Supporting an ethnic minority woman's choice for pain relief in labour: a reflection

Despite professional expectations for midwives to provide care to women that is founded in equality and recognises diversity (Nursing and Midwifery Council, 2015), women from ethnic minority populations consistently suggest that they are not heard (Briscoe and Lavender, 2009; Tobin et al, 2014). This article reflects upon a situation where a Portuguese woman with limited English speaking ability was denied access to epidural anaesthesia as the midwife felt that she could not give valid consent to the procedure without the presence of an interpreter. The midwife’s role within this situation will be reflected upon and implications for midwifery practice identified.

Separating the effects of ethnicity and socio-economic status on sleep practices of 6- to 7-month-old infants

Infant sleep undergoes significant re-organization throughout the first 12 months of life, with sleep quality having significant consequences for infant learning and cognitive development. While there has been great interest in the neural basis and developmental trajectories of infant sleep in general, relatively little is known about individual differences in infant sleep and the socio-economic and cultural sources of that variability. We investigated this using questionnaire sleep data in a large, unique multi-ethnic sample of 6-7 month-olds (n=174), with families from South Asian ethnic groups in the UK (Indian, Pakistani and Bangladeshi) being especially well represented. Consistent with previous data from less variable samples, no effects of SES on sleep latency or nocturnal sleep duration emerged. However, perinatal risk factors and ethnic differences did predict daytime sleep, sleep fragmentation and sleep-onset time. While these results should be interpreted with caution due to several limitations, they likely demonstrate that even when socio-economic status and ethnicity are much less confounded than in previous studies, they have a surprisingly limited impact on individual differences in sleep patterns in young infants.

Psychological safety, authentic leadership and social networks : A psycho-structural approach to the study of groups

Tese de Doutoramento em Psicologia na área de especialização de Psicologia das Organizações apresentada ao ISPA - Instituto Universitário

Prevalence of overweight and obesity among migrants in Switzerland: association with country of origin.

Migrants tend to present higher overweight and obesity levels, but whether this relationship applies to all nationalities has seldom been studied. The present study aimed to assess the prevalence of overweight and obesity according to nationality in adults. Cross-sectional population-based samples. Five-year nationwide interview surveys (Swiss Health Surveys - SHS) from 1992 to 2007 (n 63 766) and a local examination survey (CoLaus Study in Lausanne 2004-2006, n 6743). Participants were separated into Swiss, French, German, Italian, Portuguese, Spanish nationals, those from the former Republic of Yugoslavia and from other European and other countries. Compared with Swiss nationals, German and French nationals presented a lower prevalence of overweight and obesity, whereas nationals from Italy, Spain, Portugal and the former Republic of Yugoslavia presented higher levels. Adjusting the SHS data for age, gender, education, smoking, leisure-time physical activity and survey year, a lower risk for overweight and obesity was found for German (OR = 0·80, 95 % CI 0·70, 0·92) and French (OR = 0·74, 95 % CI 0·61, 0·89) nationals, whereas higher risks were found for participants from Italy (OR = 1·45, 95 % CI 1·33, 1·58), Spain (OR = 1·36, 95 % CI 1·15, 1·61), Portugal (OR = 1·25, 95 % CI 1·06, 1·47) and the former Republic of Yugoslavia (OR = 1·98, 95 % CI 1·69, 2·32). Similar findings were observed in the CoLaus Study for Italian (OR = 1·63, 95 % CI 1·29, 2·06), Spanish (OR = 1·54, 95 % CI 1·17, 2·04) and Portuguese (OR = 1·49, 95 % CI 1·16, 1·91) participants and for those from the former Republic of Yugoslavia (OR = 5·34, 95 % CI 3·00, 9·50). Overweight and obesity are unevenly distributed among migrants in Switzerland. Migrants from Southern Europe and from the former Republic of Yugoslavia present higher prevalence rates. This suggests that preventive messages should be tailored to these specific populations.

