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Masurkar, Alpita. "South Asians in Boston." Thesis, Massachusetts Institute of Technology, 2012. http://hdl.handle.net/1721.1/77881.
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Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 2012.Cataloged from PDF version of thesis. Page 101 blank.
Includes bibliographical references (p. 74-76).
Boston has a rich and diverse history of immigrants. Right from the arrival of the Puritans in 1628-30 who established the earliest immigrant settlements in Boston, this region has attracted immigrants from different parts of the world. Boston's strategic coastal location, its flourishing industries and the growing economy provided a hope of opportunities for the immigrants who came with a dream- the famine-struck Irish, the Italians, the Eastern European Jews wanting to escape religious and socio-political tensions, the Blacks wanting to escape slavery, the Chinese seeking better economic opportunities and more recently, the Asian Indians seeking better education and work opportunities. The economy of Massachusetts underwent transformation in the 20*h century with the rise of the high technology sector. The emergence of Route 128 around Boston and subsequently, 1-495 corridor in the 20th century led to the formation of a high technology cluster that attracted extremely skilled immigrants. South Asians, especially the Asian Indians constitute an integral part of this immigrant population that gravitated to this region not because of famines or wars, but the transformation in Massachusetts' economy. Their numbers grew rapidly through the 20* century and the story of their growth is remarkable. From the days of insignificant presence, South Asians have grown into a young, fast-growing ethnic community in Boston. A majority of the South Asian population today is young, educated, highly skilled and employed in the high technology sector but there are others employed in the low-skilled, working class and service occupations across the state. What happened in each of the waves of South Asian immigration to Massachusetts? Do the immigration patterns of Asian Indians differ from other South Asians? Who are these immigrants who undertook this long journey from the Indian sub-continent to the United States? This thesis is an attempt to trace the origins and growth of the South Asian immigrant community in Massachusetts, which is one of the youngest and fastest growing groups of immigrants in the state. The presence of South Asians in Massachusetts has come a long way from being negligible and invisible in the post-World War II period to being a prominent presence in its high technology nucleus of Greater Boston. Keywords: South Asians, Asian Indians, Indian Americans, Asian Indian immigrants, Boston, Immigrants in Boston, Immigrants in Massachusetts, high-skilled immigrants, skilled migrants
by Alpita Masurkar.
M.C.P.
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SUNG, Hung Mui. "Approaching South Asians in Hong Kong." Digital Commons @ Lingnan University, 2005. https://commons.ln.edu.hk/cs_etd/12.
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"South Asians" is usually an inclusive term to refer to ethnic minorities originating from countries like India, Pakistan, Bangladesh, Nepal and Sri Lanka. Despite the apparent concern with “South Asians” in Hong Kong society in recent years, such as pushing for legislation against racial discrimination and initiating social and educational programmes to help these minorities to better integrate into Hong Kong society, attention to irreducible cultural differences constituting their heterogeneity is still largely lacking.
The thesis intends to take up the question of the South Asian minorities in the context of post-1997 Hong Kong. By looking at their everyday struggles in political, linguistic and cultural realms, the thesis tries to understand three key questions - first, how “South Asians” as a minority assert their political and democratic rights and practice their citizenship in the socio-political realm; second, how the cultural identities of ethnic minority children in their formative years are shaped by the tensions between the formal institutional schooling and language policies on the one hand, and traditions, religions, customs and bonding of neighborhood living in their communities on the other hand; third, how “South Asians” are portrayed as the other in the mainstream representation such as cinema and newspapers, despite the rising awareness against discrimination.
The thesis seeks to challenge the ways mainstream Hong Kong Chinese represent these minorities and critique the deep cultural bias of racism and discrimination that prevent the fundamental opening up to the heterogeneity of the Other.
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Randhawa, Gurch. "Renal transplantation among South Asians in the UK." Thesis, University of Bedfordshire, 2005. http://hdl.handle.net/10547/313929.
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This work represents a significant contribution to the body of knowledge in the area of renal transplantation as it brings together the research related to policy analysis, empirical research, and cultural and religious issues related to organ donation and transplantation among South Asians in the UK. The candidate's work in this area is the first in the UK to systematically document and map a national picture of kidney transplant waiting lists and to identify and examine the complex reasons underlying how and why patient ethnicity impacts upon the likelihood of receiving a kidney transplant. The candidate has also developed a new evidence-base exploring the adequacies of the existing procurement arrangements and the implications of introducing any alternative policies within the context of a multi-ethnic and multifaith UK. Finally, the candidate's work has focused on developing an evidence-base of the public perceptions, attitudes, and religious viewpoints towards organ donation and transplantation among a cross-section ofthe South Asian population. The candidate's published works have been the foundation blocks for stimulating and informing the debate on the provision of renal transplant services for minority ethnic groups through the generation of an empirical evidence-base in a subject area which has traditionally relied upon anecdotal evidence. The evidence-base illuminates a very complex issue which has multi-faceted solutions that need to be addressed in different settings.
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Haycock, Philip Charles. "Lipoprotein(a) and myocardial infarction in South Asians." Thesis, University of Cambridge, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.607890.
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Kaushik, Ratika. "Homing diaspora/diasporizing home : locating South Asian diasporic literature and film." Thesis, University of Sussex, 2018. http://sro.sussex.ac.uk/id/eprint/73136/.
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This thesis contains a detailed study of contemporary South Asian diasporic literary and cinematic works in English. The majority of the works analyzed and discussed are those produced from the 1980s onwards. My research investigates how selected diasporic texts and films from South Asia problematize representations of homeland and host spaces. I reveal in the course of this study, how these works, actively negotiate alternative modalities of belonging that celebrate the plurality of cultural identities within and outside the homeland. This exploration of diasporic narratives of homeland and host land is explored by examining these narratives across two mediums: the cinematic and the literary. In so doing, the thesis initiates a dialogue between the two mediums and locates these selected diasporic works within a larger tapestry of contemporary cultural, literary and global contexts. The thesis shows that these literary and filmic representations celebrate as well as present an incisive critique of the different cultural spaces they inhabit. The thesis also reveals how, in representing the experiences of multiple-linguistic, geographical, historical dislocations, these texts invite readers to see the changing faces of diasporic cultures and identities. My thesis complements this analysis of representation with a broader analysis of the reception of these diasporic works. My analysis sets out to move away from the critical tendency to scrutinize texts in relation to a politicized rhetoric of reception which privileges a reading of texts through insider/outsider binarism, by drawing together and contrasting academic and popular responses in the reception of diasporic texts. In so doing, my thesis reads these texts as agents of cultural production, focusing on interpretative possibilities of the literary critical mode of reading and enabling nuanced modes of analysis attentive to issues of diasporic identity, the identity of nation-states and the emergent global dynamics of migrant narratives. The texts I analyze are Salman Rushdie‘s Midnight's Children (1981) and The Satanic Verses (1988), Micheal Ondaatje‘s Running in the Family (1982) and Anil's Ghost (2000), Rohinton Mistry‘s A Fine Balance (1995), Mohsin Hamid‘s The Reluctant Fundamentalist (2007), and Hanif Kureishi‘s The Buddha of Suburbia (1990) and as well as two filmic texts, Mira Nair‘s The Namesake (2007) and Gurinder Chadha‘s Bend It Like Beckham (2001).
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Mahmood, Humera. "South Asians' perspectives on therapy utilization, an exploratory study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp04/mq24485.pdf.
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Mistry, Tina. "South Asians in the United Kingdom and specialist services." Thesis, University of Warwick, 2011. http://wrap.warwick.ac.uk/49318/.
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Chapter one is a literature review of the psychosocial factors which influence alcohol use in British South Asian men. Critical analysis of fourteen research articles revealed differences between first and second-generation South Asian men. The influence of religion, parental beliefs and acculturation were reported within the literature to affect alcohol use. The literature highlighted the issue of stigma and lack of awareness of services as barriers for treatment seeking. Additionally, the effect of religious and cultural beliefs of alcohol use may also discourage support from services. Chapter two investigated the experiences of British South Asian women who accessed psychological treatment within a cancer service using in-depth semistructured interviews. Key informants participated in focus groups to gain experiences of staff who had worked with South Asian communities. Using Interpretative Phenomenological Analysis, the findings elicited themes which illustrated that the South Asian women held pre-existing beliefs about psychological services. They also described their psychological journey of cancer treatment and the impact on their family, friends and differences between generations was reported. Analysis of the key informants' focus group data highlighted the theme of challenges faced by the South Asian patients and the staff. This article provided evidence for better education and awareness for South Asian communities and staff. Chapter three is a reflective article on the process of conducting the empirical research. The article addressed the reasons that influenced the researcher to conduct the study. Issues that had arisen were of the effect of 'sameness and difference' between the researcher and participants and the impact of qualitative research methodology and empowerment. A reflection of the impact from the interview accounts was also discussed.
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Warusawithana, Kulatilake Samanti Dineshkumari. "Cranial diversity and the evolutionary history of South Asians." Thesis, University of Cambridge, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.406922.
