Childhood ethnic differences in ametropia and ocular biometry:the Aston Eye Study

Purpose: To describe the methodology, sampling strategy and preliminary results for the Aston Eye Study (AES), a cross-sectional study to determine the prevalence of refractive error and its associated ocular biometry in a large multi-racial sample of school children from the metropolitan area of Birmingham, England. Methods: A target sample of 1700 children aged 6–7 years and 1200 aged 12–13 years is being selected from Birmingham schools selected randomly with stratification by area deprivation index (a measure of socio-economic status). Schools with pupils predominantly (>70%) from a single race are excluded. Sample size calculations account for the likely participation rate and the clustering of individuals within schools. Procedures involve standardised protocols to allow for comparison with international population-based data. Visual acuity, non-contact ocular biometry (axial length, corneal radius of curvature and anterior chamber depth) and cycloplegic autorefraction are measured in both eyes. Distance and near oculomotor balance, height and weight are also assessed. Questionnaires for parents and older children will allow the influence of environmental factors on refractive error to be examined. Results: Recruitment and data collection are ongoing (currently N = 655). Preliminary cross-sectional data on 213 South Asian, 44 black African Caribbean and 70 white European children aged 6–7 years and 114 South Asian, 40 black African Caribbean and 115 white European children aged 12–13 years found myopia prevalence of 9.4% and 29.4% for the two age groups respectively. A more negative mean spherical equivalent refraction (SER) was observed in older children (-0.21 D vs +0.87 D). Ethnic differences in myopia prevalence are emerging with South Asian children having higher levels than white European children 36.8% vs 18.6% (for the older children). Axial length, corneal radius of curvature and anterior chamber depth were normally distributed, while SER was leptokurtic (p < 0.001) with a slight negative skew. Conclusions: The AES will allow ethnic differences in the ocular characteristics of children from a large metropolitan area of the UK to be examined. The findings to date indicate the emergence of higher levels of myopia by early adolescence in second and third generation British South Asians, compared to white European children. The continuation of the AES will allow the early determinants of these ethnic differences to be studied.

Within-country ethnic differences and product positioning:a comparison of the perceptions of two British sub-cultures

While cross-cultural consumer behaviour and its impact on marketing strategies has received considerable interest within the marketing literature, differences between ethnic groups within countries have received significantly less attention. This study examines the effect of within-country ethnic differences on brand positioning, using the UK automobile industry as a context. Both qualitative and quantitative research is used to identify the perceptions of two sub-cultural groups: British of Indian extraction, and Caucasian British. It was found that these two groups display appreciably different values, and also place different levels of importance on different product attributes when evaluating brands. Furthermore, the two groups exhibited different perceptions of the same set of brands. The results suggest that, to position brands effectively, marketers should take account of cultural diversity within countries as well as between them.

Ethnic diversity as a multilevel construct:the combined effects of dissimilarity, group diversity, and societal status on learning performance in work groups

The authors present a model of the multilevel effects of diversity on individual learning performance in work groups. For ethnically diverse work groups, the model predicts that group diversity elicits either positive or negative effects on individual learning performance, depending on whether a focal individual’s ethnic dissimilarity from other group members is high or low. By further considering the societal status of an individual’s ethnic origin within society (Anglo versus non-Anglo for our U.K. context), the authors hypothesize that the model’s predictions hold more strongly for non-Anglo group members than for Anglo group members. We test this model with data from 412 individuals working on a 24-week business simulation in 87 four- to seven-person groups with varying degrees of ethnic diversity. Two of the three hypotheses derived from the model received full support and one hypothesis received partial support. Implications for theory development, methods, and practice in applied group diversity research are discussed.

Ethnic conflict and war crimes in the Balkans:the narratives of denial in post-conflict Serbia

In the years following the fall of Slobodan Milo evic, Serbian social, cultural and political responses to the wars of the 1990s have fallen under intense international scrutiny. But is this scrutiny justfied, and how can these responses be better understood? Jelena Obradovic engages with ideas about post-conflict societies, memory, cultural trauma, and national myths of victimhood and justified war to shed light upon Serbian denial and justification of war crimes - for example, Serbia's reluctant cooperation with the International Criminal Tribunal for the former Yugoslavia (ICTY). Rather than treating denial as a failure to come to terms with the past or as resurgent nationalism, Obradovic argues that the justification of atrocities are often the result of a societal need to understand and incorporate violent events within culturally acceptable boundaries.

