‘Normal disruption’: South Asian and African/Caribbean relatives caring for an older family member in the UK

2005 ◽  
Vol 60 (1) ◽  
pp. 37-48 ◽  
Author(s):  
Joy Adamson ◽  
Jenny Donovan
Keyword(s):  
Family Member ◽  
South Asian ◽  
African Caribbean ◽  
The Uk

scholarly journals POS0111 DEVELOPMENT OF DAMAGE AND MORTALITY IN AN INCEPTION COHORT OF SLE PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 266.2-267
Author(s):  
C. S. Yee ◽  
V. Farewell ◽  
M. Akil ◽  
P. Lanyon ◽  
C. J. Edwards ◽  
...  
Keyword(s):  
Incidence Rate ◽  
South Asian ◽  
Drug Exposure ◽  
Inception Cohort ◽  
Research Support ◽  
Rate Of Development ◽  
Caroline Gordon ◽  
African Caribbean ◽  
The Uk

Background:There had been very limited data on the development of damage and mortality in an inception cohort of SLE patients who were recruited very soon after diagnosis.Objectives:This study aimed to analyse the development of damage and death in an inception cohort of SLE patients recruited within 1 year of diagnosis with up to 13 years of follow-up.Methods:This was a prospective multi-centre longitudinal study in the UK of SLE patients recruited within 12 months of achieving 1997 ACR revised criteria for SLE. Data were collected on BILAG-2004, BILAG2004-Pregnancy Index (during pregnancy), SLICC/ACR DI (SDI), cumulative drug exposure and death at every visit. Information on cardiovascular risk factors and antiphospholipid syndrome status were also collected. This study ran from 1st January 2005 to 31st December 2017. Mortality and development of damage were analysed.Results:There were 273 patients recruited (91.2% female, 59.3% Caucasian, 17.2% African/Caribbean, 17.2% South Asian) with mean age at recruitment of 38.5 years (SD 14.8). 97.8% had no damage at recruitment (2.2% had SDI score of 1). Median follow-up was 73.4 months (range: 1.8, 153.8) with total follow-up of 1767 patient-years.There were 13 deaths (4.8%): 76.9% female, 84.6% Caucasian, 15.4% South Asian, mean age 62.6 years (± SD 15.8) and mean disease duration 3 years (± SD 1.8). Causes of death were cancer in 5 (38.5%), infection in 3 (23.1%), ischaemic heart disease in 1 (7.7%) and unknown in 4 (30.8%).114 new damage items in 83 patients occurred during follow-up. The distribution of damage was musculoskeletal (21, 18.4%), ophthalmic (18, 15.8%), neuropsychiatric (18, 15.8%), renal (14, 12.3%), malignancy (12, 10.5%), cutaneous (7, 6.1%), GIT (7, 6.1%), cardiac (6, 5.3%), pulmonary (4, 3.5%), diabetes mellitus (4, 3.5%) and vascular (3, 2.6%). The rate of development of damage appears to be higher in the first 3 years which subsequently stabilised (Table 1).Table 1.Incidence rate of development of damage over period of follow-up at 3 yearly intervalsPeriod of follow-up (year)Person-years at riskNumber of new items of damageIncidence rate, per 1000 person-years (95% CI)0 – 3753.46079.6 (61.8, 102.6)3 – 6534.03158.1 (40.8, 82.6)6 – 9321.21237.4 (21.2, 35.8)9 – 12152.5532.8 (13.6, 78.7)> 125.90-Conclusion:Mortality is uncommon during the first 12 years of follow-up for newly diagnosed SLE patients. However, development of damage appears to be higher in the first 3 years before stabilizing to a lower rate subsequently.Acknowledgements:Versus Arthritis, VIfor PharmaDisclosure of Interests:Chee-Seng Yee Consultant of: Bristol Myer Squibb, ImmuPharma, Grant/research support from: Vifor Pharma, Vernon Farewell: None declared, Mohammed Akil: None declared, Peter Lanyon: None declared, Christopher John Edwards Consultant of: Glaxo Smith Kline, Roche, Grant/research support from: Glaxo Smith Kline, Roche, David Isenberg: None declared, Anisur Rahman: None declared, Lee-Suan Teh: None declared, Sofia Tosounidou: None declared, Robert Stevens: None declared, Ahtiveer Prabu: None declared, Bridget Griffiths: None declared, Neil McHugh: None declared, Ian N. Bruce: None declared, Yasmeen Ahmad: None declared, Munther Khamashta: None declared, Caroline Gordon Speakers bureau: UCB, Consultant of: Center for Disease Control, Astra-Zeneca, MGP, Sanofi and UCB

