The use of tobacco and related substances in ethnic minorities : the development of a culturally valid measure

Introduction. Meeting the needs of migrant groups in Europe requires cross-culturally valid questionnaires, a substantial challenge to researchers. The Rose Angina Questionnaire (RAQ) is an important measure of coronary heart disease prevalence. It consists of seven items that collectively yield a diagnosis of angina. It has been shown to perform inconsistently across some ethnic groups in Britain. This study aimed to assess the need for modifying the RAQ for cross-culturally valid use in the three main ethnic groups in Scotland.Methods. Interviews were carried out with Pakistani Punjabi speakers (n=26), Chinese Cantonese speakers (n=29) and European-origin English speakers (n=25). Bilingual project workers interviewed participants and provided translation and commentary to the English-speaking researcher. Participants were asked about general and cardiovascular health beliefs and behaviours, and about attitudes to pain and chest pain. They were also asked to comment on their understanding of an existing version of the RAQ in their language.Results. No dominant themes in the cultural construction of health, pain or cardiovascular knowledge emerged that may significantly influence RAQ response between language groups. Problems were encountered with the Punjabi and Cantonese translations of the RAQ. For example, the translation for &ldquo;chest&rdquo; was interpreted by some Pakistani and fewer Chinese women to mean &ldquo;breasts&rdquo;. &ldquo;Walking uphill&rdquo; was translated in Chinese as &ldquo;walking the hill&rdquo;, without stipulation of the direction, so that some Cantonese speakers interpreted the question as meaning walking downhill. In addition, many Chinese interpreted RAQ items to be referring to breathlessness rather than chest pain due to ambiguous wording.Conclusion. Existing Punjabi and Cantonese versions of the RAQ should be modified before being used in multi-ethnic surveys. Current versions are unlikely to be yielding data that is comparable across groups. Other language versions also require similar investigation to study the cardiovascular health of Europe&rsquo;s migrant groups.<br /

Conjunctive Use of Canal Water and Groundwater:An Analysis Based on Farmers’ Practices in Ravangaon, Maharashtra

This article examines what happens when canal water is combined with groundwater. It does so by documenting the complex web of practices that are emerging around accessing, storing and transferring water in the command area of irrigation systems in Ravangaon, a village in Maharashtra, India. From mainly accessing water through field channels that are fed by the public surface irrigation system, farmers have moved to using pumps and siphons to transport water from the canal either directly to their fields or to wells and ponds for storage. Their practices are shaped by hydrogeology – most notably the location and storage capacity of the aquifer in relation to canals and farmers’ plots - as well by the political economy – most notably their relative dependence on water-intensive crops like sugarcane. Access to water has largely become a function of one’s ability to invest in advanced pumping, transporting and storage facilities. In line with other scholars, we conclude that the conjunctive use of canal water and groundwater makes it difficult, if not impossible, to trace and monitor actual water use patterns. This means that water distribution increasingly escapes formal and public forms of regulation and control. The article ends with a reflection on what this means to the advancement of water sustainability and justice.</p

Resistance and Resignation:Responses to Typecasting in British Acting

This article draws on 38 in-depth interviews with British actors to explore the operation of typecasting. First, we argue that typecasting acts as the key mechanism through which the ‘somatic norm’ is established in British acting. It delivers an oversupply of leading roles for white, male, middle-class actors while ensuring that those who deviate somatically are restricted to largely socially caricatured roles. Second, we focus on the career trajectories of ‘othered’ actors. While they frequently experience acting roles as offensive and discriminatory, we demonstrate how most nonetheless reluctantly accept the terms of their ‘type’ in order to survive and succeed. Third, we focus on the minority who have attempted to challenge their type. Here we find that successful resistance is accomplished by carefully choosing work that subverts the somatic norm. However, the ability to exercise such choice is highly contingent on resources associated with an actor’s class origin

Changes in cardiovascular risk factors in relation to increasing ethnic inequalities in cardiovascular mortality:comparison of cross-sectional data in the Health Surveys for England 1999 and 2004

OBJECTIVES: Reducing disease inequalities requires risk factors to decline quickest in the most disadvantaged populations. Our objective was to assess whether this happened across the UK's ethnic groups. DESIGN: Secondary analysis of repeated but independent cross-sectional studies focusing on Health Surveys for England 1999 and 2004. SETTING: Community-based population level surveys in England. PARTICIPANTS: Seven populations from the major ethnic groups in England (2004 sample sizes): predominantly White general (6704), Irish (1153), Chinese (723), Indian (1184), Pakistani (941), Bangladeshi (899) and Black Caribbean (1067) populations. The numbers were smaller for specific variables, especially blood tests. OUTCOME MEASURES: Data on 10 established cardiovascular risk factors were extracted from published reports. Differences between 1999 and 2004 were defined a priori as occurring when the 95% CI excluded 0 (for prevalence differences), or 1 (for risk ratios) or when there was a 5% or more change (independent of CIs). RESULTS: Generally, there were reductions in smoking and blood pressure and increases in the waist–hip ratio, body mass index and diabetes. Changes between 1999 and 2004 indicated inconsistent progress and increasing inequalities. For example, total cholesterol increased in Pakistani (0.3 mmol/L) and Bangladeshi men (0.3 mmol/L), and in Pakistani (0.3 mmol/L), Bangladeshi (0.4 mmol/L) and Black Caribbean women (0.3 mmol/L). Increases in absolute risk factor levels were common, for example, in Pakistani (five risk factors), Bangladeshi (four factors) and general population women (four factors). For men, Black Caribbeans had the most (five factor) increases. The changes relative to the general population were also adverse for three risk factors in Pakistani and Black Caribbean men, four in Bangladeshi women and three in Pakistani women. CONCLUSIONS: Changes in populations with the most cardiovascular disease and diabetes did not decline the quickest. Cardiovascular screening programmes need more targeting