Exploring the relationship between ethnicity and hypertension in Canada

Background: Previous work examining differences in hypertension across ethnic groups employ race as the principal variable. While differences in hypertension have been identified across racial groups, there is great variation between ethnic groups amongst racial groupings that could mask differences in hypertension and cardiovascular disease (CVD) risk. In light of Canada's ethnic diversity, research aimed at identifying specific groups that are at a health disadvantage is essential for understanding the health of the overall population. In addition, this research would be beneficial for creating programs and policies aimed at reducing or eliminating these disparities. Since CVD is the leading cause of mortality in Canada and hypertension is one of the most significant and modifiable risk factors for CVD, it is important to move past crude classifications based on race and examine ethnic group differences. The purpose of this study is to examine the relationship between ethnicity and hypertension in Canada, while employing more narrow classifications for ethnicity than previous studies. In addition, because ethnicity has been shown to be representative of an individual's social experience, this study also aims to investigate whether this relationship can be explained by one or all of the following variable: socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption or acculturation. Methods. This study used the 2004 Canadian Community Health Survey, cycle 2.1 to compare 29 different ethnic groups in Canada on whether they had high blood pressure that had been diagnosed by a health professional. Associations were examined using logistic regression. Subsequent logistic regression analyses included socioeconomic status, physical activity, body mass index, smoking status, daily alcohol consumption and acculturation to test for the effect of each of these variables on the relationship between ethnicity and hypertension. Results. Ukrainians, Chinese, Portuguese, South Asians, Aboriginals, Blacks, Filipinos and South East Asians were found to have significantly higher odds of having high blood pressure than Canadians (OR's = 1.50, 1.56, 2.72, 1.38, 1.36, 1.66, 2.21 & 2.24 respectively, p<.001). In addition, the only significant mediating effects were between SES and Aboriginals as well as obesity and Aboriginals. None of the other independent variables accounted for >10% of the risk experienced by the ethnic groups that were significantly associated with hypertension. Interpretation: The odds of having high blood pressure in Canada varies considerably across ethnic groups within racial groups indicating previous research is not specific enough to inform policy and program development. Because this study was not able to explain this relationship using the sociodemographic and lifestyle factors mentioned above, future research should be done to determine what places certain ethnic groups at a greater risk in order to tailor interventions aimed at reducing high blood pressure that are suited to the specific needs of each cultural group.

Religious Diversity and Teacher Education: Experiences and Perspectives of Muslim Women as Teacher Candidates in Pre-service Programs

This qualitative research project explores the insights of Muslim women as teacher candidates completing pre-service programs in Ontario. Ontario schools cater to students from many ethnic, cultural and religious groups, including a sizable Muslim population. Muslims make up 4.6% of Ontario’s population with the highest concentration of Muslims in the GTA (Statistics Canada, 2011). The Muslim population in Ontario is of a significant enough number that, in a post 9/11 world, it has prompted discussion of how to integrate Muslim populations in Canada. In this research, I explore how Islamophobic sentiment is experienced in Ontario-based teacher education programs. I use Critical Race Theory (CRT) and Critical Race Feminism (CRF) to analyse and deconstruct experiences of female Muslim teacher candidates in pre-service programs. I discuss how Muslims are a racialized group that experience racism as discussed by critical race literature; however, there is a marked difference between how Muslim men and women experience gendered Islamophobia. By using in-depth research-based interviews, I explore how Muslim women perceived diversity, education, accommodations and Islamophobia in pre-service programs. This study adds to the current literature on critical race theory and anti-racist practices in education. Furthermore, this study adds to the voice of Muslim women in the discussion of diversity and inclusivity in educational institutions.

Blood, fire and fertility : human remains and ritual practices at the temple pyramid groups of Cantona, Puebla, Mexico

La ville préhispanique de Cantona, située dans la vallée d’Oriental dans l’état de Puebla au Mexique, atteignit sa première apogée culturelle entre 150 av. J.C. et 600/650 A.D. Durant cette période, des complexes cérémoniaux comprenant des groupes de pyramides-temples et des terrains de jeu de balle furent construits. Ces installations servirent au déroulement de nombreux rites au cours desquels les victimes de sacrifices étaient décapitées, démembrées, décharnées, écorchées, bouillies, brûlées et, dans certains cas, consommées. D’autres traitements du corps humain comportent l’inhumation d’individus en position assise et repliés sur eux-mêmes. Pour mieux comprendre le traitement mortuaire rituel des corps humains à Cantona, les découvertes faites sur place sont comparées aux données datant de la même époque obtenues dans trois régions voisines : la vallée de Mexico, Puebla-Tlaxcala et le golfe du Mexique. A partir de ces renseignements, on peut en déduire que la majorité des découvertes faites à Cantona sont les restes des dépouilles et offrandes provenant de rites destinés à la communication avec les dieux et à l’obtention de la fertilité, tandis que les dépouilles des individus en position assise appartiennent à des prêtres ou à des personnages religieux.