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Venkataraman, Hema. "Ethnic differences in gestational diabetes : impact on South Asians." Thesis, University of Warwick, 2016. http://wrap.warwick.ac.uk/80229/.
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Background: GDM is a state of glucose intolerance first diagnosed in pregnancy. It is a pre-diabetes state, predisposing both the mother and offspring to future risk of diabetes. GDM is associated with increased risk to macrosomia, adiposity, Caesarean Section (CS) delivery, shoulder dystocia, and neonatal hypoglycaemia. SA have a greater than two fold risk of both GDM and future diabetes risk compared to WC. However, despite having higher levels of hyperglycaemia in pregnancy, SA babies are amongst the smallest babies in the world. The mechanism behind this increased glycaemic risk in SA is complex, multifactorial and unclear. Disordered hypothalamic-pituitary-adrenal axis (HPA) has been linked to adult diabetes, obesity and metabolic syndrome in WC but has not been studied in SA. The current management of GDM is largely based on evidence from studies in WC and has been extrapolated to other ethnic groups such as SA. This includes: diagnostic criteria to define GDM, postnatal screening methods for postpartum glucose abnormalities, effect of GDM on offspring birth weight (BW) and fetal growth in GDM. Through this research we aim to explore the ethnic differences between SA and WC in the applicability of diagnostic criteria, post partum screening methods, effect of GDM on BW, fetal growth patterns in GDM and also examine ethnic differences in HPA activity as a potential mechanism underlying the increased glycaemic risk in SA in pregnancy. Methods: i. Retrospective analysis of a routinely collected multicentre data (n=14477) over a 3-year period was used to study the applicability of various GDM diagnostic criteria and post partum screening methods. A subgroup analysis of the above data set was used to compare fetal growth between SA and WC (177 WC and 160 SA). ii. A retrospective analysis of a large birth weight cohort (n=53,128) from Leicestershire between 1994 and 2006 was used to compare the effect of maternal diabetes and GDM on BW in SA and WC. iii. To examine fetal growth in SA, a retrospective case control analysis of serial fetal biometry was performed between GDM and control population from India. (178 controls and 153 GDM) iv. To explore underlying HPA dysfunction as a potential mechanism for increased glycemia in SA and ethnic differences in HPA behaviour a prospective cohort study comprising of high risk pregnant SA and WC women was performed. Diurnal salivary and urinary cortisol excretion was studied in relation to glycaemia in SA and WC (n=100, 50 SA, 50WC) Results: i. The newer IADPSG detects obese women with mild fasting hyperglycaemia. The benefits of treatment of hyperglycemia are not well established. The increase in detection rates of GDM with the new NICE and IADPSG criteria were uniform across ethnic groups in a selectively screened population. ii. Postnatal screening with oral glucose tolerance test (OGTT) is associated with poor uptake in all ethnic groups, which improves substantially with using HbA1c. SA were more likely to attend postnatal screening with HbA1c compared to WC. Screening for postnatal diabetes using FPG is more likely to miss women of non-WC ethnicity owing to the larger proportion of post-load glucose abnormalities. iii. The BW increase associated with maternal diabetes was lower in SA by 139g compared to WC. iv. Important ethnic differences in fetal growth were noted. SA fetuses had overall smaller measures of head and abdomen circumferences, but with disproportionately smaller abdominal circumference compared to WC, signifying early evidence of a head sparing growth restricted pattern. v. SA fetuses of GDM mothers showed early evidence of increased abdominal adiposity at 20 weeks with smaller measures of other fat free mass and skeletal growth compared to non-GDM controls vi. SA had higher cortisol awakening responses compared to WC. First trimester waking cortisol was an independent predictor of glycaemia in the third trimester. Despite significantly lower BMI, SA had similar glucocorticoid (GC) excretion to WC. Urinary GC excretion was independently predicted by maternal adiposity and not BMI in SA. Conclusion: This research addresses important gaps in the literature in gestational diabetes in SA. There are important ethnic differences in the impact of maternal diabetes and gestational diabetes on BW and fetal growth, and evidence of early increase in adiposity at the expense of lean body mass in SA. This research provides novel evidence to support the argument for ethnicity tailored management of GDM. Our research also provides novel evidence for disordered HPA activity as a possible mechanism for the increased glycemic risk in SA. Larger randomized prospective studies incorporating offspring outcomes in relation to HPA are needed.
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Shaheen, Shabana. "The Identity Formation of South Asians: A Phenomenological Study." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/5042.
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This research explores the lived experiences of South Asians college students. This research, through a qualitative study that is rooted in the philosophy of phenomenology, explores the essence South Asians’ identity formation. Qualitative data was collected through semi-structured interviews with South Asian college students. The data analysis was under a phenomenological lens that centered the lived experiences and the essence of these experiences in the results. Seven themes emerged from this phenomenological study: negotiating bicultural identity, model minority expectations, meaningful impact of religious spaces, understandings of intra-community tensions, racialization of Islamophobia, understandings of South Asian identity and efficacy of Asian American identity. This study’s findings provide a foundation to build a more expansive framework for understanding the identity formation of South Asians.
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Pande, Raksha. "Wedding to tradition? : Arranged Marriages and South Asians in Britain." Thesis, University of Newcastle Upon Tyne, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.519561.
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Aarabi, Mohsen. "Risk stratification of coronary heart disease in UK South Asians." Thesis, University of Sheffield, 2007. http://etheses.whiterose.ac.uk/6084/.
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It is clear that South Asians living in the West have substantially greater relative (coronary heart disease) CHD mortality and morbidity than the general population. Despite this current risk functions based on classical risk factors alone underestimate risk in non-diabetic South Asians. After reviewing the available literature for longitudinal studies exploring the relationship between South Asian ethnicity, as an independent factor, and CHD an adjustment factor suitable for use with the paper- based risk prediction functions was derived. The exploration of possible explanations for the excess risk identified dysglycaemia as one possible explain. Adding 10 years to age, although crude and based on the single prospective study, provides adequate sensitivity and specificity to take into account an "ethnicity factor" accounting for average excess risk in individual UK South Asians. Using this adjustment it was shown that more South Asian men and women, living in the UK, are candidates to receive lipid-lowering therapy for primary and secondary prevention than their Caucasian counterparts. Although the evidence base for a CVD risk estimation procedure in South Asians is slight it is better that they have their risk estimated, albeit with less precision, than be excluded. The present work provides a properly researched evidence base. Moreover, it provides its own very simple, but 1. practice acceptable, adjustment for currently used paper risk estimation tools. Acceptance of ant1hypertensives as a primary prevention treatment was looked at in the South Asians community. South Asians are at least equally accepting of treatment as Caucasians when given information about the personal impact of CVD and the effect and tolerability of antihypertensive treatment. With South Asians having a greater need and at least equal acceptance of preventive therapy, they should receive more such treatment. Current evidence suggests that this is not the case and targeted intervention may be needed. Further research is still required in many areas such as risk factors, risk estimation and recalibration, lifestyle intervention, and efficacy of preventive drug therapy in ethnic minorities. Because this population is at high risk, the benefits of appropriate research will also be high.
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Davis, D. "Lifestyle self-management experiences of South Asians post myocardial infarction." Thesis, University of Salford, 2018. http://usir.salford.ac.uk/45107/.
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Background: Coronary heart disease is the biggest killer in this country. South Asians carry the burden of increased incidence and prevalence and have poorer outcomes after a MI than the general UK population. Reviews have shown lifestyle modification including physical activity, healthy diet and smoking cessation, alters the course of heart disease and reduces recurrences crystallising its significance as a cost-effective public health strategy to reduce the rising burden of this disease. There are lacunae of knowledge as to what constitutes to guarantee a therapeutic lifestyle modification for better health outcomes in the South Asian community. Aim: To explore the self-management experience of South Asians after a heart attack. Method: Pioneering of its kind, this study used a grounded theory approach to elucidate how South Asians navigate these lifestyle changes. Two phase interviews at 2 weeks and 8 weeks of discharge, were conducted with 14 participants who were newly diagnosed with heart attack - from 2015 to July 2016. Results: Theoretical categories were developed through constant comparison and theoretical sampling – these were 'patronage of the family, affinity towards one's group and conforming to the religious and health (causal) beliefs'. Discussion: By providing a unique insight that choosing and prioritising lifestyle style changes is not an 'individual act', but a 'shared act', a case for 'shared efficacy' is made. The concept of 'shared efficacy' as an essential strategy to enhance an individual’s ability to make meaningful choice, is showcased. The novel presentation of making and maintaining lifestyle choices as a 'conflict resolution strategy' with the aim of 'maintaining harmony' among South Asians calls for a ‘harmony model’ to deal with diagnosis of heart attack and subsequent lifestyle changes. This proposed harmony model homes in on a family centred approach, where there is an 'awareness' of the family's needs, an 'appreciation' of the cardiac patient’s religious and causal beliefs as well as an 'acknowledgement' of their cultural priorities, in self-management programmes. 'Conclusion:' Migrant South Asians across the globe have an increased propensity to this disease. The findings contribute to the development of supporting negotiating strategies by capturing concepts that crystallise the significance of lifestyle self-management. To alleviate the burden, there is a need for ethno-sensitivity rather than an ethnocentricity in the delivery of services. This calls for a move from cultural competence to cultural intelligence.
