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South Asian (south + asian)

Distribution by Scientific Domains

Medical Sciences	72%
Life Sciences	11%
Humanities and Social Sciences	11%

Terms modified by South Asian

south asian patient

south asian woman

Selected Abstracts

The prevalence of depressive symptoms in a white European and South Asian population with impaired glucose regulation and screen-detected Type 2 diabetes mellitus: a comparison of two screening tools

DIABETIC MEDICINE, Issue 8 2010
N. Aujla
Diabet. Med. 27, 896,905 (2010) Abstract Aims, To compare the identification of prevalent depressive symptoms by the World Health Organization-5 Wellbeing Index (WHO-5) and Centre for Epidemiological Studies Depression Scale (CES-D) for South Asian and white European people, male and female, attending a diabetes screening programme, and to explore the adequacy of the screening tools for this population. An additional aim was to further explore associations of depressive symptoms with impaired glucose regulation (IGR) and Type 2 diabetes mellitus (Type2 DM). Methods, Eight hundred and sixty-four white European (40,75 years old) and 290 South Asian people (25,75 years old) underwent an oral glucose tolerance test (OGTT), detailed history and anthropometric measurements and completed the WHO-5 and CES-D. Depressive symptoms were defined by a WHO-5 score , 13, and CES-D score , 16. Results, Unadjusted prevalence of depressive symptoms with the WHO-5, for people with Type2 DM was 42.3% (47.4% in white European; 28.6% in South Asian) and for IGR 30.7% (26% in white European; 45.8% in South Asian). With the CES-D, the prevalence in Type2 DM was 27.2% (25.4% in white European; 31.8% in South Asian) and for IGR 30.7% (27.8% in white European; 40.7% in South Asian). Statistically significant differences in the prevalence of depressive symptoms for sex or ethnicity were not identified. Odds ratios adjusted for age, sex and ethnicity showed no significant association of depression with Type2 DM or IGR, with either WHO-5 or CES-D. Agreement was moderate (, = 0.48, 95% confidence intervals 0.42,0.54), and reduced when identifying depressive symptoms in people with Type2 DM. For this group, a WHO-5 cut-point of , 10 was optimal. Conclusions, Depressive symptoms, identified by WHO-5 or CES-D, were not significantly more prevalent in people with Type2 DM or IGR. The WHO-5 and CES-D differed in their identification of depressive symptoms in people with Type2 DM, though discrepancies between sex and ethnicity were not identified. [source]

Validation of an algorithm combining haemoglobin A1c and fasting plasma glucose for diagnosis of diabetes mellitus in UK and Australian populations

DIABETIC MEDICINE, Issue 2 2009
S. E. Manley
Abstract Aim, To determine whether glycated haemoglobin (HbA1c) can be used in combination with fasting plasma glucose (FPG) for the diagnosis of diabetes in patients with impaired fasting glucose (IFG) and in a broader spectrum of patients. Methods, An algorithm was derived from oral glucose tolerance test (OGTT) capillary samples in 500 consecutive UK patients with IFG by World Health Organization criteria. It was validated in a further 500 UK patients and, with venous specimens, in 1175 unselected Australian patients. Results, The derivation cohort was aged 61 years (50,69 years) (median IQ range) with 52% male and 12% South Asian. Diabetes Control and Complications Trial-aligned HbA1c was 6.2% (5.8,6.6%) (reference interval < 6.0%) and FPG 6.7 mmol/l (6.3,7.2 mmol/l). FPG was in the diabetes range in 36% of patients, with an OGTT identifying a further 12% with diabetes. The derived algorithm, (HbA1c , 6.0% with FPG < 7.0 mmol/l) identified those patients requiring an OGTT to diagnose diabetes. When applied to the UK validation cohort, sensitivity was 97% and specificity 100%. The algorithm was equally effective in the unselected group, aged 59 years (49,68 years) and 54% male, with sensitivity 93% and specificity 100%. HbA1c was 6.0% (5.6,6.6%) and FPG 6.0 mmol/l (5.3,6.8 mmol/l), with 26% having IFG. Use of the algorithm would reduce the number of OGTTs performed in the UK validation cohort by 33% and by 66% in the Australian patients studied. Conclusions, Use of this algorithm would simplify procedures for diagnosis of diabetes and could also be used for monitoring pre-diabetes. Validation is now required in other populations and patient groups. [source]

Differing aspects of insulin resistance in diabetes complications: the shape of things to come.

