RESUMO
Pain is a common cancer-related symptom, but little research has been conducted that explores the meanings of this symptom across different ethnic groups. This study involved qualitative interviews to explore and compare the meanings of pain among 26 Black Caribbean and 19 White patients with advanced cancer. Patients were recruited from oncology outpatient clinics, a lung clinic and palliative care teams. Interview transcripts were analysed using the framework approach. A total of 23/26 Black Caribbean and 15/19 White patients reported cancer-related pain. Accounts of Black Caribbean and White patients identified pain as a 'challenge' that needed to be mastered by the individual, not necessarily by drugs and identified pain as an 'enemy' that represented an unfair attack. Two further meanings of pain emerged from Black Caribbean patients' accounts: pain as a 'test of faith' that referred to confirmation and strengthening of religious belief, and pain as a 'punishment' that was associated with wrongdoing. These meanings influenced the extent patients were able to accommodate their distress. Pain assessment needs to consider the patients' narratives that include the meanings they attribute to this symptom, and which may be governed by culture.
Assuntos
Atitude Frente a Saúde/etnologia , População Negra/psicologia , Cultura , Neoplasias/psicologia , Medição da Dor/psicologia , População Branca/psicologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , População Negra/etnologia , Comparação Transcultural , Feminino , Humanos , Londres/etnologia , Masculino , Pessoa de Meia-Idade , Neoplasias/etnologia , Pesquisa Qualitativa , Doente Terminal/psicologia , Índias Ocidentais/etnologia , População Branca/etnologiaRESUMO
BACKGROUND AND AIMS: The measurement of airway resistance using the interrupter technique (R(int)) is feasible in preschool children and other subjects unable to undertake spirometry. This makes it potentially useful for the measurement of lung function in these groups. Commercial devices use different algorithms to measure pressure and flow from which R(int) is derived. This study provides normative values for British children using devices from a single manufacturer. METHODS: R(int) was measured in 236 healthy children of three ethnic groups (Afro-Caribbean and black African, Bangladeshi, and white British) aged 2-10 years using Micro Medical devices. Software in the devices calculated R(int) from pressure measured by the two point, back extrapolation method from the pressure transient during valve closure, with flow measured just before valve closure. RESULTS: R(int) is related to both age and height, but when age is allowed for there is not a significant relation with height. Neither gender nor any of the ethnicities studied was significantly related to R(int). DISCUSSION: These measurements in healthy children using this technique may be used as reference data for similar populations.
Assuntos
Resistência das Vias Respiratórias/fisiologia , Envelhecimento/fisiologia , Bangladesh/etnologia , População Negra , Estatura/fisiologia , Criança , Pré-Escolar , Estudos de Viabilidade , Feminino , Humanos , Londres/etnologia , Masculino , Valores de Referência , Índias Ocidentais/etnologia , População BrancaRESUMO
INTRODUCTION: Although the prevalence and pattern of parkinsonism in white caucasian population have been reported, little is known about the pattern and prevalence of parkinsonism in black and Asian patients (from the Indian subcontinent). We recently reviewed this topic and felt that contrary to popular belief parkinsonism may be commoner in UK. Furthermore, the pattern of parkinsonism appears to be different in this group. METHODS AND RESULTS: Based on this observation we have now set up a worldwide and British study involving Afro-Caribbean and India (patients originating from the Indian subcontinent) subjects. In the first leg of this study, we carried out a door to door knocking assessment for Parkinsonism in one electoral ward in London with a high Afro-Caribbean population and identified three cases of atypical parkinsonism. We have subsequently been reviewing the case files of over 150 patients attending Movement Disorders clinical in areas of London with a high population of the Afro-Caribbean and Indian population. So far, we have identified 18 cases of Parkinsonism in patients of Afro-Caribbean and Asian origin. Fourteen out of 18 cases show non familial atypical parkinsonism with signs of progressive supranuclear palsy in five, probable striato nigral degeneration in four, and a levodopa unresponsive progressive parkinsonism which falls but no dystonia in three, spino-cerebellar atrophy type three in one and autopsy proven Pick's disease in 1.4. High field Magnetic resonance imaging and CT brain scanning have been remarkable apart from non-specific cortical atrophy and signs of vascular disease in some. CONCLUSIONS: Our observations suggest that parkinsonism is probably more common than realized in the Afro-Caribbean and Asian populations and these patients may be more susceptible to atypical parkinsonism. The reason for this is unclear and may reflect genetic or environmental factors as has been postulated in relation to higher incidence of diabetes and ischaemic heart disease in migrant Asian population in UK. Further epidemiological studies addressing this issue are in progress. (AU)
Assuntos
Humanos , Doença de Parkinson/epidemiologia , Negro ou Afro-Americano , Etnicidade , Estudos Transversais , Imageamento por Ressonância Magnética/estatística & dados numéricos , Londres/etnologiaRESUMO
BACKGROUND: Twenty-six per cent of patients in two Inner London districts were admitted to acute wards under the provisions of the Mental Health Act. Compared with those not under compulsion, they were young, male, more likely to be of black Caribbean origin, and to have a diagnosis of schizophrenia of short duration. The hypothesis is tested that ethnicity determines rates of compulsory admission independently of the other factors. METHOD: Sampling and data collection methods were described in the first paper. Statistical analyses included a log-linear analysis of six key variables: compulsory admission, challenging behaviour, diagnosis, ethnicity, age, and sex. RESULTS: There were no substantial differences between districts. Analysis provided two similar statistical models. In both, admission under the Act was strongly associated with challenging behaviour and diagnosis of schizophrenia. In the model of best fit there was no significant interaction term for ethnicity and compulsion. In the second model there was a weak association. CONCLUSIONS: Ethnicity did not appear to be of outstanding importance in decisions to use the Mental Health Act. There was a strong link between ethnicity and diagnosis, independent of compulsion. Differences between the districts made no major contribution to the rates of compulsory admission.
Assuntos
Auditoria Médica , Transtornos Mentais/reabilitação , Admissão do Paciente , Fatores Etários , Etnicidade/psicologia , Feminino , Humanos , Londres/etnologia , Masculino , Serviços de Saúde Mental/estatística & dados numéricos , Fatores Sexuais , Reino Unido/etnologia , Índias OcidentaisRESUMO
The liver/islet glucose transporter (GLUT2) is mainly expressed in the hepatocytes of the liver and the beta-cells of the pancreatic islets and a defect in this transporter could lead to diabetic phenotypes, such as relative hypoinsulinaemia and reduced uptake and metabolism of glucose in the liver. DNA from unrelated individuals was digested with the restriction endonucleases Bgl-I and Taq-I followed by blotting and hybridisation with a 32P-labelled GLUT2 cDNA which revealed three restriction fragment length polymorphisms (RFLPs) (B1, T1 and T2) in both Caucasian and West Indian populations. Linkage analysis between these variant sites demonstrated that the alleles of these polymorphisms were in strong linkage disequilibrium. Disease association of genetic variants at the GLUT2 locus with type 2 diabetes was examined with these RFLPs in both Caucasian (n = 54) and West Indian (n = 46) populations with type 2 diabetes. There were no significant differences in the frequency of alleles, genotypes or haplotypes between diabetic patients and non-diabetic controls. However, there were significant differences in the allele frequencies of all these three polymorphisms between Caucasian and West Indian populations.