How young people from culturally and linguistically diverse backgrounds experience mental health: Some insights for mental health nurses

This article reports on part of a study that looked at the mental health of culturally and linguistically diverse (CALD) young people. The research sought to learn from CALD young people, carers, and service providers experiences relevant to the mental health of this group of young people. The ultimate goal was to gain insights that would inform government policy, service providers, ethnic communities and most importantly the young people themselves. To this end, qualitative interviews were undertaken with 123 CALD young people, 41 carers and 14 mental health service providers in Queensland, Western Australia and South Australia. Only one aspect of the study will be dealt with here, namely the views of the young CALD participants, which included risk factors, coping strategies and recommendations about how they could be supported in their struggle to maintain mental health. One of the most important findings of the study relates to the resilience of these young people and an insight into the strategies that they used to cope. The efforts of these young people to assist us in our attempts to understand their situation deserve to be rewarded by improvements in the care that we provide. To this end this article sets out to inform mental health nurses of the results of the study so that they will be in a position to better understand the needs and strengths of their CALD clients and be in a better position to work effectively with them.

Fatigue and Co-occurring Symptoms in Women with Irritable Bowel Syndrome

Thesis (Ph.D.)--University of Washington, 2016-06

HBV core sequence: definition of genotype-specific variability and correlation with geographical origin

There are eight genotypes and nine subtypes of HBV. Small differences in geographical origin are associated with sequence changes in the surface gene. Here, we compared core gene sequences from different genotypes and geographical regions. Specific combinations of 24 amino acid substitutions at nine residues allowed allocation of a sequence to a subtype. Six of these nine residues were located in different T cell epitopes depending on HBV geographical area and/or genotype. Thirty-seven nucleotide changes were associated uniquely with specific genotypes and subtypes. Unique amino acid and nucleotide variants were found in a majority of sequences from specific countries as well as within subtype ayw2 and adr. Specific nucleotide motifs were defined for Korean, Indian, Chinese, Italian and Pacific region isolates. Finally, we observed amino acid motifs that were common to either South-east Asian or Western populations, irrespective of subtype. We believe that HBV strains spread within constrained ethnic groups, result in selection pressures that define sequence variability within each subtype. It suggests that particular T cell epitopes are specific for geographical regions, and thus ethnic groups; this may affect the design of immunomodulatory therapies.

Snoring and its association with asthma in Indigenous children living in the Torres Strait and Northern Peninsula Area

Objective: Respiratory health of Indigenous and minority ethnic groups in affluent countries is poorer than their non-minority counterparts and sleep disorders are no exception. In children, obstructive sleep apnoea has the potential to result in serious long-term consequences. In 1999, we studied 1650 children and adolescents living in the Torres Strait and the Northern Peninsula Area, Australia. Here we report prevalence of snoring in these communities and relate its association with asthma symptoms. Methods: A population-based cross-sectional study was conducted in the Torres Strait region. Five indigenous communities were randomly selected and information was collected using a structured face-to-face interview based on a standardized questionnaire. There was a 98% response rate, and 1650 children, 0-17 years of age, were included in the study. Results: Overall, the prevalence of snoring was 14.2% (95% CI 12.5-15.9); 3.6% (95% CI 2.7-4.6) reported snorting, and 6% (95% CI 4.9-7.2) reported restless sleep. The prevalence of snoring was significantly higher among males (17.1% for males and 10.8 for females, P = 0.005). Children were five times more likely to have experienced snoring and snorting if they reported wheezing in the last 12 months. Conclusion: We conclude that the prevalence of symptoms suggestive of obstructive sleep problems is relatively high in children of this region. This highlights the need for awareness among the community patients and physicians about the problem of obstructive sleep-disordered breathing, especially in children with asthma, and for the need for further studies to measure prevalence of sleep breathing disorders among Indigenous Australians.

