the gate so as to prevent bad influences from entering the house and the courtyard. Incense is also burned on a small altar close to the stove in the kitchen of a house where Communal incense use usually takes place on special occasions, such as ceremonies in temples. Both incense sticks and powders are used. Powders are predominately used inside temples, where the necessary censers and incense burners are available. Sticks are used outside as well as inside the temples.Zhengci . Incense is also burned at water wells, where it can be used to show respect to Longwang  are worshiped in special places outside the villages. These deities are preferably called for blessings before departure to or after returning from the mountains.Burnt and unburnt joss sticks were observed at the sites of large and ancient trees. It was explained that they are placed there to worship Qingmingjie (Tomb Sweeping Day).Graves are another important site for the use of incense sticks. Due to the danger of wildfires, the sticks are not burned, but only placed on the graves Figure . It was Weddings are another occasion during which fumigations are performed. On such auspicious occasions incense sticks made of bamboo, which if produced properly will curl with combustion, are preferred Figure . CurlingSome informants mentioned the influence that fumigations have on the well-being of the user. For example, it was explained that fumigations in combination with the chanting of certain verses and prostrations can be performed by women to heal sick family members. These actions are seen as an offering to bad, old ghosts that cause diseases and can be driven out this way. Other informants described the linkages of fumigations and personal well-being through more psychological aspects. Some feel that people who burn incense just feel happier, which in turn can improve personal health. A Buddhist nun in one of the temples underlined, that incense has mainly an effect on the individual performing the fumigation, i.e. as a way to strengthen self-awareness:"Burning incense has five main effects:- It is a statement of not doing bad things any more.- Through the burning of incense you settle down.- Through the burning of incense you get rid of hardness.- Burning incense increases wisdom.- Through the burning of incense you get rid of the feelings about precious old things."  - Fieldnotes, May, 2010Several informants ascribed pharmacological activity to the smoke of incense: For example, the effect of incense smoke to clean the air, especially in crowded rooms like temple halls, and in that sense of killing germs, was mentioned.Besides the general consent that the fumigations practiced in Shaxi are traditionally linked with religion, some informants dismissed them as superstition:mixin]. The younger generation has experienced another education than the older women, so they do not believe in Buddhism anymore."  - Fieldnotes, May, 2010"I don't burn incense by myself and think that young people in general have little time to burn incense. The young people don't believe in superstition and don't belong to a religion. Nonetheless, I feel comfortable when smelling it. In my family, my mother burns incense and, in general, older women do it. They are all victims of superstition [Prinsepia utilis Royle and Populus sp. can be placed in the category of "ghost plants". The uses of both species to ward off evil spirits, ghosts, or bad things were mentioned by many informants, and both species were observed to hang on many walls and gates of houses in Shaxi. Both species occasionally occur in the eastern mountains, where they are collected for use. Prinsepia utilis branches are stuck into cracks in gates or house walls mostly on the 1st day of the 7th month , which takes place on the 14th the same month . The branches of P. utilis prevent the ghosts that are released from heaven between the 1st and the 15th day of the 7th month (LC) from entering the home. Similarly, branches of Populus sp. were often observed to be stuck into house gates or holes of outer house walls  to keep unwelcome people outside.s Figure . PopulusImperata cylindrica (L.) Rausch. was directly observed on the occasion of a funeral; then it was planted on top of the grave directly after the burial of the deceased person. On top of a grave this is believed to support the prosperous development of the family, especially if it has grown well and developed many stolons. The use and meaning of this species are also reflected in its local name, Zisuncao, meaning the child's and grandchild's grass. The planting of Imperata cylindrica and other grass species on top of graves seems to be a widespread practice that was observed in many villages of Shaxi  Blume and C. sintok Blume), India (C. camphora (L.) J. Presl), and the Himalayas  [Cupressus torulosa D. Don have been reported from Nepal and such with Pistacia lentiscus L. from Vietnam [Besides these striking similarities of ritual plant uses on a species level between the Shaxi and Shuiluo valley, comparable uses from other areas also exist on the genus level for the genera Pistacia . The burd beyond ,32. For d beyond . Also Ard India, ,13,33. IJunipers . The use. Presl) . Additio Vietnam . No infoCupressus funebris, Gaultheria fragrantissima, and Ligustrum sempervirens are