A very merry Christmas
&
Happy, healthy and prosperous New Year.

Charles, Jan, Justin, Karla, Genine, Carole, Dave,
Bart, Magda, Janessa & Steve.

As another year hoves into sight, what lies beyond the horizon?

The combined demand from patients for greater satisfaction and lower taxation will make economic evaluations of all treatments of central importance to the National Health Service (NHS) . Complementary & Alternative Medicine (CAM) will necessarily be competing with other services for budgetary provision in the NHS and the National Institute for Health and Clinical Excellence will have to make the difficult decisions relating to the cost-effectiveness of treatments.

However, regardless of whether CAM treatments are cost-effective, it is self-evident that the safety of CAM therapies must be established. CAM practitioners and proponents need to show that the benefits of the treatment sufficiently outweigh its risks before public bodies can advocate its use.  The importance of safety concerns should not be dismissed lightly by CAM practitioners; nor should it be forgotten that, as with many conventional treatments, adverse effects that are rare will only appear with very large samples. Hence CAM treatments may only be able to prove their safety when given the opportunity and the funding for studies that include sufficiently large numbers.

All the same, CAM therapies are moving towards voluntary self-regulation.  Whether or not such voluntary self-regulation can achieve similar quality and safety assurances as statutory regulation is still to be seen.  However, it is important that all therapies can show that the competency of practitioners is assessed, modes of practice are set out, complaints can be heard, and information can be disseminated to practitioners, policy makers and patients. Regulatory bodies must play a central role in setting standards and accrediting professional training in their respective therapies.

Aromatherapy Council launched.
Aromatherapy’s voluntary self-regulatory body will be launched on the 1st of December 2006.  It will be called the Aromatherapy Council (AC).

In response to the House of Lords Report on Complementary Medicine (2000), which urged complementrary therapy groups to unite to form a single body to regulate each profession, the discrete organizations of the British aromatherapy profession have been working together since 2003, under the banner of the Aromatherapy Consortium, to establish the structure and policy documents for a regulatory body for the profession. This has now come to fruition and aromatherapy will finally have its own voluntary self-regulatory body in place. All are to be heartily congratulated on their efforts.

What’s it all about?
Regulation is your chance to own your profession. Aromatherapists will be able to decide what is right for the future of the profession rather than having policy foisted on them from outside sources. The new Council will be capable of contributing to the ever-changing CAM debate, for instance with regard to the provision of Integrated Healthcare and the political control issues emanating from the European Commission. It will safeguard your freedom to practise in the future.

The primary role of regulation is public safety, which in itself will lead to greater credibility  being attributed to the profession.  Council believes that regulation of the profession will give the NHS the confidence to use registered aromatherapists.  The new Council will launch its regulatory register on 1st December 2006, which will be the single source register for the aromatherapy profession in the United Kingdom.

Who will run it?
The new Aromatherapy Council will be run by aromatherapists from the register, who will be elected by their peers. In the first year, however, members will be elected from the lists of professional organizations which have contributed to the work of developing regulation, as no regulatory register yet exists.  Nevertheless, these aromatherapists will not be representing the interests of their organization on Council, but will sit as individual aromatherapists working for the good of the profession as a whole.

Lay members will also sit on Council, as their involvement will demonstrate impartiality, a commitment to open processes, and provide a greater sense of inclusion in moving forward with voluntary self-regulation.  Although lay members may have an interest in the therapy, they will not be qualified aromatherapists nor will they have any connection with professional aromatherapy organizations or any related commercial interests. The Council adheres to the principle of professionally-led regulation in partnership with the public. 

How do you apply to be registered?
Application forms are ready now and can be downloaded from the Council’s new website (www.aromatherapycouncil.co.uk), or telephone the Council office on 0870 7743477. The annual registration fee will be £60.

Are you eligible?
The Aromatherapy Council will need to be assured that you are working at least to the level agreed by the profession and Government, that is National Occupational Standards (NOS - published in 1998 and revised 2002 & 2006), as well as the Core Curriculum (published and agreed March 2005) which is available on the Council’s website.