DIABETIC MEDICINE, Issue 12 2002
RD Lawrence lecture 2000
Abstract The anticipated global epidemic of diabetes, largely as a consequence of increased rates of obesity, will particularly impact on people of South Asian and African Caribbean descent, two populations at elevated risk of insulin resistance. This article contrasts the consequent heightened risk of heart disease on the one hand in South Asians, and the paradoxical protection from heart disease in African Caribbeans on the other. Protection from the hypertriglyceridaemic effects of insulin resistance is likely to account for much of the African Caribbean paradox, although the mechanisms remain unclear. The growing evidence that insulin resistance is commonly observed in people with Type 1 diabetes, as well as those with Type 2 diabetes, and that features of insulin resistance may play a crucial role in the development of microvascular, as well as macrovascular complications, is also discussed. This indicates novel targets for the prevention and treatment of diabetes complications. Diabet. Med. 19, 973,977 (2002) [source]

Molecular Epidemiology and Outcome of Helicobacter pylori Infection in Thailand: a Cultural Cross Roads

HELICOBACTER, Issue 5 2004
Ratha-Korn Vilaichone
ABSTRACT Background., Thailand is at the cultural cross roads between East and South Asia. It has been suggested that this is also the region where the predominant Helicobacter pylori (H. pylori) genotype changes from East Asian to South Asian. Methods., We compared the molecular epidemiology and outcome of H. pylori infections among different ethnic groups in Thailand (Thai, Thai-Chinese and Chinese). H. pylori isolates were genotyped by polymerase chain reaction based on cagA, cag right end junction and vacA genotypes. Results., Ninety-eight isolates from 38 ethnic Thai, 20 ethnic Chinese and 40 Thai-Chinese were categorized into East Asian (45%), South/Central Asian (26%), Western (1%) or mixed type (29%). The East Asian genotype was the most common among Chinese (85%) and Thai-Chinese (55%) (p < .01 compared to ethnic Thai). The ethnicity of the mother among mixed Thai-Chinese marriages predicted the genotype of the child's H. pylori (e.g. when the mother was Chinese, 84% had East Asian type vs. 29% when the mother was Thai) (p < .001). Gastric cancer was common among ethnic Chinese with East Asian genotype (e.g. all Chinese with gastric cancer or peptic ulcer disease had East Asian genotype, whereas only 40% of Chinese with gastritis had this genotype). Conclusions., Immigration, intermarriage and the variety of H. pylori genotypes in Thailand suggest that Thailand is an ideal site for epidemiological studies attempting to relate H. pylori genotypes and host factors to outcome. Our data also support the hypothesis that the primary caretaker of the children is most likely the source of the infection. [source]

Recent trends in breast cancer incidence among 6 Asian groups in the Greater Bay Area of Northern California,

INTERNATIONAL JOURNAL OF CANCER, Issue 6 2007
Theresa H.M. Keegan
Abstract Asians and Pacific Islanders are typically aggregated in United States (US) cancer statistics even though the few studies that have considered subgroups separately have found marked differences in cancer incidence. The objective of this study was to evaluate trends in breast cancer incidence rates separately for US Chinese, Japanese, Filipino, Korean, South Asian and Vietnamese women overall and by age at diagnosis, histologic subtype and stage at diagnosis. Age-adjusted incidence rates and annual percent changes (APC) of new, primary breast cancer diagnosed in the Greater Bay Area Cancer Registry of Northern California (1990,2002) were calculated using SEER*Stat. In women under 50 years of age, annual incidence rates decreased for Japanese (APC = ,4.1, p = 0.02) and Filipinas (APC = ,1.9, p = 0.11), and increased or fluctuated in other subgroups over the study period. In women 50 years or older, rates of invasive breast cancer increased for most subgroups, except Filipinas (APC = ,1.3, p = 0.32), and in Japanese until 1998,2000. Rates of breast cancer in situ increased in most subgroups from 1990 to 2002, as did rates of lobular breast cancer for Chinese (APC = +7.46, p < 0.01) women. In Japanese women, rates of lobular breast cancer were highest in 1995,1997 and decreased thereafter. Our data support the notion that the prevalence of established risk factors influence breast cancer incidence, as breast cancer rates increased for more recently immigrated groups and decreased among more established groups, and may suggest leads into other avenues of research, such as genetic differences, that may explain differences in incidence rates among Asian subgroups. © 2006 Wiley-Liss, Inc. [source]

Prevalence, morbidity and service need among South Asian and white adults with intellectual disability in Leicestershire, UK

JOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 4 2002
C. W. McGrother
Abstract Background Previous reports have suggested that South Asian and white UK populations have different prevalences of intellectual disability (ID), related psychological morbidity and service use. The aim of the present study was to compare these rates among South Asian and white adults in Leicestershire, UK. Method This cross-sectional study is comprised of two parts. The analysis of prevalence is based on data from all South Asian and white adults known to the Leicestershire Learning Disabilities Register in 1991, with population denominators being drawn from the 1991 census. The other analyses use data collected from the most recent semi-structured home interviews, carried out between 1987 and 1998, with 206 South Asian and 2334 white adults. Results The prevalence of ID in adults in Leicestershire is 3.20 per 1000 in South Asians and 3.62 per 1000 in whites. Among adults with ID, South Asians have similar prevalences of disabilities to whites and significantly lower skill levels. South Asians show similar levels of psychological morbidity, but make significantly lower use than whites of psychiatric services, residential care and respite care. South Asians use community services as extensively as whites, but feel that they have a substantially greater unmet need, especially with regard to social services. Conclusion South Asian and white populations have similar prevalences of ID and related psychological morbidity. Culturally appropriate services for South Asian adults may need to focus on skill development and community care. [source]