Lack of association between genetic markers on chromosome 16q22-Q24 and type 1 diabetes in Russian affected families

Aim To evaluate whether the T1D susceptibility locus on chromosome 16q contributes to the genetic susceptibility to T1D in Russian patients. Method Thirteen microsatellite markers, spanning a 47-centimorgan genomic region on 16q22-q24 were evaluated for linkage to T1D in 98 Russian multiplex families. Multipoint logarithm of odds (LOD) ratio (MLS) and nonparametric LOD (NPL) values were computed for each marker, using GENEHUNTER 2.1 software. Four microsatellites (D16S422, D16S504, D16S3037, and D16S3098) and 6 biallelic markers in 2 positional candidate genes, ICSBP1 and NQO1, were additionally tested for association with T1D in 114 simplex families, using transmission disequilibrium test (TDT). Results A peak of linkage (MLS = 1.35, NPL = 0.91) was shown for marker D16S750, but this was not significant (P = 0.18). The subsequent linkage analysis in the subset of 46 multiplex families carrying a common risk HLA-DR4 haplotype increased peak MLS and NPL values to 1.77 and 1.22, respectively, but showed no significant linkage (P = 0.11) to T1D in the 16q22-q24 genomic region. TDT analysis failed to find significant association between these markers and disease, even after the conditioning for the predisposing HLA-DR4 haplotype. Conclusion Our results did not support the evidence for the susceptibility locus to T1D on chromosome 16q22-24 in the Russian family data set. The lack of association could reflect genetic heterogeneity of type 1 diabetes in diverse ethnic groups.

Validity of BMI as a measure of obesity in Australian white Caucasian and Australian Sri lankan children

Background: Body mass index ( BMI) is used to diagnose obesity. However, its ability to predict the percentage fat mass (% FM) reliably is doubtful. Therefore validity of BMI as a diagnostic tool of obesity is questioned. Aim: This study is focused on determining the ability of BMI- based cut- off values in diagnosing obesity among Australian children of white Caucasian and Sri Lankan origin. Subjects and methods: Height and weight was measured and BMI ( W/H-2) calculated. Total body water was determined by deuterium dilution technique and fat free mass and hence fat mass derived using age- and gender- specific constants. A % FM of 30% for girls and 20% for boys was considered as the criterion cut- off level for obesity. BMI- based obesity cut- offs described by the International Obesity Task Force ( IOTF), CDC/ NCHS centile charts and BMI- Z were validated against the criterion method. Results: There were 96 white Caucasian and 42 Sri Lankan children. Of the white Caucasians, 19 ( 36%) girls and 29 ( 66%) boys, and of the Sri Lankans 7 ( 46%) girls and 16 ( 63%) boys, were obese based on % FM. The FM and BMI were closely associated in both Caucasians ( r = 0.81, P < 0.001) and Sri Lankans ( r = 0.92, P< 0.001). Percentage FM and BMI also had a lower but significant association. Obesity cut- off values recommended by IOTF failed to detect a single case of obesity in either group. However, NCHS and BMI- Z cut- offs detected cases of obesity with low sensitivity. Conclusions: BMI is a poor indicator of percentage fat and the commonly used cut- off values were not sensitive enough to detect cases of childhood obesity in this study. In order to improve the diagnosis of obesity, either BMI cut- off values should be revised to increase the sensitivity or the possibility of using other indirect methods of estimating the % FM should be explored.

Delivering culturally sensitive care: The perceptions of older Arabian Gulf Arabs concerning religion, health, and disease

Health professionals need to be cognizant of the varying perceptions of health shared by people from different religious, sociocultural, and linguistic backgrounds to deliver culturally sensitive health care. In this qualitative study, the authors used semistructured interviews to provide insight into how 10 older Arabian Gulf Muslim persons understand and perceive health and illness with emphasis on the role of Islam in formulating health behaviors. Participants' views were strongly influenced by their religious convictions. Good health was equated with the absence of visible disease, with participants demonstrating limited understanding of silent or insidious disease. They attended doctors for treatment of visible disease rather than seeking preventive health care for diseases such as hypertension, diabetes, and hyperlipidemia. Building oil the results from this study could help inform both health service planners and providers to improve the appropriateness, relevancy, and effectiveness of aged care services for these individuals.