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Heydon, Emma Elizabeth. "Telomere length and cardiovascular disease risk factors in South Asians." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.708496.
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Bhatnagar, Prachi. "Intergenerational differences in the physical activity of UK South Asians." Thesis, University of Oxford, 2014. http://ora.ox.ac.uk/objects/uuid:215410f0-edc8-4abf-ac63-148e04a81594.
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This thesis examines intergenerational change in prevalence of and attitudes to physical activity by comparing first and second-generation South Asians in Britain. British South Asians have poorer health outcomes including a higher prevalence of cardiovascular disease (CVD) and diabetes than White British people. Physical inactivity is one of the risk factors for CVD and diabetes. Physical activity levels are lower among British South Asians than the White British population, for reasons that include cultural factors related to being South Asian, the low socioeconomic status of some South Asian groups, and living in deprived neighbourhoods. However, existing literature on physical activity levels does not clearly distinguish between first and second-generations. Understanding generational differences in the influences on physical activity among South Asians is important for developing appropriate interventions. First, I review the existing quantitative and qualitative literature on physical activity in second-generation South Asians. There is some evidence that second-generation South Asians are more physically active than the first-generation. Despite this, second-generation South Asians remain less active than White British people. Neither the quantitative nor the qualitative literature has adequately explored the reasons for these findings. I then use data from the Health Survey for England to explore the ways that adult Indians, Pakistanis and Bangladeshis are physically active. When analysed by age and sex, all South Asians and the White British group were physically active in different ways to each other. However, there was little difference between younger Indians and younger White British people in the contribution of walking to total activity. Finally, I present a qualitative analysis of how ethnicity influences physical activity in second-generation South Asians. I interviewed 28 Indian women living in Manchester, England. I found that a British schooling and messages from the media had strongly influenced second-generation Indian women's attitudes to physical activity. Consequently, their motivations and barriers to physical activity were generally very similar to those reported for White British women. Second-generation Indian women had mostly adopted Western gender roles, with Indian gender expectations having a limited impact on their physical activity. In contrast, the traditional roles of Indian women constrained the leisure-time physical activity of the first-generation Indian women. There was no generational difference in how the local neighbourhood influenced physical activity. This thesis demonstrates clear differences in physical activity prevalence and attitudes between first and second-generation South Asian women in the UK. Interventions aimed at improving local environments for physical activity are likely to help all people living in deprived areas, regardless of ethnic background. Changing generic Western social norms around femininity and being physically active may be more important than tailored interventions for second-generation Indian women.
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Khan, Mohammed. "The genetic susceptibility of South Asians to inflammatory bowel disease." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/the-genetic-susceptibility-of-south-asians-to-inflammatory-bowel-disease(cbf0a01e-16ac-460b-af7a-6a100948a5d3).html.
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The inflammatory bowel diseases (IBD) are chronic conditions of the intestinal tract, divided into two main subtypes Crohn’s disease (CD) and ulcerative colitis (UC). The exact pathogenesis is unclear but the current paradigm is thought to be an aberrant immune response in a genetically susceptible individual. The incidence and prevalence of IBD has traditionally been higher in North America, Europe, Australia and Israel compared to other regions of the world including China, Japan, India and Korea. More recently there is evidence of an increase in immigrant populations. Studies have also suggested that the clinical characteristics differ across ethnic groups. This has been mirrored by genetic studies that suggest different genetic susceptibilities between groups. A systematic review was performed to define the relevance of gene variants to IBD in a South Asian population. This found that few studies (n=6) have genotyped susceptibility variants in the South Asian population. The majority of these studies examined three common polymorphisms (R702W, G908R, 1007fs) in NOD2/CARD15 in Caucasians and have determined that these are absent in South Asians. The first hypothesis of this study was that clinical characteristics and mucosal distribution differed in South Asians compared with White British in the North of England. A total of 1318 individuals (314 South Asians) with a diagnosis of IBD were recruited. In the South Asian cohort 59% had a diagnosis of UC, 41% CD. In contrast the Caucasian cohort 56% had CD and 44% had UC. South Asians had twice the rate of extensive colitis compared to White British cohort (46% SA vs. 24% White British) and a younger age of diagnosis (30 years vs. 40 years). In the CD cohort South Asians were twice as likely to have colonic disease than White British (54% vs. 20%). Also they had a younger age of onset and were less likely to need surgery for CD.The second hypothesis was that common variants in the same genes described in Caucasian IBD were relevant in South Asians. 13 known SNPs from GWA Studies robustly associated with IBD in Caucasian cohorts were sequenced in South Asians IBD cohort (n=255) and unrelated ethnically matched controls (n=275) to determine if they were relevant to IBD in South Asians. These were genotyped by Sequenom MassArray and no significant associations were discovered. The final hypothesis was that rare highly penetrant variants underlie a group of IBD in consanguineous families in South Asian IBD. A consanguineous family in which the proband had inflammatory colitis diagnosed at 18 months of age was recruited. No disease causing mutations were present in IL10RA, IL10RB and ADAM17. DNA from other family members was used to perform autozygosity mapping of the proband and family. Exome sequence analysis identified 6099 variants in autozygous regions. Further analysis focused on three novel variants. One variant (PPP1R3G) was considered a likely candidate and Sanger sequencing was performed which confirmed it was homozygous in the proband, but it did not segregate in the family and so unlikely to underlie IBD in this individual. In summary this thesis has shown that few genetic studies have been done in South Asian IBD. Also there are significant differences in the clinical characteristics and mucosal distribution between groups and that 13 SNPs associated with IBD in Caucasians were not replicated in the South Asian IBD cohort. Finally autozygosity mapping and exome sequencing has not been successful in identifying a rare novel variant responsible for IBD in the consanguineous family but work is continuing.
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Bosworth, Joanne L. "Land and society in South Kigezi, Uganda." Thesis, University of Oxford, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338762.
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Herzig, Pascale. "South Asians in Kenya gender, generation and changing identities in diaspora." Münster Lit, 2006. http://deposit.d-nb.de/cgi-bin/dokserv?id=2902101&prov=M&dok_var=1&dok_ext=htm.
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Mirza, Dr Ilyas Qayyum. "Substance use in South Asians with schizophrenia : a mixed methods study." Thesis, Queen Mary, University of London, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.515516.
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Jain, Piyush. "Prevalence of sub clinical atherosclerosis among UK South Asians and Europeans." Thesis, Imperial College London, 2015. http://hdl.handle.net/10044/1/25743.
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Background: South Asians demonstrate high coronary heart disease mortality, largely unexplained by conventional risk factors and unidentified by risk stratification tools. Developments in technology allow us to visualize coronary atherosclerosis non-invasively, thus providing the potential to identify presence of coronary atherosclerosis before it manifests clinically. Coronary artery calcification is closely correlated with total plaque burden and provides an assessment of coronary plaque burden. Myocardial perfusion scintigraphy provides an estimate of myocardial blood flow and thus, severity of coronary artery disease. Increased coronary artery calcification and silent myocardial ischemia predict future risk of coronary heart disease mortality, independent of conventional factors. Inflammation is a key factor in initiation and progression of atherosclerosis. High sensitivity C-reactive protein (CRP) is an important marker of active inflammation and is considered an independent predictor of future cardiovascular events. Thus, markers of subclinical atherosclerosis and inflammation could provide us with a tool for early identification of South Asians at risk of coronary events, unidentified by traditional means. However, majority of the data for such markers is from North American and European populations, with no data evaluating the role of coronary artery calcification, myocardial perfusion scintigraphy and CRP in assessing the coronary heart disease risk in South Asians. Methods and Results: I carried out assessments including coronary artery calcium, myocardial perfusion imaging and assessment of high sensitivity C-reactive protein for a cohort of asymptomatic South Asians and Europeans men and women, aged 35 to 75 years, who were part of the London Life Sciences Population (LOLIPOP) study. I found that: 1) Coronary artery calcification scores were closely associated with age, male gender, cigarette smoking, hypertension, systolic blood pressure, diabetes and total cholesterol. 2) There were no differences in either coronary artery calcification prevalence or mean levels of coronary artery calcification between South Asians and Europeans, after adjustment for the measured cardiovascular risk factors. 3) Presence of diabetes and increasing coronary artery calcification were independent predictors for silent myocardial ischemia. 4) South Asian ethnicity did not influence the prevalence or the extent of silent myocardial ischemia, after adjustment for conventional risk factors. 5) C-reactive protein levels did not correlate with measures of plaque burden. 5) South Asian ethnicity was an independent predictor of inflammation as seen by levels of high sensitivity C-reactive protein. This effect was independent of, and remained significant after adjusting for conventional cardiovascular risk factors and novel factors linked to inflammation such as diabetes and indices of abdominal obesity. Conclusions: While traditional risk factor correlate well with markers of atherosclerosis, the higher coronary heart disease risk and mortality observed in South Asians is not identified by markers of atherosclerotic burden such as coronary artery calcification and myocardial perfusion scintigraphy. South Asians have elevated levels of inflammation as seen by high sensitivity C-reactive protein levels. C-reactive protein levels are not correlated with coronary artery calcium or myocardial ischemia measured by myocardial perfusion scintigraphy. These findings suggest a role of factors such as systemic and plaque inflammation, unrelated to and unmeasured by plaque burden assessment in the higher coronary heart disease mortality observed among South Asians. The study therefore suggests a role of potential risk stratification tools reflecting the multisystem nature of CHD. These could be a combination of clinical risk factors contributing towards CHD, imaging of atherosclerotic plaque and assessment of plaque or systemic inflammation.