the central incense species. Possible roles of the other species range from being used to stretch incense powders to serving as substitutes for other, unavailable species.The Bai people of Shaxi use a variety of ritual plants, especially incense plants, both on a communal and household level. The documented incense plants were never used solely, but only in mixed powders or in the form of joss sticks. Ritual fumigations are mainly conducted for the communication with ancestors, spirits, and deities, and in some cases also for personal well-being and to strengthen self-awareness. Some informants mentioned pharmacological effects, and some dismissed the fumigations practiced by others as superstition. Incense use was documented in diverse contexts. Among these contexts, no significant differences regarding the type of incense used, but differences in the contexts of place, time, and meaning of the uses were found. The foremost quality for which species are selected as incense seems to be the smell of their smoke. Interview data and the incense powder compositions strongly suggest that Cupressus funebris, Pistacia weinmanniifolia, Juniperus squamata, and Cornus oblonga were also reported from the Shuiluo Valley in the Hengduan mountain range. Juniperus squamata is used as incense in even wider parts of the Himalayas. These finding indicate that the documented incense plant knowledge probably does not constitute exclusive knowledge of the inhabitants of Shaxi and may be strongly influenced by Tibetan Buddhism and the knowledge exchange along the Southern Silk Road, which has been influential to Shaxi for hundreds of years.Similar uses of The authors declare that they have no competing interests.The first and last authors designed the study, drafted and finalized the manuscript. POS and MSG conducted field research and CSW supported both during the research project. All three authors read and approved the final manuscript.Ten local informants were asked to list and describe the most important festivals throughout the year. They were also asked if plants play an important role for the practices on these festival days. If not otherwise stated, plants do not play an important role, except for incense, which is burned on all of these occasions. The presented dates follow the Chinese lunisolar calendar.yu) is pronounced the same way as the word for surplus. Paper-cuts in red displaying the character for good fortune (fu) are hung on doors and windows. Usually, at least one member of each family goes worshipping at the Chenghuang temple, to ask for the prosperous development of the family in the new year.The Spring Festival or Chinese New Year marks the beginning of the new lunar year. For many people in Shaxi it is the most important festival throughout the year. Family members working outside the valley usually return home for the festivities. The celebrations last for one week, feasts are common and firecrackers are let off throughout the whole week. On the New Year's Dinner, almost all families eat fish, as the Chinese word for fish (Shakyamuni) as he was still Prince Siddhartha Gautama, wandering through his father's lands. On this day, a Buddha statue from the Three Religions Temple in Changle is put on a palanquin and carried to the Xingjiao temple in Sideng. Thereafter, a statue is carried throughout the village and the party holds at every gate, so the prince can bless the household. Local boys are dressed up as the Prince Siddhartha and people from throughout the valley participate in the parade. This festival is only celebrated by some Bai communities, particularly in the counties of Jianchuan and Eryuan. None of the local people knew where the tradition originated.The Prince Festival is celebrated to remember the historical Buddha  are Buddhist festivals celebrated because of the symbolic value of the numerals of the dates. No one considered these to be important festivals in Shaxi. Nonetheless, all three are celebrated by large crowds, and Mamahuis (religious women's associations) from distant villages use these opportunities to visit one another. They are, however, not celebrated in families but only in temples, where the Mamahuis hold ceremonial dances and prepare food and paper figures for offerings.All informants mentioned that this and related festivals (Populus sp.) twigs are stuck in the corners of the home and close to openings  in the walls of the courtyard. These are supposed to hinder the ghosts from entering. On this day Zongzi (glutinous rice stuffed with various fillings and wrapped in bamboo leaves) are prepared and eaten. Further, a special soup is prepared of local herbs and drunken as a tonic by the festival participants.The Dragonboat Festival is celebrated in Shaxi in memory of a legend, in which two beautiful girls are turned into a blue and a white snake. On this day, the evil spirits symbolized by these snakes come to haunt the living. In order to protect the family from the negative influence poplar , other snacks and most importantly yuebing (mooncakes) is placed outside and the food is eaten while marveling at the full moon.The Mid Autumn Festival is celebrated with a large feast where all family members should be present. Afterwards, a table with apples, chestnuts, pears, walnuts, water chestnuts (Sanyuesansee tangyuan (sweet dumplings). Usually, the whole family helps to prepare the filling and then forms the dumplings out of dough made of glutinous rice.The Winter Solstice Festival is celebrated with the immediate family to commemorate the shortest day of the year. The only fixed ritual for this festival is to make