Demographic category membership and leadership in small groups: A social identity analysis

Developing the social identity theory of leadership (e.g., [Hogg, M. A. (2001). A social identity theory of leadership. Personality and Social Psychology Review, 5, 184-200]), an experiment (N=257) tested the hypothesis that as group members identify more strongly with their group (salience) their evaluations of leadership effectiveness become more strongly influenced by the extent to which their demographic stereotype-based impressions of their leader match the norm of the group (prototypicality). Participants, with more or less traditional gender attitudes (orientation), were members, under high or low group salience conditions (salience), of non-interactive laboratory groups that had instrumental or expressive group norms (norm), and a male or female leader (leader gender). As predicted, these four variables interacted significantly to affect perceptions of leadership effectiveness. Reconfiguration of the eight conditions formed by orientation, norm and leader gender produced a single prototypicality variable. Irrespective of participant gender, prototypical leaders were considered more effective in high then low salience groups, and in high salience groups prototypical leaders were more effective than less prototypical leaders. Alternative explanations based on status characteristics and role incongruity theory do not account well for the findings. Implications of these results for the glass ceiling effect and for a wider social identity analysis of the impact of demographic group membership on leadership in small groups are discussed. (c) 2006 Elsevier Inc. All rights reserved.

Evaluation of the healthy village program in Kapit district, Sarawak, Malaysia

Sarawak, Malaysia has a large population of ethnic minorities who live in longhouses in remote rural areas where poverty, non-communicable diseases, accidents and injuries, environmental hazards and communicable diseases all contribute to a lower quality of life than is possible to achieve in these regions. To address these issues and improve the quality of life for longhouse people, the Kapit Divisional Health Office implemented the World Health Organization's Healthy Village programme in 2000. An evaluation was undertaken in 2003 to determine physical and behavioural changes resulting from the programme. The main changes evaluated were those involving smoking habits, exercise habits, health screening, fire safety, environmental improvements and food preparation and hygiene. A qualitative evaluation was conducted using participant observation and key-informant interviews, focus groups and observation. Results indicate that the programme is inspiring changes in various behavioural and physical characteristics of the study population. It is clear that the Healthy Village programme is a widely accepted way of improving health outcomes in longhouses, and that it is succeeding in making beneficial health changes.

The cultural facet of suicidal behaviour: Its importance and neglect

Culture is a central but debated concept in many disciplines and its complexity may become an even bigger source of argument in Suicidology. In spite of the intricacy of the study of this construct, the paper illustrates that various scholars have recognised the relevance of culture and ethnicity in the understanding of suicidal behaviour. The author provides evidence of the need to pay more attention to the meaning and interpretation of suicide in cross-cultural research and underlines the necessity to establish cultural-sensitive prevention strategies. The paper closes by providing methodological considerations and suggestions for future research on cultural aspects of suicidal behaviour.

The linguistic situation in Kirkuk:a sociolinguistic study

This study is concerned with the linguistic situation in the town of Kirkuk in north eastern Iraq. In this town there are three main ethnic groups: Kurds, Arabs and Turkmana with some very smell minorities such as Chaldeene, Assyrians and Armenians. The languages spoken by these three ethnic groups belong to different language Family groups. In the First cart of the study the historical background of the population, a review of the literature, both of the present linguistic situation in Kirkuk end of relevant sociolinguistics in general, and the theoretical Framework, have been discussed in detail in order to provide background to this study which is mainly concerned with the Following areas: 1. The relationships existing between ethnic background and language usage and language loyalty in Kirkuk. 2. The attitudes of Kirkukiane towards language maintenance and language shift in Kirkuk. 3. Bilingual, multilingual individual communicative competence of Kurds, Arabs and Turkmans in the languages concerned, including the degree to which such a speaker is bilingual or multilingual and the nature of bilingualism or multilingualism in different domains and situations in Kirkuk. To throw light a these areas a situationally-oriented language survey was conducted; the relevant data was collected by randomly distributed questionnaire, by parsonal interview, by personal observation of language use and language attitudes in this town. The data subjected to commuter analysis and the results proved that the were no significant and substantial correlations between the language use, attitudes and competence based on the socio-economic status of respondents in this town, on the other hand, the correlations between the ethnic backgrounds and the language, use, attitudes and competence are indisoutable.