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Naz, Noreen. "British South Asians who hear voices : a narrative analysis of understanding." Thesis, University of Leicester, 2015. http://hdl.handle.net/2381/33552.
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Part One: Literature Review: Introduction: The systematic literature review explored the conceptual models used by South Asian women in making sense of their experiences of depression. Method: A systematic search of five databases generated a total of ten qualitative papers to be included in this review. Results: A total of four themes emerged in explaining beliefs about depression. These were; a) Inter-Generational Identity and Conflict, b) Marital Abuse and Adjustment, c) Somatisation and Medical Treatment and d) Distress as Part of Gods Plan. Many of the themes were shared by South Asian women living in South Asia and those living in the West. Discussion: There is evidence to suggest that South Asian women are not averse to receiving support from mental health services but Western models of mental health are not inclusive of cultural factors resulting in isolation of these women from receiving appropriate and timely support for depression. Part Two: Research Report: Introduction: The aim of the current study was to explore the types of narratives held by South Asian individuals who hear voices. Method: A qualitative approach was adopted for this study. Seven South Asian participants who actively heard voices were interviewed. These were audio recorded, transcribed and analysed using Narrative Analysis with a particular focus on Frank’s narrative typologies. Results: Results demonstrated that individuals held a range of narratives in understanding their experiences of hearing voices. These included elements of Restitution, Chaos and Quest. Cultural stories enabled effective meaning making and created more opportunities for collaborative interventions inclusive of religious and spiritual strategies. The absence of cultural dimensions in stories increased conflict between mental health services and South Asian individuals. Discussion: Supporting individuals to explore cultural stories and facilitating these to be incorporated into existing biomedical frameworks is more likely to result in individuals moving towards restitution in their experiences of hearing voices. Part Three: Critical Appraisal: This chapter described the reflexive account of the researcher throughout the research project.
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Chawdhury, Valentina. "HEALTH DISPARITIES AMONG SOUTH ASIANS: IS FOOD INSECURITY THE MISSING LINK?" CSUSB ScholarWorks, 2019. https://scholarworks.lib.csusb.edu/etd/900.
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Objective: Food insecurity among South Asians in the US is a public health issue. Food insecure adults face a plethora of adverse outcomes and research shows that individuals with ancestral origins from South Asia have a higher susceptibility rate for cardiovascular disease after migrating to urban environments. As such, the goal of this study was to research possible barriers South Asians face when creating cultural dishes in the US.
Methods: This was a convergent parallel mixed-methods analysis to understand how South Asians feel about food insecurity. Pricing and availability of cultural food items were obtained from South Asian and Western grocery stores. Focus groups were conducted among twelve participants who identified as South Asian immigrants where participants discussed their experiences obtaining cultural food items. After the interviews, the discussions were transcribed, and patterns were identified and analyzed.
Results: The results of the study demonstrate that South Asians find barriers such as availability, price, and quality when shopping for cultural food items. Participants reported cooking cultural foods at a lower frequency than what they would prefer because while many of the food items commonly used in cultural dishes were available at both Western and South Asian grocery stores, South Asian stores were more expensive. Furthermore, participants reported that some culturally specific ingredients were not available at South Asian stores thus further limiting their ability to cook healthy items.
Conclusion: The results of the study highlight the need for more public health initiative to address food insecurity among South Asians in the US.
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Hutnik, N. "Ethnic minority identity : The case of second generation South Asians in Britain." Thesis, University of Oxford, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.371670.
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Diaz, Sara Diana Garduno. "Diet and ethnicity associated risk factors for metabolic syndrome in South Asians." Thesis, University of Leeds, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.578657.
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The South Asian population in the United Kingdom has been reported to be at high risk of developing cardiovascular diseases and type 2 diabetes. These two chronic diseases are the end result of a condition known as the metabolic syndrome (MS). Although MS and its association to dietary patterns has been reported in various studies, most research has focused on western countries and minority group populations have been overlooked to a great extent. The identification of dietary patterns and other ethnicity associated risk factors is especially relevant to the South Asian population due to their high prevalence of diet-related diseases and their susceptibility to increased risk of co-morbidities. In addition, South Asians present a distinctive metabolic phenotype as well as unique dietary intakes both at home and abroad. Using detailed dietary information collected from a sample of the local South Asian community in Leeds, UK, the objective of this work was to describe the dietary patterns of South Asians and to investigate their association with metabolic syndrome risk factors. Anthropometric data was collected to identify existing MS components. Further, the study aimed to recognize lifestyle risk factors associated to ethnicity including religion, culturally-acceptable physical activity practices and the process of acculturation as time of residency in the UK increases. Related aspects such as education level and income and their link to diet quality were also explored. Finally, comparison was made between the diet and ethnicity associated risk factors for MS in South Asians and the mainstream population in the UK. Although results were in accordance with the existing literature in terms of diet composition, the examination of additional risk factors demonstrates the importance of developing public health prevention strategies tailored to the different minority ethnic groups in the UK's heterogeneous population.
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Bashir, Huma. "Understanding Diversity in Cultural Identify in South Asians: Implications for Clinical Practice." University of Cincinnati / OhioLINK, 2012. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1338905887.
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Gunputh, Vanessa. "An exploration of help-seeking among South Asians living in the UK." Thesis, Canterbury Christ Church University, 2015. http://create.canterbury.ac.uk/13904/.
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Culture can often influence how psychological distress is experienced and where help is sought. South Asians are the largest ethnic minority group in the United Kingdom (UK). This paper aimed to explore how second-generation South Asian adolescents make sense of their experiences of psychological distress and the meanings attributed to help-seeking. Semi-structured interviews were carried out with nine second-generation adolescents aged 13-19 years. Interpretative Phenomenological Analysis was employed. Five superordinate themes emerged from the analysis: feeling distressed, negative impact of family and cultural ideals on the self, connectedness to others, perception of help-seeking outside the family and intergenerational differences in help-seeking. The results indicated that help is sought from families when participants perceive they are able to relate to the source of distress. However, when there is a lack of understanding of distress, participants sought this from external sources of help. Professional help-seeking appeared influenced by the interplay between not meeting family ideals, intergenerational differences in understanding of distress and the stigma of seeking help. Clinical and research implications are discussed.
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Lisenby, Brenda Ellen. "Understanding the educational experience and needs of South Asian families." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B44390610.
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Sankhla, Deepak. "British attitudes towards sexuality of men and women with learning disabilities : a comparison between white westerners and South Asians." Thesis, Royal Holloway, University of London, 2014. http://digirep.rhul.ac.uk/items/63311b0e-a49e-ea4b-f6e7-7fa5e22295b4/1/.
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This study aimed to investigate public attitudes towards the sexuality of people with learning disabilities within a UK residing sample, and compare such attitudes between people from White Western and South Asian backgrounds. A mixed-method approach using an online questionnaire was employed. Three-hundred and thirty-one UK residing adults were recruited. Participants provided demographic details, completed five attitudes towards sexuality scales, in addition to measures of recognition and prior contact of a person with a mild learning disability. One of the sexual attitudes scales measured attitudes towards sexual openness in the typically developing men or women. The other four measured attitudes towards the sexuality of men or women with learning disabilities. These included four different aspects of sexuality (sexual rights, non-reproductive sexual behaviour, parenting and self-control). Participants completed either a male or female version of these scales. One open-ended question that asked about the sexuality of either men or women with learning disabilities was also included and responses to this question were analysed via a thematic analysis. Mean scores indicated that compared to White Westerners, South Asians had significantly more negative attitudes towards the sexual openness of men and women in the developing population and also towards the sexual rights of men and women with learning disabilities. Recognition was found to be poor in both ethnic groups, although White Westerners were found to be significantly more likely to be able to recognise mild learning disabilities compared to South Asians. These findings implicate the need to develop culturally sensitive interventions in improving knowledge and awareness of learning disabilities in addition to being aware of the differences in attitudes towards the sexuality of people with learning disabilities that may exist between different ethnic groups. These implications, the limitations of the study and suggested directions for future research are discussed.