We prepared a consolidated list of edible and therapeutic insects used in Arunachal Pradesh (N.E. India) by two tribal societies . The list is based on thorough, semi-structured field-interviews with 20 informants of each tribal group. At least 81 species of local insects, belonging to 26 families and five orders of insects, namely Coleoptera (24 species), Orthoptera (17 species), Hemiptera (16 species), Hymenoptera (15 species) and Odonata (9 species), are being used as food among members of these two indigenous societies. However, Nyishi use overall more species of insects as food than Galo people do and consume mostly Coleoptera and Hemiptera; amongst the Galo, on the other hand, Odonata and Orthoptera dominate. The selection of the food insects amongst the Nyishi and Galo is dictated by traditional tribal beliefs as well as the taste and availability of the insects. Depending on the species, only particular or all developmental stages are consumed. Some food insects may be included in the local diet throughout the year, others only when seasonally available. Commonly specimens are being prepared for consumption by roasting, frying or boiling. Twelve species of insects are deemed therapeutically valuable by the locals and are being used by the tribes investigated to treat a variety of disorders in humans and domestic animals. Members of the Galo use a greater number of insect species for remedial purposes than the Nyishi. With the degradation of natural resources, rapid population growth, and increasing influence of 'westernization', the traditional wisdom of entomophagy and entomotherapy is at risk of being lost. There is thus an urgent need to record the role insects play as components of local diets and folk remedies and to assess insect biodiversity in the light of these uses. The term entomophagy refers to the use of insects as food. Insects represent a traditional food category in many cultures of the world. Insects, as the most species-rich taxon of all animals, exhibit an enormous biodiversity and represent a colossal biomass in Nature. According to Bodenheimer  they havPreference given to insect species utilized as food by humans, depends on the insect's palatability, availability, and nutritional value as well as on local traditions and customs. Besides being described by many insect enthusiasts as a tasty food commodity of high nutritive value, many insects are also considered to possess health-enhancing properties. In many parts of the world, different sections of the society have been using medico-entomological drugs to this day in their lives. A number of studies has in recent years drawn attention to the therapeutic value of certain species of insects, their products, and their developmental stages -15. AccoTraditional ethnobiological knowledge and the habit of accepting insects as food and as an integral part of local therapies is nowadays confined to the traditionally living, largely indigenous societies of regions that until now have experienced only a limited amount of 'westernization'. The therapeutic uses of insects are often a closely guarded secret and only passed on to certain individuals from one generation to another by word of mouth. Transfer of knowledge in this way is an age-old practice and a well accepted socio-cultural attribute among the ethnic societies of North-East India.Most of the edible insects, some of which are crop pests, but at the same time possess high nutritional qualities, constitute an important part of the local daily diet and, stressed by Reim  and Meye2 [Arunachal Pradesh, the largest state in North-East India, lies between 26° 28' and 29° 30' N latitude and 90° 30' and 97°30' E longitude and biogeographically is situated in the Eastern Himalayan province, a territory characterized by a complex system of mountains and valleys of variable elevation (50 to 7000 m). By virtue of its geographical position, climatic zones and altitudinal variations, the state's biodiversity is rich with large tracts of tropical, wet evergreen forests and subtropical, temperate and alpine vegetation. It is regarded a global biodiversity hot spot  and one 2 . Our futExtensive field surveys to record the various uses of insects amongst members of the Nyishi and Galo tribe were carried out in the two respective districts of East Kameng and West Siang in the north-east Indian state of Arunachal Pradesh. Ten villages, selected at random, were visited in each of the two tribal areas. The number of households per village was 12 - 20 (one village had 30). Frequently at least 2 houses were unoccupied, because the families had moved into the towns in search of work. At least two households inhabited by village elders and their families were visited. Recommendations by the headman or village elders to visit certain knowledgeable persons in another village were sometimes followed. The surveys were based on interviews during which a total of 20 persons aged between 45 and 70 years of age  from each tribe