Leadership and the negotiation of order in small groups

This thesis is focussed on the role differentiationhypothesis as it relates to small groups (Bales, 1958). The hypothesis is systematically examined, both conceptually and empirically, in the light of the Equilibrium Hypothesis (Bales, 1953) and the Negotiated Order Theory of leadership (e.g. Hosking, 1988). Chapter 1 sketches in a context for the research,which was stimulated by attempts during the 60s and 70s to organise small groups without leaders (the leaderless group, based on isocratic principles). Chapter 2 gives a conceptual and developmental overview of Bales' work, concentrating on the Equilibrium Hypothesis. It is argued that Bales' conceptual approach, if developed, can potentially integrate the disparate small groups and leadership literatures. Chapters 3 and 4 examine the concepts `group', `leader' and `leadership' in terms of the Negotiated Order perspective. In chapter 3 it is argued that two aspects of the concept group need to be taken separately into account; physical attributes and social psychological aspects (the metaphysical glue). It is further argued that a collection of people becomes a group only when they begin to establish a shared sense of social order. In chapter 4 it is argued that leadership is best viewed as a process of negotiation between those who influence and those who are influenced, in the context of shared values about means and ends. It is further argued that leadership is the process by which a shared sense of social order is established and maintained, thus linking the concepts `leadership' and `group' in a single formulation. The correspondences with Bales' approach are discussed at the end of the chapter. Chapters 5 to 8 present a detailed critical description and evaluation of the empirical work which claims to show role differentiation or test the hypothesis, both Bales original work and subsequent studies. It is argued here, that the measurement and analytical procedures adopted by Bales and others, in particular the use of simple means as summaries of group structures, are fundamentally flawed, and that role differentiation in relation to particular identifiable groups has not been demonstrated clearly anywhere in the literature. Chapters 9 to 13 present the empirical work conducted for the thesis. 18 small groups are examined systematically for evidence of role differentiation using an approach based on early sociometry (Moreno, 1934). The results suggest that role differentiation, as described by Bales, does not occur as often as is implied in the literature, and not equivocally in any case. In particular structures derived from Liking are typically distributed or weak. This suggests that one of Bales' principal findings, that Liking varies independently of his other main dimensions, is the product of statistical artifact. Chapter 14 presents a general summary of results and presents some considerations about future research.

Premature cardiovascular events and mortality in south Asians with type 2 diabetes in the United Kingdom Asian Diabetes Study - effect of ethnicity on risk

Background/Aim - People of south Asian origin have an excessive risk of morbidity and mortality from cardiovascular disease. We examined the effect of ethnicity on known risk factors and analysed the risk of cardiovascular events and mortality in UK south Asian and white Europeans patients with type 2 diabetes over a 2 year period. Methods - A total of 1486 south Asian (SA) and 492 white European (WE) subjects with type 2 diabetes were recruited from 25 general practices in Coventry and Birmingham, UK. Baseline data included clinical history, anthropometry and measurements of traditional risk factors – blood pressure, total cholesterol, HbA1c. Multiple linear regression models were used to examine ethnicity differences in individual risk factors. Ten-year cardiovascular risk was estimated using the Framingham and UKPDS equations. All subjects were followed up for 2 years. Cardiovascular events (CVD) and mortality between the two groups were compared. Findings - Significant differences were noted in risk profiles between both groups. After adjustment for clustering and confounding a significant ethnicity effect remained only for higher HbA1c (0.50 [0.22 to 0.77]; P?=?0.0004) and lower HDL (-0.09 [-0.17 to -0.01]; P?=?0.0266). Baseline CVD history was predictive of CVD events during follow-up for SA (P?groups and short period of follow-up are key limitations. Longer follow-up is required to see if the observed differences between the ethnic groups persist. Conclusion - South Asian patients with type 2 diabetes in the UK have a higher cardiovascular risk and present with cardiovascular events at a significantly younger age than white Europeans. Enhanced and ethnicity specific targets and effective treatments are needed if these inequalities are to be reduced.