Allison L. Hopkins

Hibiscus sabdariffa L. in the treatment of hypertension and hyperlipidemia: a comprehensive review of animal and human studies.

The effectiveness of Hibiscus sabdariffa L. (HS) in the treatment of risk factors associated with cardiovascular disease is assessed in this review by taking a comprehensive approach to interpreting the randomized clinical trial (RCT) results in the context of the available ethnomedical, phytochemical, pharmacological, and safety and toxicity information. HS decoctions and infusions of calyxes, and on occasion leaves, are used in at least 10 countries worldwide in the treatment of hypertension and hyperlipidemia with no reported adverse events or side effects. HS extracts have a low degree of toxicity with a LD50 ranging from 2,000 to over 5,000mg/kg/day. There is no evidence of hepatic or renal toxicity as the result of HS extract consumption, except for possible adverse hepatic effects at high doses. There is evidence that HS acts as a diuretic, however in most cases the extract did not significantly influence electrolyte levels. Animal studies have consistently shown that consumption of HS extract reduces blood pressure in a dose dependent manner. In RCTs, the daily consumption of a tea or extract produced from HS calyxes significantly lowered systolic blood pressure (SBP) and diastolic blood pressure (DBP) in adults with pre to moderate essential hypertension and type 2 diabetes. In addition, HS tea was as effective at lowering blood pressure as the commonly used blood pressure medication Captropril, but less effective than Lisinopril. Total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides were lowered in the majority of normolipidemic, hyperlipidemic, and diabetic animal models, whereas high-density lipoprotein cholesterol (HDL-C) was generally not affected by the consumption of HS extract. Over half of the RCTs showed that daily consumption of HS tea or extracts had favorable influence on lipid profiles including reduced total cholesterol, LDL-C, triglycerides, as well as increased HDL-C. Anthocyanins found in abundance in HS calyxes are generally considered the phytochemicals responsible for the antihypertensive and hypocholesterolemic effects, however evidence has also been provided for the role of polyphenols and hibiscus acid. A number of potential mechanisms have been proposed to explain the hypotensive and anticholesterol effects, but the most common explanation is the antioxidant effects of the anthocyanins inhibition of LDL-C oxidation, which impedes atherosclerosis, an important cardiovascular risk factor. This comprehensive body of evidence suggests that extracts of HS are promising as a treatment of hypertension and hyperlipidemia, however more high quality animal and human studies informed by actual therapeutic practices are needed to provide recommendations for use that have the potential for widespread public health benefit.

Use of Network Centrality Measures to Explain Individual Levels of Herbal Remedy Cultural Competence among the Yucatec Maya in Tabi, Mexico.

Common herbal remedy knowledge varies and is transmitted among individuals who are connected through a social network. Thus, social relationships have the potential to account for some of the variation in knowledge. Cultural consensus analysis (CCA) and social network analysis (SNA) were used together to study the association between intracultural variation in botanical remedy knowledge and social relationships in Tabi, Yucatan, Mexico. CCA, a theory of culture as agreement, was used to assess the competence of individuals in a domain of herbal remedies by measuring individual competence scores within that domain. There was a weak but positive association between these competence scores and network centrality scores. This association disappeared when age was included in the model. People in Tabi, who have higher competence in herbal remedies tend to be older and more centrally located in the herbal remedy inquiry network. The larger implication of the application of CCA and SNA for understanding the acquisition and transmission of cultural knowledge is also explored.

Distribution of Herbal Remedy Knowledge in Tabi, Yucatan, Mexico.

Distribution of Herbal Remedy Knowledge in Tabi, Yucatan, Mexico. The distribution of herbal remedy knowledge among a group of people is studied for two main reasons: (1) to identify plants that are promising for pharmacological analysis, and (2) to examine the factors that lead to herbal remedy knowledge erosion as opposed to dynamism in the acquisition of knowledge. The goal of this particular study, which is aligned with the second reason, is to establish the variation in herbal remedy knowledge among the Yucatec Maya in Tabi, Yucatan, Mexico. Free listing and cultural consensus analysis revealed that knowledge about a few medicinal plants and herbal remedies was distributed widely among the Yucatec Maya in Tabi, whereas the majority of knowledge was idiosyncratic. This finding was consistent with other studies of herbal remedy knowledge distribution among indigenous groups in Latin America and Africa. Assessing patterns in the distribution of herbal remedy knowledge is an important next step in determining the degree of dynamism or erosion in knowledge acquisition and transmission in Tabi.Distribución del conocimiento de los remedios herbales en Tabi, Yucatán, México. La distribución del conocimiento de remedios herbolarios entre grupos de personas se ha estudiado por dos razones principales: primero, para la identificación de plantas prometedoras en el análisis farmacológico y segundo, para examinar los factores que contribuyen a la erosión del conocimiento de estos remedios en lugar de la adquisición dinámica del conocimiento. El reto de este estudio, el cual esta alineado con la segunda razón, es establecer la variación en el conocimiento de dichos remedios entre los mayas yucatecos de la comunidad de Tabi, Yucatán, México. El listado libre y el análisis de consenso cultural revelaron que el conocimiento de pocas plantas medicinales y remedios herbolarios se distribuyó extensamente entre los mayas yucatecos de Tabi, mientras que la mayoría del conocimiento de los remedios fue idiosincrásico. Este resultado fue consistente con otros estudios de la distribución del conocimiento de remedios herbolarios entre grupos indígenas de América Latina y África. La evaluación de los patrones en la distribución del conocimiento de estos remedios será el próximo paso para determinar el grado de dinamismo o erosión en la adquisición y transmisión del conocimiento en Tabi.