L’impact du loisir sur l’intégration sociale des minorités ethniques à Montréal : le cas des nouveaux arrivants originaires du Pérou

L’immigration au Québec se caractérise depuis quelques années par une nouvelle dynamique. La présence d’immigrants socialement perçus comme « minorités ethniques », ou plus précisément comme « minorités visibles », est de plus en plus évidente, surtout dans des contextes urbains où la diversité ethnique est une donnée palpable au quotidien. Dans ce mémoire nous proposons de travailler sur l’impact du loisir défini comme un ensemble de pratiques culturelles, c'est-à-dire des pratiques de loisir enracinées dans l’habitus, à l’appui de l’analyse du processus d’intégration sociale d’un groupe d’immigrants péruviens nouvellement arrivés à Montréal. Cette enquête cherche à explorer le rapport entre loisir et intégration, à partir d’un cadre théorique qui nous permet d’aborder le loisir comme un domaine particulièrement fécond sur le plan de la participation à la société d’accueil. Pour ce faire, nous avons privilégié une approche qualitative qui nous a aidé à « reconstruire » la trajectoire d’intégration de cinq nouveaux arrivants péruviens installés à Montréal depuis cinq ans ou moins. L’analyse des données révèle que le processus d’intégration de ces migrants est difficile, en raison des épreuves de l’adaptation (l’acculturation) à la société hôte, et que les activités liées aux loisirs ont un impact positif sur ledit processus, en partie parce qu’elles jouent un rôle stratégique qui favorise l’adaptation et la participation. Ces activités illustrent aussi les modalités d’une incorporation dans certains domaines de la vie sociale (l’emploi, la vie culturelle, la socialisation amicale) qui permet de ne pas rompre totalement les liens avec la communauté d’origine. Au quotidien, les loisirs permettent un rapprochement avec le groupe majoritaire et, plus largement, avec les autres groupes présents à Montréal : des liens d’amitié se développent, des pratiques de sociabilité se déploient, la consommation de certains biens et services est stimulée, l’individu fait de nouvelles connaissances, etc. Le lien entre communalisation ethnique et intégration permet alors de traverser différents espaces et groupes. Le plaisir reste par ailleurs le moteur des loisirs, c'est-à-dire que les activités choisies par les individus correspondent à leurs goûts, leurs intérêts, et que le loisir, en général, va de pair avec le plaisir. Ce lien favorise le déploiement de « réponses » spécifiques par nos interlocuteurs face aux problèmes d’adaptation, et la confirmation d’une sorte de sentiment d’intégration chez eux.

Le rapport Displaced Persons and Their Resettlement in the United States et le début des politiques d’accueil aux États-Unis

RÉSUMÉ : Avec le dénouement de la Deuxième Guerre mondiale, le problème des réfugiés en Europe devient un enjeu international. Plusieurs millions de personnes, que l’on nomme les Displaced Persons (DP), sont sans refuge et doivent recevoir une aide immédiate pour survivre. Même si la majorité de ces gens retourneront dans leurs pays d’origine, il reste encore des centaines de milliers de réfugiés en 1948. La seule solution concrète pour régler cette problématique est l’émigration des réfugiés dans des pays prêts à les accepter. Les Américains jouent un rôle crucial en acceptant 415 000 DP entre 1948 et 1952 grâce au Displaced Persons Act de 1948 et ses amendements en 1950 et 1951. Après d’âpres discussions entre les restrictionnistes et ceux qui défendent la libéralisation des lois d’immigration, naîtra le Displaced Persons Act (DP Act) signé avec beaucoup de réticence, le 25 juin 1948, par le président Harry S. Truman. Cette loi qui prévoit la venue de 202 000 DP en deux ans, contient des mesures jugées discriminatoires à l'endroit de certaines ethnies. Afin d'améliorer le DP Act, le Congrès effectue des recherches sur la situation des réfugiés toujours dans les camps en 1949 tout en étudiant l’impact de la venue des DP aux États-Unis entre 1948 et 1950. Cette étude est soumise sous forme de rapport, le Displaced Persons and Their Resettlement in the United States, le 20 janvier 1950. Ce mémoire propose une analyse minutieuse du rapport et de son contexte politique afin de démontrer le rôle important de cette étude dans le processus décisionnel du Congrès américain visant à accueillir un plus grand nombre de DP tout en posant les bases pour une politique d’accueil en matière de refugiés.