For those of you who are already a member of a professional association that measures its full membership to at least these standards and complies with Council’s CPD policy, you will be able to complete a condensed application form and will be able to register immediately and be available for public referral.

If you are not eligible, what can you do?
For those whose qualifications may have originally been below the required standards, or if your association’s criteria for full membership is not NOS and it does not have a CPD policy, you will need to complete the full application form. Then, you will be referred to one of the Council’s national centres to have your portfolio of evidence assessed. There will be a charge for this service.

The centre will be trained to help you either to confirm your competence and currency, by looking at the training and work you have done since qualifying or, by identifying where the gaps in your experience are, help you to do the necessary upgrades. 

Whilst you are being assessed you will be placed on a provisional register which will not be available for public referral, but the public can be assured of aromatherapists on this register because you will require insurance to practise, and you will sign up to the Council’s Code of Ethics & Professional Conduct as well as the Disciplinary/Complaints Procedures and CPD requirements. Whilst you do not have to be a member of a professional association to be on this new register, it is highly recommended that you are.  You will have three years in which to upgrade.

What’s the purpose of the register?
The regulatory register will exist primarily to protect the general public from aromatherapists who are inadequately qualified to practise at the agreed national level of competence.  The existence of the single regulatory register will lend credence to the profession and, by being regulated, it will give other healthcare professions the confidence to refer patients/clients.  It is hoped that the establishment of the single register will allow the Aromatherapy Council to explore further joint initiatives with other healthcare practitioners that are statutory regulated.

The Foundation for Integrated Health will launch its Integrated Healthcare Associates (IHA) network later this year which will bring together GPs, nurses, midwives, physiotherapists, osteopaths and chiropractors to discuss the integrated healthcare agenda.  IHA is endorsed by the NHS Alliance, which represents Primary Care Trusts (PCTs), GP practices and over 3,000 primary care clinicians. It is hoped that once this network is firmly established voluntary regulators such as the Aromatherapy Council will be able to contribute to the discussions on integrated healthcare.

Will registration affect your membership of any other professional organization?
No.  Your professional association (e.g. IFA, IFPA, FHT, etc.) represents your interests as a practitioner. It looks after your needs and requirements, whether it be through offering cheap block insurance schemes, CPD, support in the event of a complaint being made against you, or keeping you up to date with aromatherapy through journals, newsletters, conferences and therapist support groups.  Aromatherapy has more than one professional association and you can choose to belong to which you like, or even two or three if you wish, but it will be most important that you are registered with the regulatory body as well.       

Why should you be registered?
Although the Aromatherapy Council is currently only developing voluntary self-regulation of aromatherapy it will likely be a disadvantage to you if you are not on the regulatory register, because shortly a public relations campaign will be set up to ensure that the general public and NHS check that their aromatherapist is AC Registered. Council will also be lobbying private healthcare companies. 

As an AC Registered Aromatherapist you will receive public recognition of your status and will be on a single national regulatory register for United Kingdom aromatherapists. You will receive an AC Registration Certificate to display in your treatment room or clinic. You will be able to purchase leaflets to use in your clinic to advertise to patients/clients the benefits of using a Registered Aromatherapist. You will be able to put “AC Registered” after your name, on your letterheads, cards and in your advertisements. 

The general public and all healthcare professionals will be educated through editorials and advertising to look for AC Registered Aromatherapists. Your details (name, registration number and business telephone numbers only) will be made available on the AC website, which members of the public and other healthcare professionals will be able to check. With consumer awareness acute as ever, do you have any alternative? 

Therapies United in Scotland.
Every Hogmanay I have a guilty conscience. Another year has passed and I still have not hosted an Open Day in Scotland.  After all, when Justin was at St. Andrew’s, Jan and I were travelling regularly to this wonderful part of the British Isles, and always enjoyed ourselves immensely.