were shown museum specimens or photographs of insects. The interviewed people were then asked simple questions in order to obtain information on the vernacular names of the edible or otherwise important insects, on seasonal availabilities, stages of insects consumed or used, mode of preparation, assumed therapeutic value, folklore related to insects and anything else deemed important in connection with the insect in question. As the knowledge of Hindi or English of the locals was often not great, our questions had to be simple and to the point.Insects were collected from different habitats, e.g., ponds and streams, soils and farmland, shrubs and trees, grassland and dwellings. They were then preserved according to standard methods  and idenMembers of the Galo tribe, inhabiting the West Siang district of Arunachal Pradesh located at 94°02'E - 95°15'E and 27°29' N-29°23'N at altitudes between 60 - 5000 m. The region's climate is markedly continental in character with average annual rainfall of 3000 mm and temperatures ranging from 5°C in the month of December to 38°C in the month of July. The total population of the district, which is inhabited by not only members of the Galo, but also Adi, Memba and Khamba tribes, is approximately 105,000. Galo people make up roughly one fourth of the population and are found in the southern part of this district. Traditionally Galos practiced shifting cultivation, but nowadays wet rice and terrace cultivations have become common.2. The major part of the area inhabited by Nyishis is covered by forests, cropped areas being very limited. Settled agriculture is yet to take on in a sizeable manner and only 0.03% of the area of the district is under regular cultivation.Nyishi people inhabit the East Kameng district of Arunachal Pradesh located at 92° 36' E - 93° 24' E and 26° 56' N - 27° 59' N. The district is shared by people of the Sulung, Aka, Miji, and Bangni Nyishi. This study explores only the ethno-entomological knowledge of the Bangni Nyishi and Sulung, designated, however, together as Nyishi in the following text, because their inextricably linked life-styles. The temperature of the region ranges from 17°C in the month of December to 27°C in the month of July and the altitude range is 360 - 1900 m. Total population is ca. 57,000 and literacy rate is 41%; population density 14/kmDetails on the taxonomic position as well as the vernacular names are given for insect species that are consumed by members of the two ethnic groups. The information with regard to edible species and the assumed therapeutic uses of insects was considered only reliable, when it came from at least 40% of the respondents. Despite this precaution, we do not consider this study to be a quantitative one and, therefore, wish to stress that this is a qualitative study and the first of its kind for any Arunachal Pradesh tribe.An inventory on what is known to date on the edible insects of the two ethnic tribes of the studied areas is presented in Tables cf. Tables Although edible insects generally occur throughout the year, their densities and diversities are determined by their food plants as well as by seasonal conditions. Observations on the seasonal availability , availability and the convenience with which the sought-after insects can be obtained, and furthermore taboos or religious beliefs may be involved. With regard to Odonata their aquatic larvae are clearly easier to collect than their adults and for Coleoptera with their wood-boring grubs the same would hold true.Members of both tribes ate immature as well as adult stages of insects. However, in some cases, as with virtually all of the Odonata whose aquatic larvae were greatly preferred to the flying adults, only immature insects were consumed, but in others, as with the Orthoptera and Hemiptera the adult stages were more highly appreciated. Katydid species were an exception and preferred as wingless, immature specimens. Hymenopterans were eaten at all development stages: eggs, larvae, pupae and adults and even their products like honey, propolis, and wax were used. Most of the edible beetles were consumed as adults, although some like Methods to prepare the edible insects for human consumption include roasting, boiling, or frying. Pentatomid bugs and honeybees, however, are being consumed both raw and roasted. Members of the two ethnic tribes interviewed by us explained that they possess various ways to improve the taste of an insect dish. Short-horned grasshoppers (Acrididae), for instance, are fried in oil after having their wings removed and are then simply eaten with salt. The insects, however, may also be stuffed in a bamboo pipe, smoked dry for 3-4 days, mixed with chili and salt and then added to rice meals. Long-horned grasshoppers (Tettigonidae), collected in smaller numbers than their short-horned cousins because of the solitary habits of the former, are roasted or fried in oil after having their wings removed. They are usually fed to children or aged persons.Schizodactylus monstrosus (Schizodactylidae). Freshly collected specimens are put inside a bamboo pipe and smoked dry for nearly one week. Completely dried material is then crushed into a powder and mixed with chili peppers, salt and bamboo shoots to form a special type of chutney. This chutney is taken