Between Convergence and Divergence: Reformatting Language Purism in the Montreal Tamil Diasporas

JOURNAL OF LINGUISTIC ANTHROPOLOGY, Issue 1 2008
Sonia Neela Das
This article examines how ideologies of language purism are reformatted by creating interdiscursive links across spatial and temporal scales. I trace convergences and divergences between South Asian and Québécois sociohistorical regimes of language purism as they pertain to the contemporary experiences of Montreal's Tamil diasporas. Indian Tamils and Sri Lankan Tamils in Montreal emphasize their status differences by claiming that the former speak a modern "vernacular" Tamil and the latter speak an ancient "literary" Tamil. The segregation and purification of these social groups and languages depend upon the intergenerational reproduction of scalar boundaries between linguistic forms, interlocutors, and decentered contexts. [Tamils, Quebec, diaspora, linguistic purism, spatiotemporal scales] [source]

Rape and Rape Avoidance in Ethno-National Conflicts: Sexual Violence in Liminalized States

AMERICAN ANTHROPOLOGIST, Issue 1 2000
Robert M. Hayden
Mass rape is a common but not universal occurrence in ethnic or nationalist conflicts. Using South Asian and Bosnian data, in this article I argue that mass rape is likely when such conflicts take place during the partition of a territory and its population, when the state itself is liminal, both its territory and control over it uncertain. In conflicts in which the state is not itself threatened, and thus groups feel that they will continue to coexist, there is some evidence that rape is avoided, even when murder is accepted. However, such instances of rape avoidance are largely unstudied, in large part because of the focus on the violence of mass rape. Further, this focus on violence tends toward classifying all sexual relations between groups whose members have participated in mass rape as improper, thus depriving women who may not wish to rejoin their natal groups of agency, [rape, genocide, violence, India, Yugoslavia/Bosnia] [source]

Agreement between normative and perceived orthodontic need amongst deprived multiethnic school children in London

ORTHODONTICS & CRANIOFACIAL RESEARCH, Issue 2 2001
Bilal Ahmed
The Index of Orthodontic Treatment Need (IOTN) has been used in dental epidemiology and to prioritize orthodontic treatment. The aim of this paper was to use the aesthetic component (AC) of the IOTN to measure agreement between normative and perceived orthodontic need amongst school children. Three hundred and seventy-eight children aged 11,14 years, enrolled in London UK state schools participated in this survey. The study focused on three ethnic groups: white, black and South Asian. Townsend deprivation scores suggested that the children were from areas of high socio-economic deprivation. Logistic regression analysis was carried out for agreement between normative and perceived need at each threshold value. Perceived need for braces, ethnic background, social class and hours of television viewing were significant variables. Black pupils were significantly less likely to concur on normative and perceived need scores, tending to perceive less need for treatment than did the dentist. Subjects from lower social classes were significantly more likely to concur on normative and perceived need scores. In conclusion, the study showed that using the IOTN AC at various points along the scale, different influences play a significant role in agreement/disagreement between normative and perceived needs, indicating that patient,clinician agreement regards orthodontic treatment is sensitive to several cultural factors. [source]

Autosomal microsatellite variability of the Arrernte people of Australia

AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 1 2008
M. A. Alfonso-Sánchez
The genomic diversity of the Arrernte people of Australia or caterpillar people was investigated utilizing 13 autosomal short tandem repeat (STR) markers. Significant departures from Hardy,Weinberg equilibrium were detected at the D18S51, TPOX and CSF1PO loci, which persisted after applying the Bonferroni correction. Gene diversity values oscillate between 0.6302 (CSF1PO) and 0.8731 (D21S11). Observed heterozygosity (Ho) ranges from 0.2632 (D18S51) to 0.8333 (vWA) and is lower than the expected heterozygosity (He) for 12 of the 13 loci analyzed. The genetic relationships of the Arrernte with Middle Eastern, East Asian, South Asian and Indian populations were analyzed by distance-based methods, including Neighbor-Joining trees and nonmetric multidimensional scaling. In addition, the genetic contribution of the populations included in the analysis to the Arrernte gene pool was estimated utilizing weighted least square coefficients. Although the Arrernte population exhibits a remarkable level of genetic differentiation, results of the phylogeographic analyses based on autosomal microsatellite data suggest a certain degree of genetic relatedness between the Arrernte tribe of Australia and populations from the Indian subcontinent. In contrast, the STR diversity analyses failed to detect substantial East Asian contribution to the genetic background of the Arrernte group. Am. J. Hum. Biol., 2008. © 2007 Wiley-Liss, Inc. [source]

Colonizing nature: scientific knowledge, colonial power and the incorporation of India into the modern world-system