Ethnic groups as market segments: implications of the demand structure

Ethnic market potential in Britain has not yet been thoroughly researched. Important recent trends have focused mainly on the affective and emotional aspects of ethnicity, and included deliberations on the emergence of a revitalised neo-ethnic consciousness; its identification; politicisation, and the impact on it; of a rising third-world consciousness. This investigation attempts to take cognizance of the consuner demand of the ethnic Asian and West Indian groups, as specific market segments. It discusses the rationale for ethnic segmentation on the underlying premise, that the starting point for all product marketing is a response to perceived market opportunities. On the basis of this approach, the UK laundry detergent and automobile markets were investigated; as being representative of product categories constitutirg extremes along the purchase-search-time continuun in consuner decision-making. Ethnic groups were further analysed for their retail patronage patterns; media usage, and the differential effectiveness of alternative advertisirg strategies. The basic technique of marketing research namely the sample survey, was used with the aim of applying scientific techniques in obtaining information on ethnic groups. The integrated marketirg framework utilised allowed, moreover, for the collection of market research data on the specific issues of ethnic product penetration dealing with retailing, advertising and product promotion. The evidence highlights the fact that the cultural orientations of ethnic groups are instrunental in providing for differential demand structures. It points to the answer that ethnicity is an anchor not only for a deeper sense of identity; but also serves as a focus for the economic interests of ethnic groups. On this basis it is argued here, that since cultural levelling would eventually produce stagnation; current marketing strategies should utilise ethnic diversity as an econanic artifact; which; per se is necessary for profitability and growth; especially in innovative product design and development.

A political economy of the ethnic chinese catering industry

The present political climate in which the ideals of entrepreneurship and self-help are strongly encouraged has drawn attention to those ethnic minorities noted for their entrepreneurial activity. Since the Chinese appear to be an exemplary case in point, this thesis focusses upon the historical material conditions which have led to the formation of a Chinese 'business* community in Britain, both past and present As such, it rejects the theories of cultural determinism which characterise most studies of the Chinese. For rather than representing the endurance of cultural norms, the existence of the contemporary Chinese 'niche' of ethnically exclusive firms in the catering industry is due to the conjunction of a number of historical processes. The first is the imperialist expansion into China of Britain's capitalist empire during the nineteenth century which established a relationship of dependency upon the interests of British capital by colonial Chinese labour. The second is the post war development of the catering industry and its demand for cheap labour as administered by the British state together with the contemporaneous development of the agricultural economy of colonial Hong Kong. Far from representing a source of material benefit to all, the ethnic Chinese 'niche' in catering is highly exploitative and merely underlines the racial oppression of Chinese in Britain. Attempts to promote business interests within the ethnic community therefore serve merely to entrench the structures of oppression.

Black and minority ethnic graduate entrepreneurs: motivations, characteristics and access to finance

This paper draws upon four case studies to examine characteristics, entrepreneurial motivations and access to finance of black and minority ethnic (BME) graduates in the UK. We find that BME graduates starting a business are motivated by a desire to “do better”, and rely heavily on personal savings and family sources for start-up capital. In addition: • There is no conclusive evidence that suggests in this study that BME graduates entered entrepreneurship because of unemployment; with the exception of a few, all had jobs prior to entering self employment. • “Glass ceilings” were often cited by participants of the case studies as a kind of barrier, but there was reluctance to specify exactly what that meant. • Also, lack of satisfaction from working for others is considered to be a strong motivator for entering self-employment but other reasons, to be one’s own boss and the prospect of higher earnings, are also strong motivators. There is, therefore, a need for support agencies and universities to recognise the distinctive nature of BME graduate enterprise in order to provide effective solutions for different groups. This might include a) work experience, b) advice on an adequate capital structure at start up, c) adequate funding and training, and d) appropriate training for all graduates in basic business education.

Access to start up finance for ethnic minority graduate entrepreneurs in the West Midlands: a gendered perspective

This aim of this paper, from a study funded by the National Council for Graduate Entrepreneurship (NCGE), is to explore access to finance for ethnic minority graduate entrepreneurs (EMGEs) with a particular focus on comparisons between different ethnic groups, and men and women. The authors interviewed selected individuals based upon a review of literature on finance for ethnic minority enterprise. A number of key results from the survey, in that EMGEs: • use external finance significantly (more so than non graduates) and encounter barriers in accessing finance at start-up, in particular those belonging to poor families. • rely excessively on personal savings and family finance, at the start-up and long after the start-up stage, that has implications for the optimal capital structure. • start up businesses that are, on average, larger than non-graduate enterprises and have the potential to reduce economic inactivity amongst the ethnic population. • have, in contrast to general graduate start-ups, a high level of unemployment, take a longer period of time to enter employment and there is a higher level of dissatisfaction with career progression. These findings raise the question whether the right financial advice is taken and whether this behaviour constrains EMGEs' expansion.