scholarly journals Ethnic differences in guideline-indicated statin initiation for people with type 2 diabetes in UK primary care, 2006–2019: A cohort study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (6) ◽  
pp. e1003672
Author(s):  
Sophie V. Eastwood ◽  
Rohini Mathur ◽  
Naveed Sattar ◽  
Liam Smeeth ◽  
Krishnan Bhaskaran ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
South Asian ◽  
Ethnic Differences ◽  
Asian Ethnicity ◽  
African Caribbean ◽  
South Asian Ethnicity ◽  
Ascvd Risk ◽  
The Uk ◽  
To Receive

Background Type 2 diabetes is 2–3 times more prevalent in people of South Asian and African/African Caribbean ethnicity than people of European ethnicity living in the UK. The former 2 groups also experience excess atherosclerotic cardiovascular disease (ASCVD) complications of diabetes. We aimed to study ethnic differences in statin initiation, a cornerstone of ASCVD primary prevention, for people with type 2 diabetes. Methods and findings Observational cohort study of UK primary care records, from 1 January 2006 to 30 June 2019. Data were studied from 27,511 (88%) people of European ethnicity, 2,386 (8%) people of South Asian ethnicity, and 1,142 (4%) people of African/African Caribbean ethnicity with incident type 2 diabetes, no previous ASCVD, and statin use indicated by guidelines. Statin initiation rates were contrasted by ethnicity, and the number of ASCVD events that could be prevented by equalising prescribing rates across ethnic groups was estimated. Median time to statin initiation was 79, 109, and 84 days for people of European, South Asian, and African/African Caribbean ethnicity, respectively. People of African/African Caribbean ethnicity were a third less likely to receive guideline-indicated statins than European people (n/N [%]: 605/1,142 [53%] and 18,803/27,511 [68%], respectively; age- and gender-adjusted HR 0.67 [95% CI 0.60 to 0.76], p < 0.001). The HR attenuated marginally in a model adjusting for total cholesterol/high-density lipoprotein cholesterol ratio (0.77 [95% CI 0.69 to 0.85], p < 0.001), with no further diminution when deprivation, ASCVD risk factors, comorbidity, polypharmacy, and healthcare usage were accounted for (fully adjusted HR 0.76 [95% CI 0.68, 0.85], p < 0.001). People of South Asian ethnicity were 10% less likely to receive a statin than European people (1,489/2,386 [62%] and 18,803/27,511 [68%], respectively; fully adjusted HR 0.91 [95% CI 0.85 to 0.98], p = 0.008, adjusting for all covariates). We estimated that up to 12,600 ASCVD events could be prevented over the lifetimes of people currently affected by type 2 diabetes in the UK by equalising statin prescribing across ethnic groups. Limitations included incompleteness of recording of routinely collected data. Conclusions In this study we observed that people of African/African Caribbean ethnicity with type 2 diabetes were substantially less likely, and people of South Asian ethnicity marginally less likely, to receive guideline-indicated statins than people of European ethnicity, even after accounting for sociodemographics, healthcare usage, ASCVD risk factors, and comorbidity. Underuse of statins in people of African/African Caribbean or South Asian ethnicity with type 2 diabetes is a missed opportunity to prevent cardiovascular events.

scholarly journals Does racial discrimination cause mental illness?

