Inflammatory bowel disease in young patients : challenges faced by black and minority ethnic communities in the UK

This document is the peer reviewed version of the following article: Christopher Alexakis, Avril Nash, Michele Lloyd, Fiona Brooks, James O. Lindsay, and Andrew Poullis, ‘Inflammatory bowel disease in young patients: challenges faced by blank and minority ethnic communities in the UK’, Health and Social Care in the Community, Vol. 23 (6): 665-672, first published 9 February 2015, which has been published in final form at doi: 10.1111/hsc.12188. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.There is strong evidence indicating that inflammatory bowel disease (IBD) is increasing among black and minority ethnic (BME) communities. Despite this rise in prevalence, there is a paucity of research relating to ethnicity and IBD outside the USA. Furthermore, the symptoms of IBD are reported to start during childhood or adolescence in 20–25% of people with the condition. It is therefore important that young people's experiences of diagnosis, treatment and living with IBD are fully understood to ensure effective services and information provision. The study reported on in this paper was commissioned by a UK charity (Crohn's and Colitis UK) with the aim of increasing understanding of the specific issues and service needs of young people with IBD from BME communities. Empirical research entailed in-depth semi-structured interviews with 20 young people from BME groups accessed through gastroenterology departments at three collaborating NHS hospitals in England serving ethnically diverse populations. Interviews were carried out from June to December 2010 and sought to capture young people's views with IBD. A thematic analysis of their experiences identified many commonalities with other young people with IBD, such as the problematic route to formal diagnosis and the impact of IBD on education. The young people also experienced tensions between effective self-management strategies and cultural norms and practices relating to food. Moreover, the ability of parents to provide support was hampered for some young people by the absence of culturally competent services that were responsive to the families’ communication needs. The findings highlight the need for more culturally appropriate information concerning IBD, and improved responsiveness to young people with IBD within primary care and the education system, as well as culturally competent messaging relating to the specific nature of the condition among the wider South Asian and black communitiesPeer reviewedFinal Accepted Versio

ARCH effects and cointegration: Is the foreign exchange market efficient?

Extensive empirical work has produced mixed evidence regarding the validity of the unbiased efficient expectations hypothesis in the foreign exchange market. Empirical analysis in this paper, via cointegration techniques, produces the same inconclusive results for three currency markets, namely, the FFR/$US, the DM/$US and the Yen/$US foreign exchange market. However, when modeling conditional heteroskedasticity of exchange rates, through autoregressive conditional heteroskedasticity (ARCH) models, the results are fairly conclusive; the presence of the efficient foreign exchange market hypothesis is found in all these three currency markets.N/

Meta-analysis of one- vs. two-stage laparoscopic/endoscopic management of common bile duct stones

Background: The present study is a meta-analysis of English articles comparing one-stage [laparoscopic common bile duct exploration or intra-operative endoscopic retrograde cholangiopancreatography (ERCP)] vs. two-stage (laparoscopic cholecystectomy preceded or followed by ERCP) management of common bile duct stones. Methods: MEDLINE/PubMed and Science Citation Index databases (1990-2011) were searched for randomized, controlled trials that met the inclusion criteria for data extraction. Outcomes were calculated as odds ratios (ORs) with 95% confidence intervals (CIs) using RevMan 5.1. Results: Nine trials with 933 patients were studied. No significant differences was observed between the two groups with regard to bile duct clearance (OR, 0.89; 95% CI, 0.65-1.21), mortality (OR, 1.2; 95% CI, 0.32-4.52), total morbidity (OR, 0.75; 95% CI, 0.53-1.06), major morbidity (OR, 0.95; 95% CI, 0.60-1.52) and the need for additional procedures (OR, 1.58; 95% CI, 0.76-3.30). Conclusions: Outcomes after one-stage laparoscopic/endoscopic management of bile duct stones are no different to the outcomes after two-stage management

The Feldstein-Horioka puzzle and exchange rate regimes: Evidence from cointegration tests

Many economists specialized in international finance claim that international capital markets are highly integrated (at least during the flexible exchange rate era). The main consequence of the above claim is that there is no longer any close relationship between investment and savings decisions. In other words, the close link between savings and investment ceases to exist under perfect capital mobility. Therefore, we construct a general equilibrium optimization model that is capable of generating artificial (model) data for savings and investment. Then, using the methodology of cointegration testing on these artificial data, we test whether there exists or not any link between savings and investment. The test is implemented between two different exchange rate regimes, that is, that of the Bretton Woods and that of the floating or flexible exchange rate regime. The results from the empirical analysis provide support for integrated capital markets over the second exchange rate era in the case of the United States of America.N/

Inflation volatility and stock prices: Evidence from ARCH effects

This paper examines the impact of inflation uncertainty on stock prices in developed as well as in emerging capital markets over the period 1980:1–93:12 via an Autoregressive Conditional Heteroskedasticity (ARCH) model for inflation. The results seem to support the presence of a negative association between inflation uncertainty and stock prices.N/

Stock returns and inflation volatility: Evidence from developed and emerging capital markets

N/

Integration of international capital markets: further evidence from EMS and non-EMS membership

The present paper examines whether real interest rates from nine financial markets—five European Monetary System (EMS) and four non-EMS markets—are financially integrated both on a world-wide basis and within each market individually. Monthly data on nominal interest rates and prices over the period 1982:1–1993:12 along with the methodology of cointegration are used to serve the purposes of the empirical analysis. The results provide support to the integrated market hypothesis as regards the financial markets considered altogether, as well as the financial markets in each `block' of markets. The presence of a systematic real interest rate relationship in the long run is accepted both on a non-EMS and an EMS basis. This relationship proves to be stronger on the EMS basis than on the non-EMS basis; this is probably due to the lower exchange rate volatility within the EMS environment.N/