I have few excuses, because I have found the ideal spot in Edinburgh for such an event and, doubtless, there are several north of the border who would attend to make it a splendid day.  Perhaps, to spur me on, there are some who might even volunteer to come and speak. Give me a call! 

Meanwhile, therapists around Scotland are being invited to join Therapists United, which is now expanding after its recent success. This directory of therapists offers you the opportunity to promote your business and expertise with the Maggie’s Centre in Edinburgh, Dundee and Fife, and the Sick Kids Hospital Drop-In Centre. Via the website and copies of the directory placed in the centres, you are referred also to the public, companies and schools in Scotland.

Therapists United was established initially to aid staff at Maggie’s Centre in Edinburgh to direct anyone using the Centre, for example people with cancer and their families/friends, to complementary therapists who could help support them to reduce stress levels and improve their sense of wellbeing.  They received funding from Scotland Unltd to assist setting up the website and the directory.

The aims of the directory are simple - to help people looking for a credible and professional therapist find one! This is particularly important for people who have had or have cancer, as the directory highlights any training or experience you may have in this field. However this directory does more than just list your details - it is a proactive tool to help raise awareness of therapies and therapists.

However, not everyone who registers is accepted on to the directory. First of all, you have to demonstrate your experience and training via the registration process and, secondly, you must show your commitment through keeping your details and insurance cover up to date and offering a discounted rate to anyone who uses the Maggie’s Centre and Sick Kids Centre. 
    
To sustain the directory, there is a joining fee.  Normally this is £39, but it is reduced to £25 until 31st December 2006. This is only payable if you are accepted on to the directory. Any profits are distributed between donations to charity and further development of the directory.

You are not tied into any agreement, other than the directory’s terms and conditions of ethical practice, and you can leave at any time with a month’s notice.

There are currently more than 20 contacts on the database who actively use Therapies United therapists.

To register your interest for further information, visit www.therapiesunited.com and click on ‘register’ to receive further information by post.

Combating colds.
I have just received my annual invitation from the doctor to attend for a flu jab but, as in years gone by, I am disinclined to accept. When such vaccinations were first introduced, however, I remember that it was mandatory to accept because employers would not tolerate a day lost to upper respiratory tract infection.  In fact, to refuse could lose you your job.  Nevertheless, I would still stagger into the office with flu or flu-like symptoms, as this was often one of the side-effects of such vaccines.  To be honest, I doubted that the pharmaceutical companies had a remedy for this debilitating affliction.

At home and school, all seemed to have only one weapon against the threat - a constant round of brisk walks and runs on the coldest days, but it seemed to work.  However, it failed to save me from chickenpox, measles and mumps, all of which I had suffered by the age of twelve (a fact, I recollect, that was celebrated by all!).  Still, I rarely caught a cold and, if perchance I did, the omnipotent aspirin was deemed to scare it off. Failing that, it was head under a towel over a steaming bowl of friar’s balsam (a tincture of storax, benzoin, tolu and aloes), which I rather enjoyed! 

In the home, few had the luxury of central heating and it was not at all unusual to wake to ice inside the windows, the dying embers in the bedroom grate having failed to ward off the chill. At school, to ensure that the immune system was always in fine fettle, windows were thrown wide open at night.  Of course, duvets were unknown and comfort lay between ice-cold sheets beneath coarse and scratchy blankets.  How often I longed for the added warmth of my snug eiderdown at home, but that would never have been allowed. Still, it did me no harm.

Nevertheless, today, the demands of modern society preclude such rigour and I am the first to crank the heating up. However, my scepticism for flu jabs continues and, therefore, I have been perusing what’s on offer from alternative medicine.

A dip into aromatherapy suggests that there are several essential oils which could assist, not only to diminish the discomfort of colds but also help reduce the risk of secondary infections, partly because the oils are bactericidal and partly because they stimulate the immune system. Among the heavy hitters are Lavender, Eucalyptus species, Tea Tree and the closely related Niaouli.  Peppermint, Rosemary and Pine may also assist, and Thyme is said to be a valuable inhalant for sore throats.  Bathing with Sweet Marjoram could help reduce shivers and aches, and relieve headaches associated with a cold.  Specifically for flu, Ravensara might be worth adding to the bathroom cupboard as it is a respected anti-viral.