2002 ◽  
Vol 180 (06) ◽  
pp. 475-477 ◽  
Author(s):  
Apu Chakraborty ◽  
Kwame McKenzie
Keyword(s):  
Mental Illness ◽  
Racial Discrimination ◽  
Ethnic Groups ◽  
South Asian ◽  
Prevalence Rates ◽  
High Incidence ◽  
African Caribbean ◽  
The Uk ◽  
Caribbean Populations

Different rates of mental illness have been reported in ethnic groups in the UK (Nazroo, 1997). Early work was criticised because of methodological flaws but more rigorous studies have confirmed high community prevalence rates of depression in both South Asian and African-Caribbean populations (Nazroo, 1997), high incidence and prevalence rates of psychosis in African-Caribbean groups (see Bhugra &amp; Cochrane, 2001, for review), and higher rates of suicide in some South Asian groups (Neeleman et al, 1997) compared with the White British population. Similarly high rates have not been reported in the countries of origin of these groups (Hickling &amp; Rodgers-Johnson, 1995; Patel &amp; Gaw, 1996), which has led to a search for possible causes within the UK.

scholarly journals Type 2 diabetes risks and determinants in second-generation migrants and mixed ethnicity people of South Asian and African Caribbean descent in the UK

Diabetologia ◽  
2021 ◽  
Author(s):  
Aliki-Eleni Farmaki ◽  
Victoria Garfield ◽  
Sophie V. Eastwood ◽  
Ruth E. Farmer ◽  
Rohini Mathur ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
South Asian ◽  
First Generation ◽  
Second Generation ◽  
African Caribbean ◽  
First Generation Migrants ◽  
The Uk ◽  
Mixed Ethnicity ◽  
Second Generation Migrants

Abstract Aims/hypothesis Excess risks of type 2 diabetes in UK South Asians (SA) and African Caribbeans (AC) compared with Europeans remain unexplained. We studied risks and determinants of type 2 diabetes in first- and second-generation (born in the UK) migrants, and in those of mixed ethnicity. Methods Data from the UK Biobank, a population-based cohort of ~500,000 participants aged 40–69 at recruitment, were used. Type 2 diabetes was assigned using self-report and HbA1c. Ethnicity was both self-reported and genetically assigned using admixture level scores. European, mixed European/South Asian (MixESA), mixed European/African Caribbean (MixEAC), SA and AC groups were analysed, matched for age and sex to enable comparison. In the frames of this cross-sectional study, we compared type 2 diabetes in second- vs first-generation migrants, and mixed ethnicity vs non-mixed groups. Risks and explanations were analysed using logistic regression and mediation analysis, respectively. Results Type 2 diabetes prevalence was markedly elevated in SA (599/3317 = 18%) and AC (534/4180 = 13%) compared with Europeans (140/3324 = 4%). Prevalence was lower in second- vs first-generation SA (124/1115 = 11% vs 155/1115 = 14%) and AC (163/2200 = 7% vs 227/2200 = 10%). Favourable adiposity (i.e. lower waist/hip ratio or BMI) contributed to lower risk in second-generation migrants. Type 2 diabetes in mixed populations (MixESA: 52/831 = 6%, MixEAC: 70/1045 = 7%) was lower than in comparator ethnic groups (SA: 18%, AC: 13%) and higher than in Europeans (4%). Greater socioeconomic deprivation accounted for 17% and 42% of the excess type 2 diabetes risk in MixESA and MixEAC compared with Europeans, respectively. Replacing self-reported with genetically assigned ethnicity corroborated the mixed ethnicity analysis. Conclusions/interpretation Type 2 diabetes risks in second-generation SA and AC migrants are a fifth lower than in first-generation migrants. Mixed ethnicity risks were markedly lower than SA and AC groups, though remaining higher than in Europeans. Distribution of environmental risk factors, largely obesity and socioeconomic status, appears to play a key role in accounting for ethnic differences in type 2 diabetes risk. Graphical abstract

scholarly journals Imaging protocol, feasibility and reproducibility of cardiovascular phenotyping in a large tri-ethnic population-based study of older people: the Southall and Brent Revisited (SABRE) study

2020 ◽  
Author(s):  
Lamia Al Saikhan ◽  
Muath Alobaida ◽  
Anish Bhuva ◽  
Nish Chaturvedi ◽  
John Heasman ◽  
...  
Keyword(s):  
Older People ◽  
South Asian ◽  
Ethnically Diverse ◽  
Population Based ◽  
Limited Data ◽  
Ethnic Population ◽  
Population Based Study ◽  
Imaging Protocol ◽  
African Caribbean ◽  
The Uk