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Mukadam, N. "The EAST-Dem study : encouraging access for South Asians to timely dementia diagnosis." Thesis, University College London (University of London), 2017. http://discovery.ucl.ac.uk/1560934/.
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BACKGROUND: People from Black and Minority Ethnic backgrounds tend to seek help later in the course of dementia than people from the majority ethnic population. Aim: To develop an intervention to encourage people from South Asian backgrounds to seek help earlier for memory problems and test its acceptability and feasibility. Methods: I systematically reviewed the literature and analysed routinely collected data to find interventions which improved dementia diagnostic rates. I then completed my qualitative study with South Asian community members to inform the development of an intervention to encourage earlier help seeking for memory difficulties by South Asian people. After piloting, I tested the intervention in a pilot cluster randomised controlled trial (RCT) with South Asian patients from participating GP practices. Primary outcomes were: 1. Feasibility - recruitment and retention rates 2. Acceptability - rating on a Likert scale. Results: No trials to increase dementia diagnosis rates have been successful, but rates increased significantly after implementation of the English National Dementia Strategy. South Asian community members said that understanding, through a story, that dementia was a physical illness, would normalise dutiful family members seeking interventions. I developed a bilingual leaflet and trilingual DVD with this content. I recruited and randomised 8 GP practices; 78/102 (76%) patients who allowed me to contact them, consented to the study (37 treatment-as-usual and 41 intervention). 76 (97%) participated in follow-up. 37/41 (90%) who received the intervention found it acceptable. Conclusion: I designed the first culturally-appropriate intervention to encourage help-seeking for dementia in the South Asian population. Participants found it acceptable. It was feasible to recruit and follow-up participants. A full-scale RCT would require a very large number of GP practices to participate so is likely to be expensive. It may be preferable to make this acceptable and simple intervention available and disseminate it.
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Munib, Ahmed Mujibur Rahman. "The effects of immigration and resettlement on the mental health of South-Asian communities in Melbourne /." Connect to thesis, 2006. http://eprints.unimelb.edu.au/archive/0002323.
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Bhui, Kamaldeep Singh. "Common mental disorders among Punjabi Asians : prevalence, explanatory models and the general practitioner's assessment." Thesis, University of London, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248407.
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Daryani, Poonam. "Identification and Analysis of Contextual Factors Impacting Polytobacco Use Among Young Adult South Asians." Scholarship @ Claremont, 2013. http://scholarship.claremont.edu/scripps_theses/193.
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This study examines the contextual factors influencing polytobacco use behavior, or the concurrent use of two or more forms of tobacco, among young adult South Asians. Fifteen in-depth and qualitative case studies of South Asian college students were conducted in order to illuminate and understand the intrapersonal, social, cultural, and environmental determinants of polytobacco use. Results from the study highlight the dynamic and diverse nature of tobacco use, as patterns of consumption were found to be profoundly influenced and differentially distributed across lines of gender, socioeconomic status, age, nationality, situational context, and ethnic identity. Participants used two to five forms of tobacco, with 60% using more than two. In addition to cigarettes, several alternative tobacco forms, predominantly hookah, spliffs, and dokha, emerged as popular modes of tobacco consumption among this population. South Asian college students use multiple products intermittently in community settings, where use is normalized as a component of a social activity. The current cigarette-centered model for tobacco control must be adjusted to account for the variety of tobacco forms now accessible to and utilized by young adult South Asians, whose choice of product and frequency of usage is guided by the contextual factors identified in the case studies. Tobacco intervention efforts and cessation programs must develop cultural sensitivity that is attuned and responsive to unique patterns of polytobacco use in order to effectively combat the current tobacco epidemic.
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Anand, Sonia S. Yusuf Salim. "Ethnicity and the determinants of cardiovascular disease among South Asians, Chinese, and European Canadians /." [Hamilton, Ont.] : McMaster University, 2002.
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Hall, Lesley. "Impaired skeletal muscle fat oxidation as a mechanism for insulin resistance in South Asians." Thesis, University of Glasgow, 2011. http://theses.gla.ac.uk/2916/.
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The impending global pandemic of obesity, type 2 diabetes and vascular disease suggests an urgent need for both prevention strategies and effective treatment. Of all the common ethnic groups South Asians, who make up a fifth of the world’s population, have the highest prevalence of both diabetes and vascular disease. The high rates of diabetes, in particular, occur with lower average adiposity levels, suggesting that South Asians are more susceptible to the effects of obesity. Differences in insulin sensitivity and diabetes prevalence between South Asians and Europeans cannot be fully explained by differences in adiposity alone. The aim of this thesis was to investigate whether differences in oxidative capacity and capacity for fatty acid utilisation in South Asians might contribute, using a range of whole-body and skeletal muscle measures. Twenty South Asian men and 20 age and BMI-matched white European men underwent exercise and metabolic testing and muscle biopsy to determine expression of oxidative and lipid metabolism genes and of insulin signalling proteins. In fully adjusted analyses, South Asians, compared to Europeans, exhibited significantly reduced insulin sensitivity; lower VO2max and reduced fat oxidation during submaximal exercise at the same exercise intensities. South Asians exhibited significantly higher skeletal muscle gene expression of CPT1A and FASN and significantly lower skeletal muscle protein expression of PI3K and PKB Ser473 phosphorylation. Fat oxidation during submaximal exercise and VO2max both correlated significantly with insulin sensitivity index and PKB Ser473 phosphorylation, with VO2max or fat oxidation during exercise explaining 10–13% of the variance in insulin sensitivity index, independent of age, adiposity and physical activity. These data suggest that reduced oxidative capacity and capacity for fatty acid utilisation at the whole body level are key features of the insulin resistant phenotype observed in South Asians, but that this is not the consequence of reduced skeletal muscle expression of oxidative and lipid metabolism genes.
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Chackathayil, Julia. "Antecedents, characterisation and validity of cardiovascular disease biomarkers amongst South Asians in the UK." Thesis, University of Birmingham, 2013. http://etheses.bham.ac.uk//id/eprint/4418/.
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The increased risk of cardiovascular disease (CVD) amongst South Asians (SAs) is unclear. This thesis examined potential biomarkers to address this. Cross-sectional data on SAs from community (n=1304) and hospital (n=148) populations was collected. Biomarkers were analysed by genotyping, mass spectrometry, automated-immuno-colourimetric-assays, ELISAs, and a new in-house assay for a novel marker, ferritin bound to apolipoprotein B. Diagnostic performance was assessed using receiver operating curves, logistic and linear regression models. C-reactive protein (CRP) was a comprehensive marker of CVD risk, where a range of 1.43-2.30 mg/L maximised sensitivity and specificity. CRP SNP (single nucleotide polymorphism) -390C>T/A contributed minimally to variation in CRP levels. Non-fasting triglycerides discriminated SAs at increased CVD risk, where APOA5 SNP -1131T>C was an independent predictor of triglycerides but APOC3 SNP -455T>C and -482C>T were not associated with triglycerides. The performance of IL-6, vWF, D-dimer and P-selectin were poor in comparison to CRP and triglycerides. BNP discriminated SAs with systolic heart failure with a cut off value of 36.4 pmol/l. Of the newly investigated biomarkers, a link between haemoglobin abnormalities and CVD was observed potentially through a mechanism involving iron transportation on lipoproteins. CRP and triglycerides should be considered in the routine CVD risk assessment of SAs.
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Macaden, Leah. "Risk perception among older South Asians with type 2 diabetes in the United Kingdom." Thesis, Northumbria University, 2009. http://nrl.northumbria.ac.uk/578/.
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South Asians living in the UK have an increased predisposition to developing Type 2 diabetes. Type 2 diabetes usually occurs later in life and has significant invisible long term risks that can affect an individual's quality of life and longevity but are preventable with life style changes. For people of South Asian origin, their perception of risks associated with Type 2 diabetes is likely to be shaped by a range of different factors, including cultural influences on gender roles, family life, and the significance of food and its preparation. The South Asian population in the United Kingdom is heterogeneous with strong socio cultural and religious beliefs that impact upon an individual's life style. Research on issues related to risk and risk perception have largely been conducted in developed countries. Models on risk perception have also evolved from these settings where people have increased personal autonomy, better resources and access to health care and related information. Risk is socially constructed and is influenced by socio cultural factors, religious beliefs and gender. Health related risks are understood differently by lay people and practitioners. Research available on risk perception among minority ethnic groups and the immigrant population living in a western context is very limited. Risk perception among South Asians with diabetes has not been explored in particular despite the escalating incidence of Type 2 diabetes in this population. This study aimed to explore how risks related to diabetes were perceived by older South Asians with Type 2 diabetes in the United Kingdom and developing a conceptual model on risk perception. A qualitative research design using grounded theory with its theoretical foundations drawn from Symbolic Interactionism was used. Data from two focus group interviews with ethnic health development workers, seven individual interviews with practitioners and twenty interviews with older South Asians with Type 2 diabetes was collected, transcribed and analysed. The process of Cross Language interpretation (Larson 1998) was used with gender and ethnically matched interpreters to collect data from non English speaking participants. Triangulation, audit trail, peer debrief and reflexivity were used to enhance rigour in the research process. Risk perception among older South Asians was interpreted in terms of risk awareness and risk engagement. Risk awareness was influenced by factors from within the cognitive and affective domains that resulted in risk engagement. Risk engagement was proactive if risk awareness was present and the locus of control was internal. Risk awareness involving the affective domain resulted in reactive risk engagement through risk response, ranking of risks, risk repair and creation of safety nets when influenced by external locus of control. The affective domain being predominant in comparison to the cognitive domain poses significant implications in the planning and provision of services to minority ethnic groups. The concept of concordance in diabetes management and the empowerment model that advocates self management towards risk prevention as the cornerstone of diabetes management may be challenging for both South Asians and their practitioners. This model on risk prevention that is largely oriented towards the cognitive domain requiring internal locus of control needs to be carefully evaluated in minority ethnic groups such as South Asians with Type 2 diabetes.