THE BRITISH JOURNAL OF SOCIOLOGY, Issue 1 2001
Zaheer Baber
ABSTRACT In this paper, the role of scientific knowledge, institutions and colonialism in mutually co-producing each other is analysed. Under the overarching rubric of colonial structures and imperatives, amateur scientists sought to deploy scientific expertise to expand the empire while at the same time seeking to take advantage of the opportunities to develop their careers as ,scientists'. The role of a complex interplay of structure and agency in the development of modern science, not just in India but in Britain too is analysed. The role of science and technology in the incorporation of South Asian into the modern world system, as well as the consequences of the emergent structures in understanding the trajectory of modern science in post-colonial India is examined. Overall, colonial rule did not simply diffuse modern science from the core to the periphery. Rather the colonial encounter led to the development of new forms of scientific knowledge and institutions both in the periphery and the core. [source]

The influence of social factors and implicit racial bias on a generalized own-race effect

APPLIED COGNITIVE PSYCHOLOGY, Issue 4 2008
Pamela M. Walker
The current study sought to determine whether the experimentally reported ,own-race effect' is other-race specific, or whether it is a generalized effect. The perceptual processing of own- versus two groups of other-race faces was therefore explored in White and South Asian individuals. Participants completed a computer-based discrimination task of White, South Asian and Black face-morphs. Results showed a generalized own-race effect for White and South Asian participants discriminating own- versus other-race (White/South Asian and Black) faces, such that individuals demonstrated a perceptual discrimination advantage for own- versus other-race faces in general. These findings were linked to implicit racial bias and other-race individuating experience, demonstrating that social variables play an important role in the magnitude of the own-race effect. Copyright © 2007 John Wiley & Sons, Ltd. [source]

A perceptual discrimination investigation of the own-race effect and intergroup experience

APPLIED COGNITIVE PSYCHOLOGY, Issue 4 2006
Pamela M. Walker
Research over the past two decades has demonstrated that individuals are better at the recognition and discrimination of own- versus other-race faces. Recent evidence, however, supports an own-race effect at the level of perceptual encoding in adults. The current study examines the perceptual basis of the own-race effect in secondary students from two racially segregated communities (White and South Asian). The contact hypothesis is investigated, as other-race experience may influence other-race face perception. Face stimuli were generated by morphing together South Asian and White faces along a linear continuum. In a same/different perceptual discrimination task participants judged whether face stimuli were physically identical to, or different from, the original faces. Results revealed a significant own-race effect for the White participants only, wherein they were better at discriminating White relative to South Asian faces. Other-race individuating experience was found to predict the own-race effect, indicating that other-race experience influences other-race face perceptual expertise. Copyright © 2006 John Wiley & Sons, Ltd. [source]

British isles lupus assessment group 2004 index is valid for assessment of disease activity in systemic lupus erythematosus

ARTHRITIS & RHEUMATISM, Issue 12 2007
Chee-Seng Yee
Objective To determine the construct and criterion validity of the British Isles Lupus Assessment Group 2004 (BILAG-2004) index for assessing disease activity in systemic lupus erythematosus (SLE). Methods Patients with SLE were recruited into a multicenter cross-sectional study. Data on SLE disease activity (scores on the BILAG-2004 index, Classic BILAG index, and Systemic Lupus Erythematosus Disease Activity Index 2000 [SLEDAI-2K]), investigations, and therapy were collected. Overall BILAG-2004 and overall Classic BILAG scores were determined by the highest score achieved in any of the individual systems in the respective index. Erythrocyte sedimentation rates (ESRs), C3 levels, C4 levels, anti,double-stranded DNA (anti-dsDNA) levels, and SLEDAI-2K scores were used in the analysis of construct validity, and increase in therapy was used as the criterion for active disease in the analysis of criterion validity. Statistical analyses were performed using ordinal logistic regression for construct validity and logistic regression for criterion validity. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Results Of the 369 patients with SLE, 92.7% were women, 59.9% were white, 18.4% were Afro-Caribbean and 18.4% were South Asian. Their mean ± SD age was 41.6 ± 13.2 years and mean disease duration was 8.8 ± 7.7 years. More than 1 assessment was obtained on 88.6% of the patients, and a total of 1,510 assessments were obtained. Increasing overall scores on the BILAG-2004 index were associated with increasing ESRs, decreasing C3 levels, decreasing C4 levels, elevated anti-dsDNA levels, and increasing SLEDAI-2K scores (all P < 0.01). Increase in therapy was observed more frequently in patients with overall BILAG-2004 scores reflecting higher disease activity. Scores indicating active disease (overall BILAG-2004 scores of A and B) were significantly associated with increase in therapy (odds ratio [OR] 19.3, P < 0.01). The BILAG-2004 and Classic BILAG indices had comparable sensitivity, specificity, PPV, and NPV. Conclusion These findings show that the BILAG-2004 index has construct and criterion validity. [source]

English language proficiency and smoking prevalence among California's Asian Americans,