with rice or with a local drink known as Apung and is regarded as most delicious by all members of the tribe irrespective of age and sex. Insect chutneys can also be based on other species, raw or dried, which are turned into a paste with chili and salt. Pentatomid bugs like Aspongopus nepalensis and other species, collected from river banks, are also highly appreciated in the form of a chutney by members of both tribes.Crickets and mole crickets  are collected mostly during summer nights between the months of May and July. Yet the most highly valued orthopteran food insects amongst the Galo are Asian dune crickets of the species Similarities and differences Figure  of the eBatocera are amongst the most widely accepted Coleoptera as food, being reported from Indonesia, Philippines, Sri Lanka and Papua New Guinea [Batocera spp. but in West Siang the Galo are not accepting these beetles. Some scarabaeid species, belonging to the genera Lepidiota, Anomala, and Propomacrus are consumed by Nyishi, but not Galo people. Catharsius sp. is one of the favourite insect food items of the Galo, but not the Nyshi people. Some of the pentatomid and pyrrhocorid bugs are rejected from the list of edible insects by the Galo, as the Galo believe these bugs are hallucinogenic, neurotoxic, allergenic and even fatal if ingested in large quantities. To avoid undesired reactions caused by the consumption of certain species of insects, sometimes highly specific preparation methods exist and frequently appendages that can cause some allergic reactions and, in the case of some bugs, parts of the abdomen that may contain hallucinogens or neurotoxins are removed by the Galo people. Obviously utilitarian principles are involved [During the field visits some Galo respondents explained that according to their belief system the use of Odonata by humans mirrors that of "the fishes that take them"; consequently these insects had to be good. The acceptability of insects as food by any indigenous society depends to a large extent on the traditions and beliefs of the society . Speciesw Guinea . In the involved  and the involved .The use of natural resources for therapeutic purposes is as old as humankind and continues around the world to this day. Ethnobiological knowledge has been passed on from generation to generation and one ought to expect that age-old practices valued to this day must be based on experience and fulfil a need. One part of our study, therefore, focuses on the traditional knowledge of insects with therapeutic properties. Although insects  are extremely numerous in Arunachal Pradesh, members of the various ethnic groups never collect and consume insects in a haphazard, random and unselective fashion, but follow unwritten rules and traditions. The traditions not only govern which species can be collected and taken as food, but extend to the insects' therapeutic uses. Species considered medicinally important by the Galo and Nyishi are listed in Table During the field survey it was observed that the inhabitants of the most remote villages do not have much of a concept of diseases like diabetes, hepatitis, cancer to name but a few. They are mostly aware of coughs, colds, fever, stomach troubles, skin disorders, pains in the body and other obvious signs of illness. Therefore, our list is only based on the information given by the locals on diseases they recognize. We also observed that the locals prefer their own home remedies to medicines they do not know (and subsequently do not trust). It became obvious, however, that both tribes visited by us use very similar types of insect-based remedies Table . MoreoveOur study identified twelve species of insects that were therapeutically used. Out of the twelve, eight species serve as the raw material for the treatment of two or more diseases. Species of the order Hymenoptera are the therapeutically most widely used insects, but the Coleoptera also feature with three medicinal species. Most of the therapeutic insects are taken raw or boiled and they are being used primarily to remedy stomach disorders, coughs and colds, skin allergies, boils, malaria, blood pressure anomalies, scabies (in case of humans) and foot and mouth disease of bovids like mithun and cattle. Galo as well as Nyishi make use of whole insects and not individual body parts, but the Galo use a greater variety of species than the Nyishi. The fact that Nyishi know more edible insect species than Galo people, but Galos value insects more from a therapeutic angle, confirms Meyer-Rochow's prediction of the greater persistency of therapeutic rather than dietary uses of insects .The use of honey and bee's wax is common among members of both tribes to treat coughs and colds and apparently has a long history. Honey is considered to soothe the inflamed membranes of the mucus-secreting tissue of the upper respiratory tract and to relieve irritating symptoms that lead to difficulties in swallowing. Honey and wax are components of several Ayurvedic formulations, but whether their use entered Nyishi and Galo traditions from Ayurvedic teachings or was independently discovered by members of these tribes is unknown.Wasps are also being used in the treatments of coughs, colds, and stomach disorders. Freshly killed wasps are meant to be chewed, but not swallowed, and