Perceptions and experiences of taking oral hypoglycaemic agents among people of Pakistani and Indian origin : qualitative study

Objective:  To explore British Pakistani and British Indian patients’ perceptions and experiences of taking oral hypoglycaemic agents (OHAs).
Design : Observational cross sectional study using in-depth interviews in English or Punjabi.
Setting and participants : 32 patients of Pakistani and Indian origin with type 2 diabetes, recruited from primary care and community sources in Edinburgh, Scotland.
Results : Respondents reported complex and ambivalent views about OHAs, which reflected their ambivalent attitudes towards Western drugs in general. Respondents considered OHAs to be an important part of the diabetic regimen because they perceived British healthcare professionals to be competent and trustworthy prescribers, and they considered the medicines available in Britain to be superior to those on the Indian subcontinent. Despite this, some respondents made deliberate efforts to reduce their tablet intake without being advised to do so. Reasons for this included perceptions that drugs worked by providing relief of symptoms and concerns that OHAs could be detrimental to health if taken for long periods, in conjunction with other drugs, or without traditional foods.
Conclusions : British Pakistani and Indian patients’ perceptions of their OHAs may partly derive from popular ideas about drugs on the Indian subcontinent. Cultural factors need to be understood and taken into consideration to ensure that these patients are given appropriate advice and to avoid unnecessary changes to prescriptions.

Diabetes service provision : a qualitative study of the experiences and views of Pakistani and Indian patients with Type 2 diabetes

Aims To explore Pakistani and Indian patients' experiences of, and views about, diabetes services in order to inform the development of culturally sensitive services.

Design Qualitative, interview study involving 23 Pakistani and nine Indian patients with Type 2 diabetes recruited from general practices and the local community in Edinburgh, Scotland. Data collection and analysis occurred concurrently and recruitment continued until no new themes emerged from the interviews.

Results Respondents expressed gratitude for the availability of free diabetes services in Britain, as they were used to having to pay to access health care on the Indian subcontinent. Most looked to services for the prompt detection and treatment of complications, rather than the provision of advice about managing their condition. As respondents attached importance to receiving physical examinations, they could be disappointed when these were not offered by health-care professionals. They disliked relying on interpreters and identified a need for bilingual professionals with whom they could discuss their diabetes care directly.

Conclusions Gratitude for free services in Britain may instil a sense of indebtedness which makes it difficult for Pakistanis and Indians to be critical of their diabetes care. Health-care professionals may need to describe their roles carefully, and explain how different diabetes services fit together, to avoid Pakistani and Indian patients perceiving treatment as unsatisfactory. Whilst linkworker schemes may meet patients' need to receive culturally sensitive information in their first language, work is needed to assess their effectiveness and sustainability.

‘I can’t do any serious exercise’ : barriers to physical activity amongst people of Pakistani and Indian origin with Type 2 diabetes

Type 2 diabetes is at least 4 times more common among British South Asians than in the general population. South Asians also have a higher risk of diabetic complications, a situation which has been linked to low levels of physical activity observed amongst this group. Little is known about the factors and considerations which prohibit and/or facilitate physical activity amongst South Asians. This qualitative study explored Pakistani (n = 23) and Indian (n = 9) patients' perceptions and experiences of undertaking physical activity as part of their diabetes care. Although respondents reported an awareness of the need to undertake physical activity, few had put this lifestyle advice into practice. For many, practical considerations, such as lack of time, were interwoven with cultural norms and social expectations. Whilst respondents reported health problems which could make physical activity difficult, these were reinforced by their perceptions and understandings of their diabetes, and its impact upon their future health. Education may play a role in physical activity promotion; however, health promoters may need to work with, rather than against, cultural norms and individual perceptions. We recommend a realistic and culturally sensitive approach, which identifies and capitalizes on the kinds of activities patients already do in their everyday lives.

Testing for the random walk hypothesis in the case of visitor arrivals : evidence from Indian tourism

Testing for the random walk hypothesis, which asserts that a series is a non-stationary process or a unit root process, in the case of visitor arrivals has important implications for policy. If, for instance, visitor arrivals are characterized by a unit root, then it implies that shocks to visitor arrivals are permanent. However, if visitor arrivals are without a unit root, this implies that shocks to visitor arrivals are temporary. This study provides evidence on the random walk hypothesis for visitor arrivals to India using the recently developed Im et al. (2003) and Maddala and Wu (1999) panel unit root tests. Both tests allow one to reject the random walk hypothesis, implying that shocks to visitor arrivals to India from the 10 major source markets have a temporary effect on visitor arrivals.

Safer injections, fewer infections : management of needles and sharps and occupational blood exposure in rural north Indian health settings

This study investigated injection practices and occupational exposure to blood in rural north Indian health settings. The findings highlighted a range of practices potentially contributing to the transmission of hepatitis and HIV to both patients and staff in these settings. Interventions need to focus on the development of organisational structures to support and facilitate safer practices.

Who will be an entrepreneur? How cultural mechanisms and social network structure together influence entrepreneurial participation

Using data collected from 35 countries over five years, this study provides an investigation of the combined influence of cultural factors and social network structure on whether or not an individual, anywhere in the world, becomes an entrepreneur. Results show that knowing someone who has started a business recently, across the world, has a significant impact on entrepreneurship participation. Regarding the potential cultural influences, it seems that importance attached to personally knowing entrepreneurs differs significantly between individuals operating in different cultures. In cultures with high power distance, personally knowing a person who recently started a business is relatively less important as a driver of entrepreneurship participation compared to cultures with low power distance. On the other hand, in cultures where the Hofstede’s ‘masculinity’construct predominates, it is more important than in cultures characterised by ‘femininity’.

Efficiency and unbiasedness in the Indian stock index futures market

This paper explores potential efficiency and unbiasedness as well as the degree of efficiency in stock index futures of an emerging market using both monthly and daily data. Besides analyzing efficiency and unbiasedness with cointegration and error correction model, the degree of efficiency is further investigated after explicitly modeling the underlying state of the market (expansion or contraction) through the first-order Markov switching set-up. The results show that a relatively longer two-month horizon is more effective in eliminating arbitrage opportunities than the short run (one-month and daily) futures.

Family generation, leadership and performance : the role of outside directors in Indian family firms

This paper addresses the presence of outside directors in family firms in India examining the generation of the firm and years of operation. Aspects of corporate leadership such as family member as CEO, as well as the CEO's role in a founding family firm, are considered in relation to financial performance. The findings show that outside directors do not significantly increase firm performance of family firms demonstrating their ineffective monitoring role. Contrary to studies from developed economies, more established family businesses in India outperform founding firms. Overall the study demonstrates that corporate governance issues related to Indian family firms differ from the findings from more developed economies. This finding has implications for further governance reforms in emerging economies.

How dynamic capabilities drive performance in the Indian IT industry : the role of information and co-ordination

This study examines key issues and effects of capability management on a fast-growing area of knowledge-intensive global business services – IT outsourcing and offshoring. An exploratory study is undertaken of Indian companies providing complex process-oriented offshore IT services to their global customers. The analysis of the data related to the service provider side shows that developing dynamic capabilities is strongly driven by management and top-clients and results in the development of business processes and in establishing a strategic partnership with the client organization. Key findings are that information exchange and coordination are the key to a leveraging firm performance.