Environmental protection pressure groups in kerala: a study on their structure, strategy and role with special reference to industrial pollution

The present study focuses attention on the social phenomenon of environmental protection pressure groups in Kerala. A detailed historical background of environmental protection pressure groups at international and national scenes as background for this study .Emphirical studies of environmental protection pressure groups in Kerala with special reference to industrial pollution is dicussed in detail . The main objective of the study is to identify the factors that make pressure groups succeed or fail in achieving their set objectives.The factors include the structure and strategies of social pressure groups and the support they receive from the environment.

Association of genetic variants in complement factor H and factor H-related genes with systemic lupus erythematosus susceptibility

Systemic lupus erythematosus (SLE), a complex polygenic autoimmune disease, is associated with increased complement activation. Variants of genes encoding complement regulator factor H (CFH) and five CFH-related proteins (CFHR1-CFHR5) within the chromosome 1q32 locus linked to SLE, have been associated with multiple human diseases and may contribute to dysregulated complement activation predisposing to SLE. We assessed 60 SNPs covering the CFH-CFHRs region for association with SLE in 15,864 case-control subjects derived from four ethnic groups. Significant allelic associations with SLE were detected in European Americans (EA) and African Americans (AA), which could be attributed to an intronic CFH SNP (rs6677604, in intron 11, Pmeta = 6.6×10-8, OR = 1.18) and an intergenic SNP between CFHR1 and CFHR4 (rs16840639, Pmeta = 2.9×10-7, OR = 1.17) rather than to previously identified disease-associated CFH exonic SNPs, including I62V, Y402H, A474A, and D936E. In addition, allelic association of rs6677604 with SLE was subsequently confirmed in Asians (AS). Haplotype analysis revealed that the underlying causal variant, tagged by rs6677604 and rs16840639, was localized to a ~146 kb block extending from intron 9 of CFH to downstream of CFHR1. Within this block, the deletion of CFHR3 and CFHR1 (CFHR3-1Δ), a likely causal variant measured using multiplex ligation-dependent probe amplification, was tagged by rs6677604 in EA and AS and rs16840639 in AA, respectively. Deduced from genotypic associations of tag SNPs in EA, AA, and AS, homozygous deletion of CFHR3-1Δ (Pmeta = 3.2×10-7, OR = 1.47) conferred a higher risk of SLE than heterozygous deletion (Pmeta = 3.5×10-4, OR = 1.14). These results suggested that the CFHR3-1Δ deletion within the SLE-associated block, but not the previously described exonic SNPs of CFH, might contribute to the development of SLE in EA, AA, and AS, providing new insights into the role of complement regulators in the pathogenesis of SLE.

Beyond divide and rule : weak dictators, natural resources and civil conflict

We propose a model where an autocrat rules over an ethnically divided society. The dictator selects the tax rate over domestic production and the nation’s natural resources to maximize his rents under the threat of a regime-switching revolution. We show that a weak ruler may let the country plunge in civil war to increase his personal rents. Inter-group fighting weakens potential opposition to the ruler, thereby allowing him to increase fiscal pressure. We show that the presence of natural resources exacerbates the incentives of the ruler to promote civil conflict for his own profit, especially if the resources are unequally distributed across ethnic groups. We validate the main predictions of the model using cross-country data over the period 1960-2007, and show that our empirical results are not likely to be driven by omitted observable determinants of civil war incidence or by unobservable country-specific heterogeneity.

