The use of biomedicine, complementary and alternative medicine, and ethnomedicine for the treatment of epilepsy among people of South Asian origin in the UK

Studies have shown that a significant proportion of people with epilepsy use complementary and alternative medicine (CAM). CAM use is known to vary between different ethnic groups and cultural contexts; however, little attention has been devoted to inter-ethnic differences within the UK population. We studied the use of biomedicine, complementary and alternative medicine, and ethnomedicine in a sample of people with epilepsy of South Asian origin living in the north of England. Interviews were conducted with 30 people of South Asian origin and 16 carers drawn from a sampling frame of patients over 18 years old with epilepsy, compiled from epilepsy registers and hospital databases. All interviews were tape-recorded, translated if required and transcribed. A framework approach was adopted to analyse the data. All those interviewed were taking conventional anti-epileptic drugs. Most had also sought help from traditional South Asian practitioners, but only two people had tried conventional CAM. Decisions to consult a traditional healer were taken by families rather than by individuals with epilepsy. Those who made the decision to consult a traditional healer were usually older family members and their motivations and perceptions of safety and efficacy often differed from those of the recipients of the treatment. No-one had discussed the use of traditional therapies with their doctor. The patterns observed in the UK mirrored those reported among people with epilepsy in India and Pakistan. The health care-seeking behaviour of study participants, although mainly confined within the ethnomedicine sector, shared much in common with that of people who use global CAM. The appeal of traditional therapies lay in their religious and moral legitimacy within the South Asian community, especially to the older generation who were disproportionately influential in the determination of treatment choices. As a second generation made up of people of Pakistani origin born in the UK reach the age when they are the influential decision makers in their families, resort to traditional therapies may decline. People had long experience of navigating plural systems of health care and avoided potential conflict by maintaining strict separation between different sectors. Health care practitioners need to approach these issues with sensitivity and to regard traditional healers as potential allies, rather than competitors or quacks

The relationship between lunar periodicity and activity of fish-parasitic gnathiid isopods in the Caribbean

Gnathiid isopod larvae are members of the marine demersal zooplankton community and are common ectoparasites of coral reef fishes, emerging from the substratum, mostly at night and crepuscular periods to feed on fish blood. Given that the activity of many marine organisms is often linked to changes in the phase of the moon, we examined the relationship between lunar phase and activity in gnathiid isopods on Caribbean reefs. We employed two sampling methods to quantify gnathiid activity: (1) Emergence traps set on reefs over a 24 h period; and (2) live fish placed in cages on reefs and retrieved during night and dawn peaks in gnathiid activity. These were compared during discrete phases as well as a continuous metric, the lunar "angle", and an estimate of ambient light availability (luminance). Lunar phase and angle varied in their statistical effect on gnathiid activity patterns by sampling method and/or year. Luminance had a significant but inconsistent effect on measures of gnathiid activity. Our results suggest that changes in the lunar cycle are not a strong predictor of gnathiid activity at our shallow reef study sites