Enhanced diabetes care to patients of south Asian ethnic origin (the United Kingdom Asian Diabetes Study):a cluster randomised controlled trial

Background - Delivery of high-quality, evidence-based health care to deprived sectors of the community is a major goal for society. We investigated the effectiveness of a culturally sensitive, enhanced care package in UK general practices for improvement of cardiovascular risk factors in patients of south Asian origin with type 2 diabetes. Methods - In this cluster randomised controlled trial, 21 inner-city practices in the UK were assigned by simple randomisation to intervention (enhanced care including additional time with practice nurse and support from a link worker and diabetes-specialist nurse [nine practices; n=868]) or control (standard care [12 practices; n=618]) groups. All adult patients of south Asian origin with type 2 diabetes were eligible. Prescribing algorithms with clearly defined targets were provided for all practices. Primary outcomes were changes in blood pressure, total cholesterol, and glycaemic control (haemoglobin A1c) after 2 years. Analysis was by intention to treat. This trial is registered, number ISRCTN 38297969. Findings - We recorded significant differences between treatment groups in diastolic blood pressure (1·91 [95% CI -2·88 to -0·94] mm?Hg, p=0·0001) and mean arterial pressure (1·36 [-2·49 to -0·23] mm?Hg, p=0·0180), after adjustment for confounders and clustering. We noted no significant differences between groups for total cholesterol (0·03 [-0·04 to 0·11] mmol/L), systolic blood pressure (-0·33 [-2·41 to 1·75] mm?Hg), or HbA1c (-0·15% [-0·33 to 0·03]). Economic analysis suggests that the nurse-led intervention was not cost effective (incremental cost-effectiveness ratio £28?933 per QALY gained). Across the whole study population over the 2 years of the trial, systolic blood pressure, diastolic blood pressure, and cholesterol decreased significantly by 4·9 (95% CI 4·0–5·9) mm?Hg, 3·8 (3·2–4·4) mm?Hg, and 0·45 (0·40–0·51) mmol/L, respectively, and we recorded a small and non-significant increase for haemoglobin A1c (0·04% [-0·04 to 0·13]), p=0·290). Interpretation - We recorded additional, although small, benefits from our culturally tailored care package that were greater than the secular changes achieved in the UK in recent years. Stricter targets in general practice and further measures to motivate patients are needed to achieve best possible health-care outcomes in south Asian patients with diabetes. Funding - Pfizer, Sanofi-Aventis, Servier Laboratories UK, Merck Sharp & Dohme/Schering-Plough, Takeda UK, Roche, Merck Pharma, Daiichi-Sankyo UK, Boehringer Ingelheim, Eli Lilly, Novo Nordisk, Bristol-Myers Squibb, Solvay Health Care, and Assurance Medical Society UK.

Comparative risk of microalbuminuria and proteinuria in UK residents of south Asian and white European ethnic background with type 2 diabetes:a report from UKADS

Objective - This study investigated and compared the prevalence of microalbuminuria and overt proteinuria and their determinants in a cohort of UK resident patients of white European or south Asian ethnicity with type 2 diabetes mellitus. Research design and methods - A total of 1978 patients, comprising 1486 of south Asian and 492 of white European ethnicity, in 25 general practices in Coventry and Birmingham inner city areas in England were studied in a cross-sectional study. Demographic and risk factor data were collected and presence of microalbuminuria and overt proteinuria assessed. Main outcome measures - Prevalences of microalbuminuria and overt proteinuria. Results - Urinary albumin:creatinine measurements were available for 1852 (94%) patients. The south Asian group had a lower prevalence of microalbuminuria, 19% vs. 23% and a higher prevalence of overt proteinuria, 8% vs. 3%, X2?=?15.85, 2df, P?=?0.0004. In multiple logistic regression models, adjusted for confounding factors, significantly increased risk for the south Asian vs. white European patients for overt proteinuria was shown; OR (95% CI) 2.17 (1.05, 4.49), P?=?0.0365. For microalbuminuria, an interaction effect for ethnicity and duration of diabetes suggested that risk for south Asian patients was lower in early years following diagnosis; OR for SA vs. WH at durations 0 and 1 year were 0.56 (0.37, 0.86) and 0.59 (0.39, 0.89) respectively. After 20 years’ duration, OR?=?1.40 (0.63, 3.08). Limitations - Comparability of ethnicity defined groups; statistical methods controlled for differences between groups, but residual confounding may remain. Analyses are based on a single measure of albumin:creatinine ratio. Conclusions - There were significant differences between ethnicity groups in risk factor profiles and microalbuminuria and overt proteinuria outcomes. Whilst south Asian patients had no excess risk of microalbuminuria, the risk of overt proteinuria was elevated significantly, which might be explained by faster progression of renal dysfunction in patients of south Asian ethnicity.