Background: People of South Asian and African Caribbean ethnicities living in UK have a high risk of cardiometabolic disease. Limited data exist regarding detailed cardiometabolic phenotyping in this population. Methods enabling this are widely available, but the practical aspects of undertaking such studies in large and diverse samples are seldom reported. Methods: The Southall and Brent Revisited (SABRE) study is the UK largest tri-ethnic longitudinal cohort. Over 1400 surviving participants (58-85 y) attended the 2nd study-visit (2008-2011) during which comprehensive cardiovascular phenotyping, including 3D-echocardiography (3D-speckle-tracking (3D-STE)), computed tomography, coronary artery calcium scoring, pulse-wave velocity, central blood pressure, carotid artery ultrasound and retinal imaging were performed. We describe the methods used with the aim of providing a guide to their feasibility and reproducibility in a large tri-ethnic population-based study of older people. Results: Conventional echocardiography and all vascular measurements showed high feasibility (>90% analyzable of clinic-attendees). 3DE and 3D-STE were less feasible in this age group (76% 3DE acquisition feasibility and 38% 3D-STE feasibility of clinic-attendees). Intra- and inter-observer variabilities were excellent for most of conventional and advanced echocardiographic measures. The test-retest reproducibility was good-excellent and fair-good for conventional and advanced echocardiographic measures, respectively, but lower than when re-reading the same images. All vascular measures demonstrated excellent or fair-good reproducibility. Conclusions: Detailed cardiovascular phenotyping is feasible and reproducible in an ethnically diverse population. The data collected will lead to a better understanding of why people of South Asian and African Caribbean ancestry are at elevated risk of cardiometabolic diseases.

Labels, Histories, Politics: Indian/South Asian Dance on the Global Stage

2008 ◽  
Vol 26 (2) ◽  
pp. 223-243 ◽  
Author(s):  
AVANTHI MEDURI
Keyword(s):  
South Asian ◽  
First Century ◽  
Nation State ◽  
The South ◽  
Global Networks ◽  
Indian Nation ◽  
The 1950S ◽  
Twenty First Century ◽  
The Uk

In this paper, I discuss issues revolving around history, historiography, alterity, difference and otherness concealed in the doubled Indian/South Asian label used to describe Indian/South Asian dance genres in the UK. The paper traces the historical genealogy of the South Asian label to US, Indian and British contexts and describes how the South Asian enunciation fed into Indian nation-state historiography and politics in the 1950s. I conclude by describing how Akademi: South Asian Dance, a leading London based arts organisation, explored the ambivalence in the doubled Indian/South Asian label by renaming itself in 1997, and forging new local/global networks of communication and artistic exchange between Indian and British based dancers and choreographers at the turn of the twenty-first century.

Staying strong: Exploring experiences of managing emotional distress for African Caribbean women living in the UK

2021 ◽  
Vol 31 (1) ◽  
pp. 140-159 ◽  
Author(s):  
Rachel Graham ◽  
Victoria Clarke
Keyword(s):  
Focus Groups ◽  
Black Woman ◽  
Emotional Distress ◽  
Emotional Wellbeing ◽  
Strong Black Woman ◽  
Caribbean Women ◽  
African Heritage ◽  
Women's Experience ◽  
African Caribbean ◽  
The Uk

The “strong Black woman” (SBW) is a Western cultural stereotype that depicts African-heritage women as strong, self-reliant, independent, yet nurturing and self-sacrificing. US research indicates that this stereotype negatively impacts the emotional wellbeing of African-heritage women, while also allowing them to survive in a racist society. UK research has documented the significance of this stereotype in relation to African Caribbean women’s experience of depression around the time of childbirth and “attachment separation and loss”. However, research is yet to explore how UK African Caribbean women make sense of and negotiate the SBW stereotype in relation to their emotional wellbeing more broadly. Using five focus groups, with a total of 18 women, this research explored how these women experienced and managed emotional distress in relation to the SBW stereotype. The importance of “being strong” consistently underpinned the participants’ narratives. However, this requirement for strength often negatively impacted their ability to cope effectively with their distress, leading them to manage it in ways that did little to alleviate it and sometimes increased it. This study offers important implications for understanding the experiences of emotional distress for UK African Caribbean women.

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