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Mujuzi, Jamil Ddamulira. "Life Imprisonment in International Criminal Tribunals and Selected African Jurisdictions - Mauritius, South Africa and Uganda." Thesis, University of the Western Cape, 2009. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_7837_1268591893.
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The study has three major aims: To give a detailed discussion of the question of punishment and the three major theories or objectives of punishment &ndash
retribution, deterrence and rehabilitation, from a philosophical point of view
To discuss the law and jurisprudence relating to life imprisonment in the international criminal tribunals of Nuremberg, Tokyo, the Former Yugoslavia, Rwanda, International Criminal Court and the Special Court for Sierra Leone (SCSL). The emphasis will be on the theories of punishment these tribunals have stressed in sentencing offenders to life imprisonment
To discuss the history and major legal developments relating to life imprisonment in three African countries, viz, Mauritius, South Africa and Uganda. The study will also discuss: the offences that carry life imprisonment
the courts with jurisdiction to impose life imprisonment
legal representation for accused facing life imprisonment on conviction
the theories of punishment that courts have emphasised in sentencing offenders to life imprisonment
and the law and mechanisms governing the release of offenders sentenced to life imprisonment in the above three countries.
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Butt, Modaser Ahmad. "A comparative study of risk factors of coronary heart disease in South Asians and Caucasians." Thesis, University of London, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.243555.
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Weston, Hannah Jill. "Seeking cultural safety : NGO responses to HIV/AIDS among South Asians in Delhi and London." Thesis, University of Cambridge, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.444103.
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Bibi, Bushra. "Health literacy and diabetes management in South Asians in the UK : a mixed methods study." Thesis, Keele University, 2017. http://eprints.keele.ac.uk/4110/.
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This thesis aimed to explore the health literacy needs of South Asians, in particular reference to diabetes management. This thesis consists of two studies: 1) a survey that examines health literacy levels and 2) study two Photovoice that explore cultural perspective in daily management of diabetes and health literacy needs. In study 1 (N=350), completed a face to face survey using standardised health literacy and diabetes measures. Findings indicated the majority of participants have limited functional health literacy (61%). Findings also suggest that people with certain characteristics, such as old age, females, low socioeconomic status, and people with limited or no formal education, are at a higher risk of inadequate health literacy. In the study 2, eleven of the participants from study 1 were recruited for Photovoice project and thematic analysis of participant’s accounts and images indicated three main themes. 1)Illustration of self-management of diabetes in day-to day life, relating to personal lifestyle, capacities and skills to manage different aspects of diabetes in their daily life; 2)NHS access and utility, concerning the use of health care services in the management of diabetes. 3) Quality of life, connected with the impact of diabetes on quality of life. It has been demonstrated from study two that, despite the limited functional health literacy, participants are able to manage their diabetes and use social support in their families, the distributed resources and health literacy skills of their family members to overcome their personal limited functional capacities. The consideration of health literacy within a particular community’s cultural perspective can have the potential to maximise the assets of that community. In increasing such a level of awareness and contributing towards the evidence of health literacy as an asset approach, made it possible to use the distributed resources of the social networks and can be one strategy to improve health literacy that can reduce the health disparities in the ethnic communities.
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Ali, Safdar. "Psychosocial predictors of health-related quality of life of South Asians with acute coronary syndrome." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/psychosocial-predictors-of-healthrelated-quality-of-life-of-south-asians-with-acute-coronary-syndrome(7d81f988-f2fb-4efa-957e-353016ec7b70).html.
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Introduction: South-Asians are the largest ethnic minority group in the UK. Depression and coronary heart disease (CHD) are common in this group. The importance of depression in South Asians has not attracted significant research interest, to date; yet there is evidence that it is associated with the development of CHD, and when it develops after CHD leads to poor prognosis. Objective: This study aims to investigate the effects of depression on quality of life of the South Asians under secondary care, by reviewing previous literature and performing a prospective research. The hypothesis was that, after controlling for demographic, psychological and medical variables depression would be associated with impaired HRQoL in South Asians 6 months after acute coronary syndrome (ACS). Methods: Demographic, psychological and medical data were collected. Participants completed the Hospital Anxiety and Depression Scale (HADS), Short-Form 36 (SF-36) and ENRICHD Social Support Instrument (ESSI) in the first phase. In the 2nd phase the Structured Clinical Interview for DSM-IV (SCID) was performed to validate the HADS. The PCS (SF-36) and HADS were completed at follow up. Results: Of the 250 enrolled patients 202 completed follow up. A HADS score of ≥ 17 was identified as the best cut off point. The prevalence of depression was 30%. Baseline depression, lack of education and retirement were predictors of poor QoL (p<0.05). Moreover, diabetes mellitus, respiratory and haematological disorders were associated (p< 0.05) with QoL; however after adjustment depression was the only significant predictor of poor HRQoL. Conclusions: This study suggests that depression is common in South Asians following ACS and it is associated with poor HRQoL. Further developments in the liaison psychiatry and increasing mental health knowledge of the cardiologists may help the earlier identification and subsequent treatment of depression to improve the prognosis of CHD patients.
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Horne, Maria. "Beliefs and attitutes about physical activity : an ethnographic study of older Caucasians and South Asians." Thesis, University of Manchester, 2007. http://www.manchester.ac.uk/escholar/uk-ac-man-scw:200336.
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Increasing levels of physical activity in older adults and fall prevention are key concerns of current UK health policy. Regular physical activity has many positive benefits for older adults, for example in fall prevention. However, sedentary behaviour among older adults is common. Forty per cent of over 50s in the UK report less physical activity than is considered necessary to maintain good health. Sedentary behaviour is even more common in South Asian older people in the UK. The aim of this research was to investigate the attitudes and beliefs that drive or hinder uptake and adherence of physical activity, in general and in relation to fall prevention, among 60-70 year old Caucasian and South Asian community dwellers. An ethnographic method was chosen as the research approach as it provided the framework for facilitating the incorporation of multiple voices. Two main geographical areas were chosen to conduct the study and included eight sites of study. Data collection used multiple methods (participant observation, focus groups and semi-structured interviews). In total 60 hours of participant observation, 15 focus group discussions (n = 87; mean age = 65.74 years) and 40 semi-structured interviews (mean age = 64.83 yrs) were conducted. Data analysis and classification followed a framework approach, comparing and contrasting themes within and across groups. Findings demonstrate that older people do not recognise falls as a risk and are not motivated to perform physical activity on a regular basis purely to help prevent falls. Social support and social benefits of physical activity appear to be key motivators to initiating and maintaining physical activity. Enjoyment, increased self-confidence and developing social networks seem to be important motivators in terms of adherence. Health, although a good motivator for the initiation of physical activity, appears to be a secondary motivator in terms of adherence. Barriers to physical activity include perceived and actual poor physical health, lack of social support, specificity of physical activity messages by health professionals as well as lack of motivation, low mood, fear of harm and domestic and carer issues. These findings suggest that older adults should be assessed individually, to address physical symptoms and possible low mood, and not according to age. The importance of exercise, even in the presence of physical illness needs to be explained. There is a need to promote confidence in older people’s ability to perform an activity, as this appears to be essential in continuing with exercise. Activities that take a ‘one size fits all’ approach, serve as a de-motivating force. Variety in exercise and physical activity is important to maintain motivation in the long-term.
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Vokes, Richard. "The Kanungu fire : power, patronage and exchange in south-western Uganda." Thesis, University of Oxford, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.400288.
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Malangu, Ntambwe. "Acute poisoning in three African countries: Botswana, South Africa and Uganda." Thesis, University of Limpopo (Medunsa Campus), 2011. http://hdl.handle.net/10386/674.