CANCER, Issue S12 2005
Hao Tang M.D., Ph.D.
Abstract The authors documented California's tobacco control initiatives for Asian Americans and the current tobacco use status among Asian subgroups and provide a discussion of the challenges ahead. The California Tobacco Control Program has employed a comprehensive approach to decrease tobacco use in Asian Americans, including ethnic-specific media campaigns, culturally competent interventions, and technical assistance and training networks. Surveillance of tobacco use among Asian Americans and the interpretation of the results have always been a challenge. Data from the 2001 The California Health Interview Survey (CHIS) were analyzed to provide smoking prevalence estimates for all Asian Americans and Asian-American subgroups, including Korean, Filipino, Japanese, South Asian, Chinese, and Vietnamese. Current smoking prevalence was analyzed by gender and by English proficiency level. Cigarette smoking prevalence among Asian males in general was almost three times of that among Asian females. Korean and Vietnamese males had higher cigarette smoking prevalence rates than males in other subgroups. Although Asian females in general had low smoking prevalence rates, significant differences were found among Asian subgroups, from 1.1% (Vietnamese) to 12.7% (Japanese). Asian men who had high English proficiency were less likely to be smokers than men with lower English proficiency. Asian women with high English proficiency were more likely to be smokers than women with lower English proficiency. Smoking prevalence rates among Asian Americans in California differed significantly on the basis of ethnicity, gender, and English proficiency. English proficiency seemed to have the effect of reducing smoking prevalence rates among Asian males but had just the opposite effect among Asian females. Cancer 2005. © 2005 American Cancer Society. [source]

Ethnic differences and determinants of diabetes and central obesity among South Asians of Pakistan

DIABETIC MEDICINE, Issue 7 2004
T. H. Jafar
Abstract Aims To study the within ethnic subgroup variations in diabetes and central obesity among South Asians. Methods Data from 9442 individuals age , 15 years from the National Health Survey of Pakistan (NHSP) (1990,1994) were analysed. Diabetes was defined as non-fasting blood glucose , 7.8 mmol/l, or known history of diabetes. Central obesity was measured at the waist circumference. Distinct ethnic subgroups Muhajir, Punjabi, Sindhi, Pashtun, and Baluchi were defined by mother tongue. Results The age-standardized prevalence of diabetes varied among ethnic subgroups (P = 0.002), being highest among the Muhajirs (men 5.7%, women 7.9%), then Punjabis (men 4.6%, women 7.2%), Sindhis (men 5.1%, women 4.8%), Pashtuns (men 3.0%, women 3.8%), and lowest among the Baluchis (men 2.9%, women 2.6%). While diabetes was more prevalent in urban vs. rural dwellers [odds ratio (OR) 1.50, 95% confidence interval (CI) 1.24, 1.82], this difference was no longer significant after adjusting for central obesity (OR 1.15, 95% CI 0.95, 1.42). However, the ethnic differences persisted after adjusting for major sociodemographic risk factors (unadjusted OR for Pashtun vs. Punjabi 0.59, 95% CI 0.42, 0.84, adjusted OR 0.54, 95% CI 0.37, 0.78). Ethnic variation was also observed in central obesity, which varied with gender, and did not necessarily track with ethnic differences in diabetes. Conclusions Unmeasured environmental or genetic factors account for ethnic variations in diabetes and central obesity, and deserve further study. [source]

A pilot randomized trial in primary care to investigate and improve knowledge, awareness and self-management among South Asians with diabetes in Manchester

DIABETIC MEDICINE, Issue 12 2003
A. Vyas
Abstract Aims To investigate whether a secondary,primary care partnership education package could improve understanding of diabetes care among South Asians. Methods In a pilot randomized controlled trial, in the setting of eight general practices randomized to intervention or control, patients were invited to four or more rotating visits per year by one of a diabetes specialist nurse, dietician or chiropodist working with general practice staff. Participants were from lists of South Asian patients with known Type 2 diabetes in each (general) practice. Results Patients and practice scores at baseline and 1-year follow-up, from an interview using a questionnaire on knowledge, awareness and self-management of diabetes. Responses were developed into educational packages used during intervention. Of the 411 patients listed at baseline only 211 were traced for interview (refusal only 4%). Mean age was 55.4 years, age of diabetes onset 47.1 years. Fourteen percent were employed and 35% were able to communicate in English fluently. Only 118 could be traced and interviewed at 1 year, although there was no significant difference in demography between those who completed the study and those who did not. Despite a mean of four visits/patient, intervention had no impact on scores for diabetes knowledge, or awareness [score change 0.14, 95% confidence interval (CI) ,0.20, 0.49] or self-management (,0.05, 95% CI ,0.48, 0.39) between baseline and 1 year. Conclusions This form of secondary/primary care support did not transfer information effectively, and we suspect similar problems would arise in other similar communities. Different methods of clinician/patient information exchange need to be developed for diabetes in this South Asian group. [source]

Differing aspects of insulin resistance in diabetes complications: the shape of things to come.