said to provide strength to a patient. Wasps have also been reported as parts of the folk medicine of various Latin and South American cultures ,38, as wThe use of ants amongst the Nyishi and Galo is also significant. These formic acid containing insects are being used in connection with scabies, malaria, tooth aches, stomach disorders, blood pressure anomalies, etc. in humans and foot and mouth disease as well as worm infections in cattle. Soil dwelling ants have been shown to produce compounds that kill both fungi and bacteria in their underground nests  and a paSharma and Khan  observedThe numerous chemicals that arthropods possess in their armament to defend themselves may either be products manufactured by them alone or represent derivatives of substances obtained from plants or prey -55. It iUnfortunately the availability of all types of modern food stuffs and the degradation of resources makes ethnic people worldwide  inclined to abandon their traditions and discard their rich indigenous knowledge. This is particularly lamentable in view of the fact that from a nutritional aspect, the traditional food is often not only healthier, it is also the product of generations of harmonious co-existence between tribe and environmental resource. The flipside of the coin is that due to unprecedented population increases, the resources of the forest, including food insects, can become over-exploited and this has apparently already resulted in the diminishment of biotic resources  in some parts of North-East India . Although hard data are not (yet) available, many of our informants indicated that it has become increasingly more difficult to collect useful insect species. Therefore, we see an urgent need to assess insect biodiversity and the role of ethno-entomology together and not separated from each other. On the one hand, we feel that it is important to make sure that practices of entomophagy and entomotherapy do not disappear; on the other hand, we need to protect the biodiversity of the region and to conserve the valuable insect resources found in this region for posterity. Squaring these two demands (conservation of indigenous practices and prevention of over-exploitation of insects considered useful) must be a priority task for the future development of the region.The authors declare that they have no competing interests.JC carried out the field work and supervised SG's research. SG participated in the field work and identification of the insects. VBM-R began the ethno-entomological studies in North-East India and participated in the design, coordination, and drafted the final manuscript. All authors read and approved the final manuscript.


Bursaphelenchus xylophilus (PWN) was found to be responsible for maritime pine (Pinus pinaster) death for the first time in Europe in 1999, in a Portuguese forest south of Lisbon. It is the causal agent of the Pine Wilt Disease (PWD) and a quarantine organism in the European Union with approximately €80 million spent from 1999 – 2009 for attempting its eradication, which must also be added to direct losses from tree mortality. During this period, important progress has been made in understanding the relationships between PWN, its insect vector and the host tree/environmental factors that result in pine wilt in all countries affected but, especially, in Portugal.The Pinewood nematode Pinus pinaster to Bursaphelenchus xylophilus as a first step for the establishment of methodologies for the improvement of its resistance, a research program was implemented recently in Portugal for this species, combining genomic and quantitative genetics approaches. Until now, more than 500 trees were phenotypically selected in a highly affected stand and monitored during two years, regarding their phytossanitary status. The percentage of mortality observed in the first year was about 10%, with this value decreasing to less than 5% in the second year. Around 200 trees (including 150 of the selected trees) were genotyped for 6 microsatellite loci and three combinations of AFLP markers. The genotyping results show a high diversity of genotypes, which may open good prospects for the selection of resistant plants to Bursaphelenchus xylophilus.Although PWN can cause devastating tree mortality, there is also evidence that some tree species or individual trees within a species are either tolerant  or resistant to the nematodes. In order to investigate the susceptibility of P. pinaster and P. pinea when inoculated with PWN. ESTs were isolated, cloned, sequenced and identified using BlastN and BlastX, and clearly indicated that at an initial stage of the disease there is activation of a defence response at a molecular level, mainly related to oxidative stress, production of lignin and ethylene and post-transcriptional regulation of nucleic acids. 58% of the isolated sequences are not yet described, which shows the lack of genomic information currently available for pine. The results obtained are presented and discussed.At the same time, genomic and transcriptomic studies have been initiated with the final goal to discover candidate genes, loci and molecular markers related with disease resistance to PWN. With regards to the effects of the disease at a transcriptional level, the SSH technique was utilised to identify ESTs in