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Thesis (PhD (Epidemiology)-- University of Limpopo, 2011.Acute poisoning constitutes one of the main reasons why patients visit emergency departments of hospitals. However, the burden and pattern of acute poisoning in African countries are not well established, hence the need for this study. This study was conducted in order to compare the patterns of acute poisoning in three countries, namely, Botswana, South Africa, and Uganda. Specifically, this study examined the similarities and differences in the patterns of occurrence of acute poisoning based on the sociodemographic characteristics of the victims, the toxic agents involved, and the circumstances of the incidents. The study was based on six papers published on the topic. Papers I and II about Botswana covered a period of 24 months (January 2004 - December 2005) and six months (January - June 2005) respectively. The data from Uganda, as reported in Paper III, covered a six-month period (January-June 2005); while studies in South Africa, Papers IV to VI, covered respectively six (January-June 2005) and 18 months (January 2000-June 2001). A re-analysis of data from Papers II to IV was conducted after recoding age category and the grouping of toxic agents. In total, the six Papers reported data on 1780 patients; 54.8% of them were male. The median age was 24 years in Uganda, but as low as 17 years in Botswana and South Africa. In Botswana and South Africa, acute poisoning incidents occurred mostly in children younger than 12 years old, then decreased among teenagers, and increased again among young adults, before decreasing among patients over 30 years old. On the contrary, in Uganda there was that less than 5% of children younger than 12 years who were victims of poisoning. There was an increase in the prevalence of acute poisoning among teenagers and young adults before a decrease occurred among adults over 30 years old. The overall case fatality rate was 2.1 %, ranging from 1.4% in Uganda, 2.4% in South Africa, to 2.6% in Botswana. With regard to similarities across the three countries, it was found that among teenagers, girls committed more deliberate self-poisoning than boys; while in young adults, men committed more self-poisoning than women. With regard to toxic agents, household products were involved in fatal Page 9 of 136 outcomes in all three countries; while agrichemicals were more involved in deliberate than accidental poisonings; food poisoning affected more females than males. With regard to disparities across the three countries, the age and gender of the victims, the circumstances of the incidents and the types of toxic agents played a significant role. With regard to gender, the majority of the victims were males in Uganda, females in South Africa; while in Botswana, females and males were affected equally. Among teenagers, the toxic agents most involved in the poisoning incidents were pharmaceuticals in Botswana; household chemicals in South Africa; but agrichemicals in Uganda. While the majority of incidents happened by accident in Botswana and South Africa, being respectively 76.7% and 59.1%; in Uganda, 64.5% of acute poisoning cases were deliberate self¬poisoning. Deliberate self-poisoning was responsible for 50% of deaths in Uganda, 30% in South Africa, but no death in Botswana. The majority of deaths occurred among teenagers in South Africa; in Uganda it was among adults over 30years; while in Botswana, the majority of deaths were distributed almost equally amongst children younger than 12years old and young adults. Diverse products were involved in fatal outcomes. In South Africa, pharmaceuticals, particularly drugs of abuse, cocaine and marijuana; as well as carbon monoxide, and organophosphates were involved in fatalities. While, in Botswana, the products involved were paraffin, traditional medicines, pharmaceuticals, food poisoning, plants, and snake envenomation. In contrast, in Uganda, alcohol intoxication, organophosphates, carbon monoxide, and some unspecified household products lead to fatalities. Household chemicals were involved in the deaths of victims in all three countries; but the extent of their involvement differed from country to country. This group of products was responsible of 75% of deaths in Uganda, half of deaths in South Africa, and in a third of deaths in Botswana. Agrichemicals were involved in the deaths of victims in Uganda and South Africa, but not in Botswana. They were involved in a quarter of deaths in Uganda and 10% of deaths in South Africa. Page 10 of 136 Plants and traditional medicines were involved in two-thirds of the deaths only in Botswana; while pharmaceuticals were involved in 40% of fatal outcomes only in South Africa. In conclusion, the contextual factors of each country led to a pattern of acute poisoning that showed some similarities with regard to the distribution of deliberate self-poisoning among females, teenagers, and young adult victims. However, there were disparities relating to the differential access to toxic agents, based on the age and gender of the victims. Moreover, though the case fatality rate was similar across the three countries, the distribution of deaths based on age, gender, circumstances of poisoning and types of toxic agents involved differed among the three countries. These findings suggest that multifaceted interventions should be implemented including policy development, enforcement of the existing legislation, and the establishment of a surveillance mechanism, in-service training of clinicians and revision of treatment guidelines. These interventions should be tailored to meet the specific realities of each country.
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Sahota, H. "Is health care seeking behaviour affected by response to chest pain amongst South Asians and Whites?" Thesis, University College London (University of London), 2011. http://discovery.ucl.ac.uk/1336075/.
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Coronary heart disease (CHD) is the leading cause of death in the UK. Despite this declines in death rates have been experienced within the UK since the 1970’s but these declines have not been experienced by South Asians. Studies on access have highlighted inconsistencies between South Asians and Whites. The present study was conducted to explore factors which may affect health care seeking behaviour following symptoms of angina amongst South Asians and Whites. 40 face to face interviews were conducted using a purposive sample from a quantitative survey (Chaturvedi et al, 1997). This sub-sample consisted of White and South Asian male and female participants aged between 35-55 years. A further 4 focus groups were conducted with another purposive sample of White and South Asian males and females aged between 35-55 years. This second sample was selected using the same sampling frame (Chaturvedi et al, 1997). Focus groups were only conducted with those participants who had not taken part in the individual face to face interviews. The individual face to face interviews consisted of 10 South Asian male and 10 South Asian female participants and 10 White male and 10 White female participants. The focus groups consisted of 5-6 participants each. The focus groups were homogenous for ethnicity and sex. The epistemological framework used to guide the analysis was social constructionism. Results indicated that trust was an important factor which affected health care seeking behaviour amongst South Asians and Whites. South Asians had high trust of their GP, were over reliant on the GP and had lower expectations following chest pain. White participants had low trust of their GP, were less reliant on the GP and had high expectation following symptoms of chest pain. Issues of trust affected response to symptoms of angina, with Whites stating that they were less likely to delay seeking health care during an acute crisis compared to South Asians who stated they would phone the GP for advice before going to A&E. Conclusion Access to appropriate health care following chest pain is likely to result from patient related factors which include response to chest pain, expectation from the health service following chest pain and most importantly an overly trusting GP patient relationship.
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Lakhani, Neena. "An exploration of factors affecting the use of community pharmacy services by South Asians in Leicester." Thesis, De Montfort University, 2012. http://hdl.handle.net/2086/9880.
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Understanding the philosophy of a different culture and integrating this understanding into the provision of pharmaceutical care is challenging and complex. This thesis argues the importance for community pharmacists to acknowledge that culture, religion, family and community dynamics can impact on patients' health, health seeking behaviour and medicines adherence. The perceptions of members of the South Asian population, general practitioners, and community pharmacists about how these factors are viewed in relation to community pharmacy services were explored in this study. It was conducted in Leicester City, which has a South Asian minority ethnic population of more than 25%. Participants' views of the role of extended community pharmacy services in the wider government agenda were explored. South Asians attitudes to healthcare, self care and the management of minor ailments were discussed. A qualitative methodology approach was adopted, which used constructivist and interpretive principles. Data collection for the study was conducted in two phases. In Phase 1, one to one semi-structured interviews were conducted separately with six local GPs and five community pharmacists from both 'white' (European) and South Asian backgrounds. In Phase 2, six gender specific focus groups were convened comprising of fifty five participants in total from the Sikh, Moslem and Hindu communities. Bi-lingual community workers were used in this study which allowed a more 'sensitive' exploration of the sociological aspects of health seeking behaviour and the impact of 'cultural' influences on medicines adherence. The need for 'cultural competence' of community pharmacists is discussed as one of the major contributions to the evidence base for pharmacy practice. Such initiatives would require pharmacists to acquire more effective consultation skills in the first instance. South Asians expressed views that community pharmacists need to be more knowledgeable, responsive and flexible in their professional practice by assessing their pharmaceutical needs and being aware of particular cultural sensitivities when planning their services in line with the new pharmaceutical contract. More specifically, South Asian participants illustrated the need for community pharmacists and their staff to be more 'culturally knowledgeable' about the communities in which they practice. It is argued that the provision of a more culturally sensitive and pro-active service is needed to develop a better patient-practitioner professional relationship that promotes trust. South Asians illustrated how certain behavioural, religious and cultural beliefs impact on medicines adherence, such as compliance issues whilst on holiday to their homeland, the impact of religious pilgrimage and fasts. Many South Asian participants had limited understanding about 'generic' medicines and considered these to be 'inferior' or 'less effective' than 'branded' medication. Participants' views of 'sharing' of medicines and medicines waste were also illustrated. Factors such as 'stress', 'fate' and 'karma' and their impact on health of the participants were discussed. Many of these factors could not be solely attributable to a South Asian 'culture'. However, the findings illustrate a need for a Medicines Use Review (MUR) service to include more 'targeted' exploration of medicines adherence and medicines optimisation for this population. The findings also highlighted why South Asians rarely consult the community pharmacist about sensitive or stigmatised issues such as depression, and how some conditions and symptoms were perceived to have negative impact on the 'social acceptance' of South Asian individuals within their own communities. South Asians suggested that community pharmacists needed to be more pro-active and 'responsive' to their pharmaceutical needs and respect confidentiality through use of private consultation areas for routine counselling, health promotion and medicines information. All participants endorsed a need for more 'professional' recognition of the pharmacist not only as an autonomous health care professional, but as one integral to providing NHS services relating to medicines and public health. The findings illustrated a lack of professional collaboration between community pharmacists and GPs, confounded by community pharmacists being 'subordinate' to GPs and portraying more of a 'shopkeeper' image. South Asians were well informed about the lack of shared medical records and relied heavily on a doctor's definitive 'diagnosis' for somatic symptoms related common ailments. South Asians pro-actively engaged with 'community action' based approaches in health education and health promotion, and an opportunity for community pharmacists to become more involved with social initiatives was inferred from the findings. Candid and animated discussions explored their understanding of exercise as part of weight management and their interpretation of effects of the use of herbal products, alternative practitioners and the importance of collaboration with religious and community leaders in promoting medicines adherence. Participants desired alternative communication methods other than leaflets (translated or otherwise), including the use of audio-visual means and use of media. Communication difficulties were still prevalent, and trained interpreters were rarely used. By embracing some of these challenges, community pharmacists could enhance the value of their services and provide a more meaningful, 'culturally' competent and responsive services based on the needs of their local populations and nurture a better trusting and professional relationship with their service users and healthcare colleagues.
