Patterns of food use and of social support and alliance are significant for the constitution of boundaries between religious and ethnic groups and the status hierarchies within them. Food and social support are also significant for health. In the case of British Asian communities, control of food intake has been identified as the key to overcoming their current epidemic of heart disease. Level of stress and social support have also been thought important for understanding levels of psychological distress among British Asians. The present study focuses on young British Asian women with ancestry in the Indian subcontinent, their patterns of food use and social support and how their choice of cultural strategies affects the likelihood of change to these patterns. The rationale for concentrating upon young women is twofold. First, middle aged women appear to suffer from a number of health disadvantages, including aspects of coronary risk and psychological distress. By focusing on a younger generation of women, factors involved in the biographical development of these problems might be ascertainable. Second, in terms of the sociology of ethnic boundaries, young women are in a pivotal position with regard of the continuation of the culture, occupying a role as daughters of migrants on the one hand, and as the first generation of British role models for British Asian children on the other. Comparison with the majority ethnic group is treated as a question about how respondents view with similarities and differences between themselves and the general population. The study addresses a range of research questions from health-related issues at one extreme to issues about the social construction of ethnic groups at the other. The first group of questions concerns the role that health plays in food choice: how health is conceptualised, how far folk ideas (possibly) deriving from biomedical, Unani and Ayurvedic conceptualisations are integrated with one another, and in what social contexts health concerns are overridden by the symbolism of ethnic identity.

<p> Every day, India sees the addition of 5,000 new cases of diabetes to its current diabetic population of 65 million people. This number is projected to cross the 100 million mark in 15 years. The emerging pandemic scale of diabetes growth is straining India's already-overburdened public healthcare resources. India is home to several well-established native and adapted foreign traditions of medicine that are widely practiced. These traditions include Ayurveda, yoga and naturopathy, unani, siddha, and homeopathy. The modern and traditional medicine approaches are extensively used as independent systems. The purpose of this qualitative research case study was to evaluate the use of an integrative approach to address the multiple challenges posed by diabetes in India. The research design for the case study was based on the theoretical framework of participatory action research. The research questions evaluated how the modern and traditional medicine systems can be jointly used to contain the spread, scale, and immensity of diabetes in India and examined the barriers and challenges in combining various systems of medicine. Data were collected from interviews with 30 modern and traditional medical practitioners and 6 policy makers identified through a stratified purposeful sampling process. The transcribed data were coded thematically and objectively analyzed. The trustworthiness of interpretations was bolstered with triangulation through records from notes and observations. In evaluating the feasibility of a synergistic and integrative approach, the study filled a gap in scholarly literature. The study contributes to social change by adding to the existing body of knowledge available to physicians and patients in preventing and containing the diabetes pandemic.</p>

M.Tech. (Homoeopathy) / Complementary and Alternative Medicine (CAM) are interventions that are used in place of or alongside conventional medication; it has been described as “complementing mainstream medicine by contributing to the common whole” (Ernst, 2000). The use of CAM is on the increase worldwide, with a prevalence of 30% to 50% recorded in industrialized countries in 1998 (Astin et al., 1998). People are increasingly consulting CAM practitioners and are also doing their own research on CAM products as well as self-medicating by purchasing products that are freely available from health shops and pharmacies. Trends seem to emerge in the type of people who seek out these modalities and people who do use CAM modalities seem to have favourable results. This study was formulated to give insight into the perceptions of CAM users in Cape Town regarding CAM use. The information obtained can be used to get a better understanding about CAM users themselves and their attitudes toward CAM in order for better education of the public on CAM and marketing of CAM professions in the future. Worldwide studies have been done on the prevalence of CAM use, and in South Africa, only one done so far in Chatsworth (Durban)(Singh et al., 2004). In South Africa, the Allied Health Professions Council (AHPCSA) registers and regulates 11 CAM professions, namely Homeopathy, Ayurveda, Traditional Chinese Medicine, Chiropractic, Naturopathy, Osteopathy, Phytotherapy, Therapeutic Aromatherapy, Therapeutic Massage, Therapeutic Reflexology and Unani-Tibb. Even though the practitioners are regulated, some CAM products are freely available in retail outlets. The aim of this study is to determine the attitudes towards Complementary and Alternative Medicine by users in Cape Town, evaluated by means of a survey. This study was conducted by means of a survey; 200 questionnaires were distributed to 10 different health shops in Cape Town. Participants completed the questionnaires privately on the premises and handed them to the staff at the health shops.Completed questionnaires were placed in sealed envelopes and collected by the researcher on completion of the study. Out of the 200 questionnaires that were distributed, 183 were completed and results were analyzed by STATKON.