Transnational marriage among Ahmadi Muslims in the UK

GLOBAL NETWORKS, Issue 4 2006
MARZIA BALZANI
In this article I explore the character and processes of transnational marriage arrangements among Ahmadi Muslims over three generations in the UK. I suggest that the process of conversion to Ahmadiyyat and the organizational structure of Ahmadi mosques have combined to produce a flexible pattern of marriage among Ahmadis that is unusual among South Asians. A significant number of earlier and contemporary Ahmadi marriages are interethnic, reflecting an expansive Ahmadiya identity that is perceived to be independent of ethnicity. Further, analysis of marriage proposals accepted as well as rejected suggests gender differences in perceptions of and motivations for marriage. The analysis suggests that while gender differences in expectations of marriage may have parallels in some other South Asian transnational marriages, Ahmadi religious identity and organization plays a distinctive role in shaping the processes of Ahmadi marriage arrangements. [source]

Why ethnic minority groups are under-represented in clinical trials: a review of the literature

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 5 2004
Mahvash Hussain-Gambles MA
Abstract Randomised controlled trials (RCTs) are considered to be the gold standard in evaluating medical interventions; however, people from ethnic minorities are frequently under-represented in such studies. The present paper addresses a previously neglected debate about the tensions which inform clinical trial participation amongst people from ethnic minorities, in particular, South Asians, the largest ethnic minority group in the UK. In a narrative review of the available literature, based mainly on US studies, the present authors aim to make sense of the issues around under-representation by providing a theoretical reconciliation. In addition, they identify a number of potential barriers to ethnic minority participation in clinical trials. In so doing, the authors recognise that the recent history of eugenic racism, and more general views on clinical trials as a form of experimentation, means that clinical trial participation among people from ethnic minorities becomes more problematic. Lack of participation and the importance of representational sampling are also considered, and the authors argue that health professionals need to be better informed about the issues. The paper concludes by offering a number of strategies for improving ethnic minority accrual rates in clinical trials, together with priorities for future research. [source]

A panel of ancestry informative markers for estimating individual biogeographical ancestry and admixture from four continents: utility and applications,

HUMAN MUTATION, Issue 5 2008
Indrani Halder
Abstract Autosomal ancestry informative markers (AIMs) are useful for inferring individual biogeographical ancestry (I-BGA) and admixture. Ancestry estimates obtained from Y and mtDNA are useful for reconstructing population expansions and migrations in our recent past but individual genomic admixture estimates are useful to test for association of admixture with phenotypes, as covariate in association studies to control for stratification and, in forensics, to estimate certain overt phenotypes from ancestry. We have developed a panel of 176 autosomal AIMs that can effectively distinguish I-BGA and admixture proportions from four continental ancestral populations: Europeans, West Africans, Indigenous Americans, and East Asians. We present allele frequencies for these AIMs in all four ancestral populations and use them to assess the global apportionment of I-BGA and admixture diversity among some extant populations. We observed patterns of apportionment similar to those described previously using sex and autosomal markers, such as European admixture for African Americans (14.3%) and Mexicans (43.2%), European (65.5%) and East Asian affiliation (27%) for South Asians, and low levels of African admixture (2.8,10.8%) mirroring the distribution of Y E3b haplogroups among various Eurasian populations. Using simulation studies and pedigree analysis we show that I-BGA estimates obtained using this panel and a four-population model has a high degree of precision (average root mean square error [RMSE]=0.026). Using ancestry,phenotype associations we demonstrate that a large and informative AIM panel such as this can help reduce false-positive and false-negative associations between phenotypes and admixture proportions, which may result when using a smaller panel of less informative AIMs. Hum Mutat 29(5), 648,658, 2008. © 2008 Wiley-Liss, Inc. [source]

The prevalence of vitamin D abnormalities in South Asians with type 2 diabetes mellitus in the UK

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 3 2010
A. A. Tahrani
Summary Background:, The high prevalence of both hypovitaminosis D and type 2 diabetes (T2DM) in the Asian community is well recognised, but the impact of diabetes on vitamin D status and vice versa, has not been well reported. Aims:, To determine the prevalence of hypovitaminosis D in Asian patients with T2DM and its impact on glycaemic control. Methods:, A cross-sectional study was conducted in a tertiary referral centre in the UK. Two hundred and ten Asian patients aged more than 40 years were included (170 with and 40 without T2DM). Each had a standard bone profile (serum calcium, phosphate and alkaline phosphatase), serum parathyroid hormone and 25-hydroxycholecalciferol. Results:, The prevalence of low serum 25-hydroxyvitamin D (< 50 nmol/l) was high in the group as a whole (> 80%) and more common in diabetics compared with controls (83% vs. 70%; p = 0.07). This was particularly so in men (82.5% vs. 57.9%; p = 0.02). HbA1c was higher in women with vitamin D deficiency (< 12.5 nmol/l) (8.11 ± 1.11% vs. 7.33 ± 1.32%, p = 0.046). In logistic regression analysis, T2DM was an independent predictor of hypovitaminosis D. In linear regression analysis, vitamin D deficiency was independently related to HbA1c in women with T2DM. Conclusions:, Hypovitaminosis D remains a major public health issue in the Asian population and is exaggerated in patients with T2DM. The fact that vitamin D deficient women had higher HbA1c levels raises the possibility that vitamin D replacement may improve glycaemic control. [source]