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George, Ramlah. "Dietary glycaemic index, glycaemic load and insulin resistance (HOMAIR) of healthy South Asians in Glasgow, UK." Thesis, University of Glasgow, 2015. http://theses.gla.ac.uk/6600/.
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High habitual dietary glycaemic index (GI) and glycaemic load (GL) may relate to elevated insulin resistance and therefore may be more important and relevant in South Asian populations known for high prevalence of insulin resistance. The main objective of this research was to investigate the dietary GI, GL and insulin resistance of a sample of healthy South Asians in Glasgow, UK (a total of 111 healthy individuals: 60 males, 30 South Asians and 30 Europeans; 51 females, 22 South Asians and 29 Europeans). Estimation of dietary GI and GL (from weighed food intake records) considered the GI values of single foods and mixed-meals from relevant publications and from laboratory food/mixed-meal GI measurements (Chapter 3). The GI of key staple South Asian foods alone (chapatti, rice, pilau rice) and as mixed meals with curried chicken was measured using standard methods on 13 healthy subjects. The key staples had medium GI (chapatti, 68; rice, 66 and pilau rice, 60) and glycaemic responses to the mixed-meal of staples with curried chicken were found to be lower than the staples eaten alone. GI of the mixed-meals fell in the low GI category (chapatti with curried chicken, 45 and pilau rice with curried chicken, 41). Weighed food intake records (WFR) (recorded for 3-7 days) and self-administered previously validated food frequency questionnaires (FFQ) (applied to habitual food intakes in the past 6 months) was assessed for agreement through correlation analyses, cross-classification analysis, weighted Kappa statistics and Bland and Altman statistics. The two methods mostly agreed in carbohydrate (CHO) food intakes implying that the WFR reflected habitual intakes (Chapter 4). In consideration of potential confounding effect of physical activity on the relationship between dietary variables and HOMAIR, physical activity level (PAL) and Metabolic equivalent score (METS) of main daily activities of study subjects were derived from self-reported physical activity records (Chapter 5). Mean PAL were similar between South Asian and European males (median PAL of 1.61 and 1.60, respectively) but South Asian females tended to be less physically active than European females (mean PAL of 1.57 and 1.66, respectively). South Asians were less physically active in structured exercise and sports activities, particularly South Asian females and South Asians (males and females combined) with reported family history of diabetes showed inverse relationship between daily energy expenditure and HOMAIR. South Asians were found to be more insulin resistant than Europeans (HOMAIR median (IQR) of 1.06 (0.58) and 0.91 (0.47), p-value= 0.024 respectively in males; mean (SD) of 1.57 (0.80) and 1.16 (0.58), p-value= 0.037, respectively in females) despite similarities in habitual diet including dietary GI and GL. The mean habitual dietary GI of South Asians was within the medium GI category and did not differ significantly from Europeans. South Asian and European males’ dietary GI (mean, SD) was: 56.20, 2.78 and 54.77, 3.53 respectively; p-value=0.086. South Asian and European females also did not differ in their dietary GI (median, IQR) was: 54, 4.25 and 54, 5.00; p-value=0.071). Top three staples ranked from highest to lowest intakes in the South Asian diet were: unleavened breads (chapatti, Naan/Pitta, Paratha), rice, bread (white, wholemeal, brown), and potatoes. After statistically controlling for energy intake, body mass index, age, physical activity level and socio-demographic status, an inverse relationship (Spearman partial correlation analyses) between dietary GI and HOMAIR was observed (r, -0.435; p-value, 0.030) in South Asian males. This may be explained by the observation that the lower the dietary GI, the lower also, the total carbohydrates and fibre intakes and the higher the fat intake. In South Asian females, dietary GI and GL respectively, did not relate to HOMAIR but sugars intake related positively with HOMAIR (r, 0.486; p-value, 0.048). South Asian females, compared to European females, reported higher intakes of dietary fat (38.5% and 34.2% energy from fat, respectively; p-value=0.035). Saturated fatty acid (SFA) intakes did not differ between ethnic groups but SFA intakes were above the recommended level of 10% of total dietary energy for the UK in all groups, the highest being in SA females. In conclusion, Ethnicity (South Asian), having family history of diabetes, the wider diet profile rather than habitual dietary glycaemic index and glycaemic load alone (low GI, low fibre and high fat diets in males for instance; and high fat, high sugar diets in females) as well as low physical activity particularly in structured exercise and sports may contribute to insulin resistance in South Asians. These observations should be confirmed in larger future studies.
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Sohi, Seema. "Echoes of mutiny : race, empire, and Indian anticolonialism in North America /." Thesis, Connect to this title online; UW restricted, 2008. http://hdl.handle.net/1773/10364.
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Kim, Yun Hee. "Family role stressors, psychological distress, and marital adjustment in South Korean families mediating role of collectivist coping strategies /." Related electronic resource: Current Research at SU : database of SU dissertations, recent titles available full text, 2009. http://wwwlib.umi.com/cr/syr/main.
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Redemo, Matilda, and Linda Radak. "Preventive nursing, an interview study on cervical cancer in south-western Uganda." Thesis, Malmö högskola, Fakulteten för hälsa och samhälle (HS), 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26839.
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Syfte: Syftet med denna studie är att belysa hur sjuksköterskor/barnmorskor upplever möjligheter och svårigheter att arbeta förebyggande med livmoderhalscancer i Uganda.Bakgrund: Livmoderhalscancer är den andra vanligaste cancerformen hos kvinnor världen över. Livmoderhalscancer är mest förekommande i Afrika söder om Sahara. I Uganda finns det få sjuksköterskor och barnmorskor som kan utföra hälsosamtal och screening av cellförändringar. Med rätt förebyggande insatser kan incidensen av livmoderhalscancer minska.Metod: En kvalitativ intervjustudie baserad på åtta semistrukturerade intervjuer. Intervjumaterialet analyserades med hjälp av innehållsanalys.Resultat: Sjuksköterskorna och barnmorskorna upplevde att förebyggande insatser möjliggjordes genom screening, behandlingar och outreaches, hälsosamtal och utbildning av hälso- och sjukvårdspersonal samt finansiering. Svårigheterna med att arbeta förebyggande med livmoderhalscancer var bristande stöd från regeringen, svåråtkomlig omgivning, attityder i samhället och brist på kunskap. Slutsats: Uganda behöver bättre finansiering, mer utbildad personal samt tillgång till vaccin och behandlingar för att förbättra förebyggandet av livmoderhalscancer. Ett nationellt screening-program som infattar hela befolkningen skulle påverka det förebyggande arbetet positivt.Aim: The aim of this study was to elucidate how nurses/midwives perceive thepossibilities and obstacles to practice preventive nursing regarding cervical cancer in Uganda.Background: Cervical cancer is the second most common cancer form amongst women worldwide. The highest incidence of cervical cancer is found in sub- Saharan Africa. In Uganda there are few nurses and midwives to support cervical cancer screening and health talks. With the right preventive measures the incidence rate could be decreased.Method: A qualitative study design based on eight semi-structured interviews. The data was analysed using content analysis.Results: The perceived possibilities to practise preventive nursing were prevention through screening, outreaches and treatments, prevention through health education and practical training plus financing. Obstacles elucidated during the interviews were lack of support from the government, remote places hard to reach, attitudes in the community and lack of knowledge.Conclusion: In order to enhance the preventive measures regarding cervical cancer, Uganda is in need of better funding, more trained staff, access to vaccine and adequate treatments. It would also be beneficial with a nation wide screening program.