M.Tech. (Homoeopathy) / Complementary and Alternative Medicine (CAM) describes a group of natural healthcare interventions that may be employed in conjunction with (Complementary) or instead of (Alternative) conventional medical treatments (Barnes and Bloom, 2008).The prevalence of CAM use in industrialised countries has shown a significant increase in recent decades, amongst consumers and professionals alike, and is being utilised by up to 50% of adults in developed communities (Astin et al., 1998). The general public are starting to take their health and well-being into their own hands by investing in CAM products and consulting with various CAM practitioners. This study is designed to gain valuable insight into the subjective experience of typical CAM users in Johannesburg. Such information may raise awareness within the current CAM climate and may be of value in formulating future marketing and educational strategies for the various CAM professions. Several global surveys have been done to determine patterns and prevalence of CAM use. In South Africa, such studies have been conducted in Cape Town (Du Plessis and Pellow, 2013) and in Durban (Singh et al., 2004). The Allied Health Professions Council of South Africa (AHPCSA) is the regulatory body of CAM in South Africa. It currently regulates and registers 11 CAM professions, namely Homoeopathy, Chiropractic, Ayurveda, Traditional Chinese Medicine, Unani-Tibb, Osteopathy, Naturopathy, Phytotherapy, Therapeutic Aromatherapy, Therapeutic Massage and Therapeutic Reflexology. Most CAM products are freely available in various retail outlets. The aim of this study is to determine the attitudes and perceptions of Complementary and Alternative Medicine users in Johannesburg health shops. This will be evaluated by means of a questionnaire survey.

Every day, India sees the addition of 5,000 new cases of diabetes to its current diabetic population of 65 million people. This number is projected to cross the 100 million mark in 15 years. The emerging pandemic scale of diabetes growth is straining India's already-overburdened public healthcare resources. India is home to several well-established native and adapted foreign traditions of medicine that are widely practiced. These traditions include Ayurveda, yoga and naturopathy, unani, siddha, and homeopathy. The modern and traditional medicine approaches are extensively used as independent systems. The purpose of this qualitative research case study was to evaluate the use of an integrative approach to address the multiple challenges posed by diabetes in India. The research design for the case study was based on the theoretical framework of participatory action research. The research questions evaluated how the modern and traditional medicine systems can be jointly used to contain the spread, scale, and immensity of diabetes in India and examined the barriers and challenges in combining various systems of medicine. Data were collected from interviews with 30 modern and traditional medical practitioners and 6 policy makers identified through a stratified purposeful sampling process. The transcribed data were coded thematically and objectively analyzed. The trustworthiness of interpretations was bolstered with triangulation through records from notes and observations. In evaluating the feasibility of a synergistic and integrative approach, the study filled a gap in scholarly literature. The study contributes to social change by adding to the existing body of knowledge available to physicians and patients in preventing and containing the diabetes pandemic.

