Pain management programmes for non-English-speaking black and minority ethnic groups with long-term or chronic pain

Increasing ethnic diversity in the UK means that there is a growing need for National Health Service care to be delivered to non-English-speaking patients. The aims of the present systematic review were to: (1) better understand the outcomes of chronic pain management programmes (PMPs) for ethnic minority and non-English-speaking patients and (2) explore the perspectives on and experiences of chronic pain for these groups. A systematic review identified 26 papers meeting the inclusion criteria; no papers reported on the outcomes of PMPs delivered in the UK. Of the papers obtained, four reported on PMPs conducted outside the UK; eight reported on ethnic differences in patients seeking support from pain management services in America; and the remaining papers included literature reviews, an experimental pain study, a collaborative enquiry, and a survey of patient and clinician ratings of pain. The findings indicate a lack of research into UK-based pain management for ethnic minorities and non-English-speaking patients. The literature suggests that effective PMPs must be tailored to meet cultural experiences of pain and beliefs about pain management. There is a need for further research to explore these cultural beliefs in non-English-speaking groups in the UK. Culturally sensitive evaluations of interpreted PMPs with long-term follow-up are needed to assess the effectiveness of current provision. Copyright © 2015 John Wiley & Sons, Ltd.

Self-monitoring of blood glucose in Black Caribbean and South Asian Canadians with non-insulin treated Type 2 diabetes mellitus:a qualitative study of patients' perspectives

Background: To examine the views and current practice of SMBG among Black Caribbean and South Asian individuals with non-insulin treated Type 2 diabetes mellitus. Methods: Twelve participants completed semi-structured interviews that were guided by the Health Belief Model and analyzed using thematic network analysis. Results: The frequency of monitoring among participants varied from several times a day to once per week. Most participants expressed similar experiences regarding their views and practices of SMBG. Minor differences across gender and culture were observed. All participants understood the benefits, but not all viewed SMBG as beneficial to their personal diabetes management. SMBG can facilitate a better understanding and maintenance of self-care behaviours. However, it can trigger both positive and negative emotional responses, such as a sense of disappointment when high readings are not anticipated, resulting in emotional distress. Health care professionals play a key role in the way SMBG is perceived and used by patients. Conclusion: While the majority of participants value SMBG as a self-management tool, barriers exist that impede its practice, particularly its cost. How individuals cope with these barriers is integral to understanding why some patients adopt SMBG more than others. © 2013 Gucciardi et al.; licensee BioMed Central Ltd.

Investigating residual rhoticity in a non-rhotic accent

This paper reports on preliminary findings of a study conducted in the Black Country area of the west midlands of England. The small number of linguistic studies carried out in this region in the last 40 years have not found evidence of the continuing existence of variable rhoticity in the local speech variety. The Survey of English Dialects in the 1950s found low levels of rhoticity among speakers in the location closest to the Black Country, and I examine here similar findings from a detailed study of the variety, carried out between 2003-2006.

From apartheid to unity: white capital and black power in the racial integration of South African football, 1976-1992

This article analyses the complex process that deracialised and democratised South African football between the early 1970s and 1990s. Based mainly on archival documents, it argues that growing isolation from world sport, exemplified by South Africa's expulsion from the Olympic movement in 1970 and FIFA in 1976, and the reinvigoration of the liberation struggle with the Soweto youth uprising triggered a process of gradual desegregation in the South African professional game. While Pretoria viewed such changes as a potential bulwark against rising black militancy, white football and big business had their own reasons for eventually supporting racial integration, as seen in the founding of the National Soccer League. As negotiations for a new democratic South Africa began in earnest between the African National Congress (ANC) and the National Party (NP) in the latter half of the 1980s, transformations in football and politics paralleled and informed each other. Previously antagonistic football associations began a series of 'unity talks' between 1985 and 1986 that eventually culminated in the formation of a single, non-racial South African Football Association in December 1991, just a few days before the Convention for a Democratic South Africa (CODESA) opened the process of writing a new post-apartheid constitution. Finally, three decades of isolation came to an end as FIFA welcomed South Africa back into world football in 1992 - a powerful example of the seemingly boundless potential of a liberated and united South Africa ahead of the first democratic elections in 1994.

Medicines non-use in primary care

This study expands the current knowledge base on the nature, causes and fate of unused medicines in primary care. Three methodologies were used and participants for each element were sampled from the population of Eastern Birmingham PCT. A detailed assessment was made of medicines returned to pharmacies and GP surgeries for destruction and a postal questionnaire covering medicines use and disposal was used to patients randomly selected from the electoral roll. The content of this questionnaire was informed by qualitative data from a group interview on the subject. By use of these three methods it was possible to triangulate the data, providing a comprehensive assessment of unused medicines. Unused medicines were found to be ubiquitous in primary care and cardiovascular, diabetic and respiratory medicines are unused in substantial quantities, accounting for a considerable proportion of the total financial value of all unused medicines. Additionally, analgesic and psychoactive medicines were highlighted as being unused in sufficient quantities for concern. Anti-infective medicines also appear to be present and unused in a substantial proportion of patients’ homes. Changes to prescribed therapy and non-compliance were identified as important factors leading to the generation of unused medicines. However, a wide array of other elements influence the quantities and types of medicines that are unused including the concordancy of GP consultations and medication reviews and patient factors such as age, sex or ethnicity. Medicines were appropriately discarded by 1 in 3 patients through return to a medical or pharmaceutical establishment. Inappropriate disposal was by placing in household refuse or through grey and black water with the possibility of hoarding or diversion also being identified. No correlations wre found between the weight of unused medicines and any clinical or financial factor. The study has highlighted unused medicines to be an issue of some concern and one that requires further study.