Lack of association between central adiposity and lipaemia in UK Sikh men

OBJECTIVE: To determine whether the positive statistical associations between measures of total and regional adiposity and measures of glucose, insulin and triacylglycerol ( TAG) metabolism reported in Caucasian men, are also observed in UK Sikhs. DESIGN: A matched cross-sectional study in which each volunteer provided a blood sample after a 12-h overnight fast and had anthropometric measurements taken. SUBJECTS: A total of 55 healthy Caucasian and 55 healthy UK Sikh men were recruited. The Caucasian and Sikh men were matched for age ( 48.7 +/- 10.9 and 48.3 +/- 10.0 y, respectively) and body mass index (BMI) ( 26.1 +/- 2.8 and 26.3 +/- 3.2 kg/m(2), respectively). MEASUREMENTS: Anthropometric measurements were performed to assess total and regional fat depots. The concentrations of plasma total cholesterol, high-density cholesterol (HDL- C), low-density cholesterol (LDL-C) and small dense LDL (LDL3), TAG, glucose, fasting insulin (ins) and nonesterified fatty acids (NEFA) were analysed in fasted plasma. Surrogate measures of insulin resistance (HOMA-IR) and insulin sensitivity (RQUICKI) were calculated from insulin and glucose (HOMA-IR) and insulin, glucose and NEFA ( RQUICKI) measurements. RESULTS: The Sikh men had significantly higher body fat, with the sum of the four skinfold measurements (Ssk) ( P = 0.0001) and subscapular skinfold value (P = 0.009) higher compared with the Caucasian men. The Sikh volunteers also had characteristics of the metabolic syndrome: lower HDL-C (P = 0.07), higher TAG (P = 0.004), higher % LDL3 (P = 0.0001) and insulin resistance (P = 0.05). Both ethnic groups demonstrated positive correlations between insulin and waist circumference (Caucasian: r = 0.661, P = 0.0001; Sikh: r = 0.477, P = 0.0001). The Caucasian men also demonstrated significant positive correlations between central adiposity (r = 0.275, P = 0.04), other measures of adiposity (BMI and suprailiac skinfold) and plasma TAG, whereas the Sikh men showed no correlation for central adiposity (r = 0.019, ns) and TAG with a trend to a negative relationship between other measures ( Ssk and suprailiac) which reached near significance for subscapular skinfold and TAG (r = - 0.246, P = 0.007). The expected positive association between insulin and TAG was observed in the Caucasian men (r = 0.318, P = 0.04) but not in the Sikh men (r = 0.011, ns). CONCLUSIONS: In the Caucasian men, the expected positive association between plasma TAG and centralized body fat was observed. However, a lack of association between centralized, or any other measure of adiposity, and plasma TAG was observed in the matched Sikh men, although both ethnic groups showed the positive association between centralized body fat and insulin resistance, which was less strong for Sikhs. These findings in the Sikh men were not consistent with the hypothesis that there is a clear causal relationship between body fat and its distribution, insulin resistance, and lipid abnormalities associated with the metabolic syndrome, in this ethnic group.

A novel experimental method for measuring vergence and accommodation responses to the main near visual cues in typical and atypical groups

Binocular disparity, blur, and proximal cues drive convergence and accommodation. Disparity is considered to be the main vergence cue and blur the main accommodation cue. We have developed a remote haploscopic photorefractor to measure simultaneous vergence and accommodation objectively in a wide range of participants of all ages while fixating targets at between 0.3 and 2 m. By separating the three main near cues, we can explore their relative weighting in three-, two-, one-, and zero-cue conditions. Disparity can be manipulated by remote occlusion; blur cues manipulated by using either a Gabor patch or a detailed picture target; looming cues by either scaling or not scaling target size with distance. In normal orthophoric, emmetropic, symptom-free, naive visually mature participants, disparity was by far the most significant cue to both vergence and accommodation. Accommodation responses dropped dramatically if disparity was not available. Blur only had a clinically significant effect when disparity was absent. Proximity had very little effect. There was considerable interparticipant variation. We predict that relative weighting of near cue use is likely to vary between clinical groups and present some individual cases as examples. We are using this naturalistic tool to research strabismus, vergence and accommodation development, and emmetropization.

Nationalised large-scale mining, trade unions and community representation: perspectives from Northern Madagascar

This article critically explores the nature and purpose of relationships and inter-dependencies between stakeholders in the context of a parastatal chromite mining company in the Betsiboka Region of Northern Madagascar. An examination of the institutional arrangements at the interface between the mining company and local communities identified power hierarchies and dependencies in the context of a dominant paternalistic environment. The interactions, inter alia, limited social cohesion and intensified the fragility and weakness of community representation, which was further influenced by ethnic hierarchies between the varied community groups; namely, indigenous communities and migrants to the area from different ethnic groups. Moreover, dependencies and nepotism, which may exist at all institutional levels, can create civil society stakeholder representatives who are unrepresentative of the society they are intended to represent. Similarly, a lack of horizontal and vertical trust and reciprocity inherent in Malagasy society engenders a culture of low expectations regarding transparency and accountability, which further catalyses a cycle of nepotism and elite rent-seeking behaviour. On the other hand, leaders retain power with minimal vertical delegation or decentralisation of authority among levels of government and limit opportunities to benefit the elite, perpetuating rent-seeking behaviour within the privileged minority. Within the union movement, pluralism and the associated politicisation of individual unions restricts solidarity, which impacts on the movement’s capacity to act as a cohesive body of opinion and opposition. Nevertheless, the unions’ drive to improve their social capital has increased expectations of transparency and accountability, resulting in demands for greater engagement in decision-making processes.