Le diabète est reconnu comme un problème majeur de santé publique causant des conséquences humaines et économiques redoutables. La phytothérapie s’offre comme une nouvelle avenue thérapeutique pour le contrôle de la glycémie. Le grenadier, Punica granatum, a servi de remède contre le diabète dans le système Unani de la médecine pratiquée en Inde et au Moyen Orient. Des études ont démontré un effet hypoglycémiant des extraits de grenadier via divers mécanismes notamment par une amélioration de la sensibilité à l’insuline et la régénération des cellules béta-pancréatiques. Cependant, aucune étude n’a démontré à ce jour, l’effet de grenadier sur le transport de glucose dans le muscle, étape cruciale dans la régulation de l’homéostasie glucidique postprandiale. De plus, l’effet de la maturation sur le potentiel antidiabétique du fruit de grenadier n’a pas été étudié. Ainsi, le but de ce projet est d’évaluer l’effet antidiabétique des extraits de grenadier sur le transport de glucose dans les cellules musculaires C2C12 en fonction de la variété et du stade de maturation du fruit et d’élucider les mécanismes d’action. Le choix des variétés du grenadier tunisien (Espagnoule [EP] et Gabsi [GB]) a été orienté pour leur pouvoir antioxydant et leur consommation locale. Deux parties de la plante ont été utilisées, les fleurs et les fruits à 3 stades de maturation soit 2, 4 et 6 mois. Les résultats ont montré que seule la variété du grenadier Gabsi stimule significativement le transport de glucose par rapport au contrôle (DMSO), et ceci sans être toxique. Cet effet est plus prononcé au stade de fruit mûr (à 6 mois) que celui de la fleur. De plus, l’extrait de fleurs stimule la voie insulino-indépendante de l’AMPK et augmente le niveau d’expression des transporteurs spécifiques de glucose (GLUT-4). Par contre, l’extrait de fruits mûrs, en plus de ces deux mécanismes, active fortement aussi la voie insulino-dépendante de l’AKT. En conclusion, cette étude présente un nouveau mécanisme d’action antidiabétique de grenadier (plus particulièrement du fruit mûr) qui est dépendant de la variété. / Diabetes is a major public health problem worldwide with astounding human and economic consequences. The seed and the flower of pomegranate (Punica granatum), a native plant of Central Asia and the Mediterranean regions, exhibited a hypoglycaemic effect in in vivo studies. However, the underlying mechanisms have not yet been elucidated. The aim of this project was to evaluate the effect of the flower and the fruit (at 3 maturation stages) of pomegranate on glucose transport in skeletal muscle cells and to determine the molecular mechanisms involved in this effect. To accomplish this, we chose two varieties of pomegranate cultivated in Tunisia (Gabsi [GB] and Espagnoule [EP]), which have been shown to be highly consumed in that area and to possess high antioxidant activity. Differentiated C2C12 cells were treated for 18 hours with 80% ethanolic extract of the flowers and fruits (at 2, 4, and 6 months) of each variety. Our results showed that the Gabsi variety of pomegranate significantly enhances glucose uptake, without any toxicity. This effect is more pronounced in the ripe fruit (6 months) than in the flower. In parallel, the ripe fruit stimulated both the insulin-dependent pathway (Akt) and the insulin-independent pathway (AMPK), while the flower stimulated the latter only. In addition, both flower and ripe fruit treatment resulted in enhanced expression level of GLUT-4 glucose transporter in the muscle. Hence, these results suggest that regulation of glucose transport in skeletal muscle is one of the components involved in the anti-diabetic effect of Tunisian pomegranate.

Le diabète est reconnu comme un problème majeur de santé publique causant des conséquences humaines et économiques redoutables. La phytothérapie s’offre comme une nouvelle avenue thérapeutique pour le contrôle de la glycémie. Le grenadier, Punica granatum, a servi de remède contre le diabète dans le système Unani de la médecine pratiquée en Inde et au Moyen Orient. Des études ont démontré un effet hypoglycémiant des extraits de grenadier via divers mécanismes notamment par une amélioration de la sensibilité à l’insuline et la régénération des cellules béta-pancréatiques. Cependant, aucune étude n’a démontré à ce jour, l’effet de grenadier sur le transport de glucose dans le muscle, étape cruciale dans la régulation de l’homéostasie glucidique postprandiale. De plus, l’effet de la maturation sur le potentiel antidiabétique du fruit de grenadier n’a pas été étudié. Ainsi, le but de ce projet est d’évaluer l’effet antidiabétique des extraits de grenadier sur le transport de glucose dans les cellules musculaires C2C12 en fonction de la variété et du stade de maturation du fruit et d’élucider les mécanismes d’action. Le choix des variétés du grenadier tunisien (Espagnoule [EP] et Gabsi [GB]) a été orienté pour leur pouvoir antioxydant et leur consommation locale. Deux parties de la plante ont été utilisées, les fleurs et les fruits à 3 stades de maturation soit 2, 4 et 6 mois. Les résultats ont montré que seule la variété du grenadier Gabsi stimule significativement le transport de glucose par rapport au contrôle (DMSO), et ceci sans être toxique. Cet effet est plus prononcé au stade de fruit mûr (à 6 mois) que celui de la fleur. De plus, l’extrait de fleurs stimule la voie insulino-indépendante de l’AMPK et augmente le niveau d’expression des transporteurs spécifiques de glucose (GLUT-4). Par contre, l’extrait de fruits mûrs, en plus de ces deux mécanismes, active fortement aussi la voie insulino-dépendante de l’AKT. En conclusion, cette étude présente un nouveau mécanisme d’action antidiabétique de grenadier (plus particulièrement du fruit mûr) qui est dépendant de la variété. / Diabetes is a major public health problem worldwide with astounding human and economic consequences. The seed and the flower of pomegranate (Punica granatum), a native plant of Central Asia and the Mediterranean regions, exhibited a hypoglycaemic effect in in vivo studies. However, the underlying mechanisms have not yet been elucidated. The aim of this project was to evaluate the effect of the flower and the fruit (at 3 maturation stages) of pomegranate on glucose transport in skeletal muscle cells and to determine the molecular mechanisms involved in this effect. To accomplish this, we chose two varieties of pomegranate cultivated in Tunisia (Gabsi [GB] and Espagnoule [EP]), which have been shown to be highly consumed in that area and to possess high antioxidant activity. Differentiated C2C12 cells were treated for 18 hours with 80% ethanolic extract of the flowers and fruits (at 2, 4, and 6 months) of each variety. Our results showed that the Gabsi variety of pomegranate significantly enhances glucose uptake, without any toxicity. This effect is more pronounced in the ripe fruit (6 months) than in the flower. In parallel, the ripe fruit stimulated both the insulin-dependent pathway (Akt) and the insulin-independent pathway (AMPK), while the flower stimulated the latter only. In addition, both flower and ripe fruit treatment resulted in enhanced expression level of GLUT-4 glucose transporter in the muscle. Hence, these results suggest that regulation of glucose transport in skeletal muscle is one of the components involved in the anti-diabetic effect of Tunisian pomegranate.