Shuffling through research reports, self-administered acupressure seems well regarded for coping with a bunged up nose, and having regular saunas is reported to lower the incidence of colds.  In a placebo-controlled trial, steam inhalation of German chamomile was shown to reduce cold symptoms. However I would not think the aroma of Matricaria recutita L. everyone’s cup of tea.

Speaking of tea, a randomized, controlled trial of almost 100 people drinking Echinacea tea showed that those taking tea had a shorter period of symptoms than those drinking a placebo. Of the various activities attributed to echinacea, the one that is probably best substantiated is its immune-stimulant effect.  This is said to be brought about by three different mechanisms: stimulating phagocytosis, increasing respiratory activity, and causing increased mobility of the leucocytes.  However, the literature on echinacea has become so vast and the hyperbole of its advocates so extensive that it has become difficult to separate fact from fiction. All the same, oral consumption of a hydroalcoholic extract of the fresh or recently dried whole plant seems to be especially useful in preventing and treating the common cold and associated conditions, such as sore throat.

To be honest, I would not have thought that homoeopathy could help, but several research papers prove me wrong.  Two placebo-controlled trials - one involving almost 300 people - showed that homoeopathy can clear colds rapidly.  What’s more, two further trials suggested that homoeopathic remedies produce results similar to those with aspirin in colds, and with minimal side-effects I imagine.

Kan Jang.
Whilst researching alternative remedies to combat the common cold, I came across a couple of reports that suggested Green Chiretta (Andrographis paniculata (Burm. f.) Wall ex Nees) taken during the first stages of a cold can reduce the severity and period of symptoms.

Chiretta rang a bell, but the botanical name had me puzzled. Chiretta (Swertia chirayita (Roxb. ex Fleming) H. Karst.), a member of the Gentianaceae, many of which are strongly bitter and are used for digestive problems, is a traditional Ayurvedic herb. Native to Nepal and northern India, it is a strongly bitter tonic and is used to treat pitta (fire) conditions.  It is perhaps best known in India as the main ingredient in mahasudarshana churna - a remedy containing more than 50 herbs, which is prescribed for fevers, including malaria, as well as for liver problems, gallstones, indigestion and nausea.  However, I could find nothing which suggested that it is specifically effective for the common cold. Was I barking up the wrong tree?

Then, whilst chatting to a customer from Scandinavia, I was reminded of Kan Jang (also known by its code name, SHA-10, produced by the Swedish Herbal Institute in Goteborg). A leading remedy, containing principally a fixed combination of andrographis leaf extract and eleutherococcus root extract, it has been extensively evaluated as to its safety and efficacy in pharmacological and clinical trials.

Since 1981, Kan Jang has been used for treatment of the symptoms of the common cold with a consumption rate of 70 million Defined Daily Dosage in Scandinavia. During this period, only 11 adverse effects have been reported.  The abundance of scientific and clinical evidence indicates that the special standardized combination of extracts of andrographis leaf (60mg) and eleuthero root (120mg) have low toxicity when used appropriately.

It transpires that the leaves of andrographis have been used in traditional Ayurvedic, Thai, and Chinese medicine to treat fever associated with infectious diseases. Pharmacological studies suggest anti-inflammatory, antipyretic, antiviral, and immunostimulatory properties.

Eleuthero (Eleutherococcus senticosus (Rupr. & Maxim.) Maxim.) is often called Siberian Ginseng, which is most unfortunate because it does not even belong to the same genus as the true ginsengs.  The name was apparently coined by commercial interests to give an expensive mystique to a relatively cheap drug.  Cognoscenti prefer the designation eleuthero. Still, the same stimulant and tonic effects attributed to ginseng are also claimed for eleuthero.