Elevated lipoprotein (a) and apolipoprotein B to AI ratio in South Asian patients with ischaemic stroke,

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 11 2007
K. M. Sharobeem
Summary Background:, Stroke is a continuing cause of excess cardiovascular disease (CVD) mortality amongst migrants from the Indian subcontinent (South Asians) living in Britain. However, little is known about the dyslipidaemia associated with stroke in South Asians. In particular, the highly atherogenic lipoprotein (a) [Lp(a)] and high apolipoprotein (Apo) B to AI ratio are emerging risk factors for CVD. Methods:, Using a case,control study, we investigated features of the dyslipidaemia in South Asian patients with stroke compared with South Asian subjects with no history of clinically detectable stroke. We studied 55 consecutive South Asian patients with ischaemic stroke (confirmed on computerised scan of the brain) and 85 controls. Results:, The stroke patients were significantly older than controls (65.2 vs. 59.8 years, p = 0.001), but were similarly matched for male gender (63.6 vs. 61.2%), smoking habit (20.7 vs. 18.1%) and presence of type 2 diabetes (25.5 vs. 19.3%). There were no differences between serum total cholesterol (p = 0.07) and high-density lipoprotein cholesterol (p = 0.08) between the groups, but stroke patients had higher serum triglycerides (p = 0.005). Mean [95% confidence interval (CI)] Apo B to AI ratio was higher amongst stroke patients [1.0 (0.9,1.0) vs. 0.7 (0.7,0.75), p < 0.001]. Similarly, geometric mean serum Lp(a) was significantly higher (p = 0.037) in stroke patients [19.9 mg/dl (14.0,28.5)] vs. controls [15.1 mg/dl (11.4,20.1)]. On logistic regression, stroke was independently associated with age and Apo B to AI ratio (p < 0.01). Conclusion:, The present study suggests that Lp(a) and the Apo B to AI ratio are associated with ischaemic stroke in South Asians. A prospective analysis is needed to elucidate the role of Lp(a), Apo B and AI as risk factors for ischaemic stroke in this population, as well as the effects of intervention. [source]

Inflammatory bowel disease in the Asia,Pacific area: A comparison with developed countries and regional differences

JOURNAL OF DIGESTIVE DISEASES, Issue 3 2010
Vineet AHUJA
The Asia,Pacific region has been marked as an area with a low incidence of inflammatory bowel disease (IBD), although confusion always existed as to whether this low incidence was a result of low diagnostic awareness, a high incidence of infective diarrhoea and its diagnostic overlap or a true low incidence. As epidemiological studies from this region are being made available it is clear that the incidence and prevalence rates of IBD in Asia,Pacific region are low compared with Europe and North America. They are however, increasing rapidly. There are substantial variations in the incidence and prevalence rates of IBD in various ethnic groups in Asia. The highest incidence rates are recorded from India, Japan and the Middle East and there exists a genetic predisposition of South Asians (Indians, Pakistanis and Bangladeshis) to ulcerative colitis (UC). It appears that certain racial groups are more prone than others to develop IBD. For instance, Indians in South-East Asia have higher rates than Chinese and Malays. While there is a host genetic predisposition, environmental factor(s) may be responsible for this difference. The clinical phenotypes and complication rates of Asian IBD resemble those of the Caucasian population in general, but some heterogeneity is observed in different regions of Asia. There is no evidence of a north-south or an east-west divide in the Asia,Pacific region. The available studies suggest an increasing incidence of UC in the Asia,Pacific region and hence it is an appropriate time to launch well-designed epidemiological studies so that etiopathogenetic factors can be identified. There is a male predominance in Crohn's disease in the Asian population. The NOD2/CARD15 gene is not associated with CD in the Japanese, Korean, Chinese and Indian population. [source]

Prevalence, morbidity and service need among South Asian and white adults with intellectual disability in Leicestershire, UK

Sex hormone-binding globulin and androgen levels in immigrant and British-born premenopausal British Pakistani women: Evidence of early life influences?

AMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 6 2006
Tessa M. Pollard
In women, raised insulin levels are associated with low sex hormone-binding globulin (SHBG) and high androgen levels, which are in turn linked to infertility. Since insulin resistance and hyperinsulinemia are major health problems for South Asians living in Western countries, we predicted that British Pakistani women would have low SHBG and raised androgen levels compared to European women. Given low birth weights in Pakistan, and known links between low birth weight and insulin resistance in later life, we also predicted that immigrant women born in Pakistan would have lower levels of SHBG and higher levels of androgens than British-born British Pakistani women. We assessed SHBG, testosterone, and the free androgen index (FAI) from a single serum sample taken on days 9,11 of the menstrual cycle from 20,40-year-old women living in the UK: 30 immigrants from Pakistan, 30 British-born British Pakistani women, and 25 British-born women of European origin. Age-adjusted analyses showed no significant differences in SHBG, testosterone, or FAI between British-born Pakistani and European-origin women. However, immigrant British Pakistani women had a significantly higher FAI than British-born British Pakistani women. Adjustment for body mass index, waist-to-hip ratio, and smoking status did not affect these results, but further adjustment for height, a marker of early environment, reduced the P -value for the difference in FAI between immigrant and British-born British Pakistani women to below significance. It is possible that the poorer early environment of immigrant British Pakistani women was at least partially responsible for their relatively high levels of free androgens. Am. J. Hum. Biol. 18:741,747, 2006. © 2006 Wiley-Liss, Inc. [source]

Dermatological signs in South Asian women induced by sari and petticoat drawstrings

CLINICAL & EXPERIMENTAL DERMATOLOGY, Issue 5 2010
S. B. Verma
Summary The sari, the elegant garment worn by Indian and many South Asian women, is associated with many cutaneous signs. With millions of South Asians settled all over the world, it is important for clinicians to be aware of the cutaneous associations of wearing a sari that is tied tightly around the waist with a drawstring. Lichenified linear hyperpigmented grooves, vitiligo, postinflammatory depigmentation, lichen planus and superficial cutaneous infections are some of the conditions seen in women wearing this garment. This review is one of the very few detailed reports of this widely worn garment and its dermatological associations. [source]

Differences in the process of diabetic care between south Asian and white patients in inner-city practices in Nottingham, UK

HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2004
Christopher David BM BS MRCGP
Abstract The prevalence and complication rate of diabetes is higher amongst British south Asians when compared to the rest of the adult population. There is some evidence to suggest that there are differences in access to healthcare in the UK for different ethnic groups, but there has been little research examining differences in processes of care between ethnic groups and place of delivery of diabetic care. The present study was a retrospective, multi-practice audit exploring differences in the processes of diabetic care provided to white and south Asian patients. Data were obtained from eight practices located in deprived areas in Nottingham, UK. A review of the evidence-based protocols for the monitoring of diabetic care generated a list of process criteria to be measured. All primary care data sources were examined over a 12-month period by a single investigator. The data were analysed with respect to patient ethnicity and place of diabetic care after adjusting for confounders. Eight hundred and thirty-nine diabetic patients were included in the audit and 671 (80.0%) received a formal annual diabetic review. One hundred and five (12.5%) patients were classified as south Asian. They were significantly less likely to have their blood pressure [86% versus 89%, odds ratio (OR) = 0.62, 95% confidence interval (95% CI) = 0.54,0.72] or serum creatinine (67% versus 76%, OR = 0.41, 95% CI = 0.32,0.52) measured when compared to white patients. Patients receiving shared care from a hospital-based diabetic team were more likely to have a range of items of the annual review recorded. When examined by ethnicity, south Asians receiving shared care were again less likely than white patients to have their blood pressure and serum creatinine measured. There was also some evidence that they may be less likely to have their body mass index recorded and their feet examined. The findings of the present study showed that, although most diabetic patients received a formal annual clinical review, scope for improvement remained. Shared care of patients with a hospital-based team produced better results when processes of care were examined. However, this benefit did not apply equally to south Asian and white patients. Further studies are indicated to confirm these results, which may have wider implications for the planning and provision of diabetic care. [source]

Human Y-chromosome short tandem repeats: A tale of acculturation and migrations as mechanisms for the diffusion of agriculture in the Balkan Peninsula

AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 3 2010
Sheyla Mirabal
Abstract Southeastern Europe and, particularly, the Balkan Peninsula are especially useful when studying the mechanisms responsible for generating the current distribution of Paleolithic and Neolithic genetic signals observed throughout Europe. In this study, 404 individuals from Montenegro and 179 individuals from Serbia were typed for 17 Y-STR loci and compared across 9 Y-STR loci to geographically targeted previously published collections to ascertain the phylogenetic relationships of populations within the Balkan Peninsula and beyond. We aim to provide information on whether groups in the region represent an amalgamation of Paleolithic and Neolithic genetic substrata, or whether acculturation has played a critical role in the spread of agriculture. We have found genetic markers of Middle Eastern, south Asian and European descent in the area, however, admixture analyses indicate that over 80% of the Balkan gene pool is of European descent. Altogether, our data support the view that the diffusion of agriculture into the Balkan region was mostly a cultural phenomenon although some genetic infiltration from Africa, the Levant, the Caucasus, and the Near East has occurred. Am J Phys Anthropol, 2010. © 2010 Wiley-Liss, Inc. [source]