It's Complicated: Negotiating Between Traditional Research and Community-Based Participatory Research in a Translational Study

Abstract: Background: The Interactive Systems Framework (ISF), a guide for translational research, encourages the balancing of traditional research and community-based participatory research (CBPR) approaches. Objectives: This paper focuses on the challenges, solutions, and lessons learned in applying the ISF to our translational research project. Methods: A community–campus partnership translated evidence-based screening guidelines on sexually transmitted infections (STIs) and depression into culturally relevant educational materials. Community health workers (CHWs) disseminated the information through a cross-over design to Hispanic women in Pima County, Arizona. Challenges, solutions, and lessons learned were identified throughout this process. Lessons Learned: We identified challenges in the areas of research design, and in the ISF systems of prevention synthesis and translation, prevention support, and prevention delivery. We successfully negotiate solutions between the scientific and local community that resulted in acceptable compromises for both groups. Conclusions: The model presented by the ISF is difficult to achieve, but we offer concrete solutions to community members and scientists to move toward that ideal.

Herbal remedy knowledge acquisition and transmission among the Yucatec Maya in Tabi, Mexico: A cross-sectional study

BackgroundEthnobotanical knowledge continues to be important for treating illness in many rural communities, despite access to health care clinics and pharmaceuticals. However, access to health care clinics and other modern services can have an impact on the distribution of medical ethnobotanical knowledge. Many factors have been shown to be associated with distributions in this type of knowledge. The goal of the sub-analyses reported in this paper was to better understand the relationship between herbal remedy knowledge, and two such factors, age and social network position, among the Yucatec Maya in Tabi, Yucatan.MethodsThe sample consisted of 116 Yucatec Maya adults. Cultural consensus analysis was used to measure variation in herbal remedy knowledge using competence scores, which is a measure of participant agreement within a domain. Social network analysis was used to measure individual position within a network using in-degree scores, based on the number of people who asked an individual about herbal remedies. Surveys were used to capture relevant personal attributes, including age.ResultsAnalysis revealed a significant positive correlation between age and the herbal medicine competence score for individuals 45 and under, and no relationship for individuals over 45. There was an insignificant relationship between in-degree and competence scores for individuals 50 and under and a significant positive correlation for those over 50.ConclusionsThere are two possible mechanisms that could account for the differences between cohorts: 1) knowledge accumulation over time; and/or 2) the stunting of knowledge acquisition through delayed acquisition, competing treatment options, and changes in values. Primary ethnographic evidence suggests that both mechanisms may be at play in Tabi. Future studies using longitudinal or cross-site comparisons are necessary to determine the whether and how the second mechanism is influencing the different cohorts.Resumen en EspañolAntecedentesEl conocimiento de la etnobotánica continua siendo importante para el tratamiento de enfermedades en muchas comunidades rurales del mundo, a pesar de que en muchos casos exista acceso a centros de cuidados clínicos y farmacias. Sin embargo, este acceso a los centros de salud y otros servicios modernos, puede tener un impacto sobre la distribución del conocimiento de la etnobotánica médica. Muchos factores han demostrado estar asociados con distribuciones en este tipo de conocimiento. El reto de los sub-análisis reportado en este documento fue entender mejor la relación entre el conocimiento de remedio herbal y dos de estos factores, la edad, y la posición dentro de la red social, entre el Maya yucateco de Tabi, Yucatán.MétodosLa muestra consistió de 116 adultos maya yucatecos. Se utilizó un análisis de consenso cultural para medir la variación en el conocimiento de remedios herbales utilizando marcadores de aptitud, a través de una medición de concordancia entre participantes sobre un dominio. También se utilizó un análisis de redes sociales para medir la posición del individuo dentro de la red usando marcadores de grado, a través del número de personas que preguntaron a un solo individuo acerca de su conocimiento de remedios herbales. Por otro parte se utilizarán cuestionarios para obtener atributos personales relevantes, incluyendo la edad.ResultadosLos análisis revelaron una correlación positiva significante entre la edad y los marcadores de aptitud de conocimiento en medicina herbal para individuos de 45 años y menores, y sin ninguna relación para individuos mayores a 45 años. Se encontró una relación insignificante entre marcadores de grado y aptitud para individuos de 50 años y menores, y una correlación positiva significante para aquellos individuos mayores a 50 años.ConclusionesExisten dos mecanismos posibles que podrían explicar las diferencias entre cohortes: 1) la acumulación de conocimiento en el tiempo; y/o 2) el retraso en el crecimiento de la adquisición del conocimiento a través de la adquisición tardía, compiten las opciones de tratamiento y los cambios en los valores. La principal evidencia etnográfica sugiere que ambos mecanismos podrían estar en juego en Tabi. Futuros estudios utilizando comparaciones longitudinales o entre sitios se consideran necesarios para determinar si se está influyendo sobre las diferentes cohortes, y como el segundo mecanismo lo está haciendo.

Healthy foods prepared at home: Diet and support as protective strategies during pregnancy for Hispanic women

ABSTRACT Birth outcomes tend to be better among Hispanics than among other ethnic groups, even when matched for poverty and education, and foreign-born Latinas compared to their US-born counterparts. These patterns suggest that sociocultural factors exhibited by recent immigrants have the potential to protect birth outcomes against the instability of minority and low socioeconomic status. To discover potential sociocultural factors, a pilot qualitative study was carried out in Tucson, Arizona, with 18 Hispanic mothers. The two most prevalent factors reported were (1) a healthy diet prepared at home from minimally processed ingredients, and (2) constant and comprehensive social support. When comparing responses related to diet by interview language preference, a proxy for acculturation, there was very little difference between participants who interviewed in Spanish and those who interviewed in English. This result may be explained by greater maternal social support and higher education levels among those who interviewed in English.