Hops.
In aromatherapy, Hops (Humulus lupulus L.) are recommended for skin care, stress-related problems, breathing conditions, nervousness, nerve pain, and insomnia, but we sell little of the oil, perhaps because of price.

Although hops have been used in beer for over 1,000 years, primarily for their bitter taste and preservative action, their medicinal or tonic properties were apparently valued from very early times.  It was observed that hop pickers tired easily, apparently as a result of the accidental transfer of some hop resin from their hands to their mouths, and the drug gained a reputation as a sedative. Hop pillows are still widely sold for sleeplessness and nervous conditions. 

The name hops is derived from the Anglo-Saxon word hoppan meaning to climb. The species name lupulus is Latin for a small wolf, referring to the plant’s habit of “wolfing” or climbing on other plants, as a wolf would climb on a sheep. 

Hops is a perennial vine growing vertically to 10 metres or so, with dark green, heart-shaped leaves. The male and female flowers grow on separate vines.  The hops of commerce are the dried yellowish-green, cone-like female flowers or fruits (stroibles).  The cones have glands at the base, surrounded by a pale yellow granular powder, called “Lupulin”. Lupulin contains resins and essential oil, and is the most important constituent of hops for flavouring beer. The resins impart to fermented beverages their characteristic bitter taste, while the essential oil is responsible for the characteristic aroma.

Only freshly dried hops should be used for distillation purposes, but it would be even better to use nothing but freshly harvested, undried hops. In general, distillation of hops must be done very carefully. If the speed of distillation is too quick, particles of the resins will be carried into the distillate and impart a dark colour to the oil.  On the other hand, if distillation is too slow, resinification and hydrolysis of the the essential oil will take place.  Thus, our own oil is extracted with carbon dioxide to obtain consistent quality. The main constituents of the oil are a-humulene (32.40%), b-caryophyllene (14.49%), b-myrcene (10.91%) and d-cadinene (6.07%).

Early studies on hops failed to identify specific sedative principles, and their value, especially when used in the form of a pillow, was thought to be more magical than medicinal. However more recently 2-Methyl-3-buten-2-ol, a bitter acid degradation product, has been identified as a sedative principle in hops.  It has been shown to possess narcotic properties in mice and motility depressant activity in rats, with the latter not attributable to a muscle-relaxant effect. It has also been suggested that isovaleric acid residues in hops may contribute towards the sedative action.

The documented human studies generally refer to hops given in combination with one or more additional herbs. They have been reported to improve sleep disorders when given in combination with valerian (Valeriana officinalis L.).  It has been stated that only low amounts of 2-methyl-3-buten-2-ol, the sedative principle, are present in sedative tablets containing hops. However, it is thought that this compound is formed in vivo by metabolism of the a-bitter acids and, therefore, the low amount of 2-methyl-3-buten-2-ol in a preparation may not indicate low sedative activity. Interestingly, relatively high concentrations were found in bath preparations, suggesting that high concentrations of 2-methyl-3-buten-2-ol may be achieved in both tea and bath products containing hops.

For those residing in hop-growing areas, it is worth bearing in mind that respiratory allergy caused by handling hops has been documented, although a subsequent patch test using dried, crushed flowerheads proved negative.  However, positive patch test reactions have been reported for fresh hop oil, humulone, and lupulone.  Myrcene, present in the fresh oil but readily oxidized, was concluded to be the sensitizing agent. Contact dermatitis to hops has long been recognized and is attributed to the pollen.

It has been stated that hops should not be taken by individuals suffering from depressive illness, as the sedative effect may accentuate symptoms. Also, the sedative action may potentiate the effects of existing sedative therapy and alcohol. Because of in vitro antipasmodic activity on the uterus, and lack of toxicity data, hops should be avoided during pregnancy and lactation.

Finally.....
All this chat of hops has me hankering for a swift pint. Have a great Christmas! 
 

charles@essentiallyoils.com

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