Introduction: Meghalaya is a state in northeast India that has a predominantly indigenous population and an age-old system of tribal medicine. There are practitioners of this system in most villages, who use medicinal plants sourced from the state’s vast forest bio-resources. This project studied the tribal medicine of Meghalaya from three perspectives, the healer, the community and the policy maker. It locates tribal medicine within the government’s policy on medical pluralism and seeks to understand how tribal medicine of a local context fits into the national policy of the Government of India. Methods: A mixed methods study design was employed. Estimates of awareness and use of traditional medicine in the community were obtained from the analysis of a household survey. For the qualitative component tribal healers, policy makers, and influential members of the community were interviewed. A combination of in-depth interviews, observations and focus group discussions was employed in the field with healers, while in-depth interviews were the main source of data from policy actors. Qualitative data was analysed using a thematic content analysis approach that incorporated elements of the grounded theory approach. Results: The community - tribal medicine has wide acceptance across the state, 87% believed it to be efficacious and 46 % reported using it in the 3 months prior to the survey. In comparison only 31% had heard of any of the AYUSH (Ayurveda, Yoga, Unani, Siddha and Homeopathy) systems that are being promoted by the state and only 10.5% had ever used it in their lifetime. Healers - tribal healers are a heterogeneous group who treat a wide variety of ailments. Their expertise is well regarded in the community for certain ailments such as musculoskeletal disorders, but often their services were sought when patients were dissatisfied with biomedicine. For physical ailments that are culturally understood their services are often the preferred option. Their expertise niches have evolved through their interactions with, and the perceived needs of the community. 16 Policy actors – although there were some appreciative voices, several biomedical doctors and policy makers in the government department of health derided tribal medicine’s unscientific nature. In comparison other systems like Ayurveda and homeopathy were assumed to have scientific merit mainly because of institutionalisation and government recognition of these systems. The comparison with homeopathy is pertinent as its scientific credentials are being increasingly questioned in scientific literature. In contrast those outside the health department, academics, biomedical doctors and other influential members of the community favoured tribal medicine because of its widely regarded efficacy and its cultural value. Neglect of tribal medicine while promoting the imported AYUSH systems was seen as illogical and disrespectful to their culture by the latter group. Conclusions: the current policy in Meghalaya of mainstreaming AYUSH medicine is not supported by locally relevant evidence. It has led to a disproportionate increase in AYUSH doctors in the public sector. It represents a top down approach to policy formulation that ignores local realities. This study demonstrates the importance of contextualising policy to cultural milieus. It emphasises the importance of research in health system development and questions the generalising of policy in a country as diverse as India. The study illustrates the complexities, but points to the potential benefits of supporting tribal medicine in Meghalaya.