Asian Ethnic Fertility In Canada: An Application Of The Minority Group Status Hypothesis

Based on the 1971 Census of Canada, the extent of fertility differentials as well as possible sources of variation in fertility behaviour of the major Asian ethnic groups--Chinese, Japanese, East Indian and other--are studied. Ethnic fertility differentials are examined in their socio-economic and historical context, based on a historical review of Asian ethnic groups in Canada. It is found that each of these ethnic groups have experienced inequality of treatment and discrimination in areas such as employment and services. Also documented are differences in socio-economic characteristics which are shown to be related to family size differences. It is indicated that Japanese are better integrated in the majority society in terms of their socio-economic characteristics. This examination suggests that the lower family sizes of characteristics. This examination suggests that the lower family sizes of Japanese women compared to the Chinese and East Indians may in fact reflect their structural assimilation in Canadian Society. Chinese tend to have larger family sizes and are low on socio-economic indicators. The East Indians are intermediate in their fertiltiy behaviour and have a young age structure.;The theoretical perspective used for explaining the differential fertility among Asian groups is the minority group status hypothesis. Since there has been no consensus regarding the validity of this hypothesis, it has been revised based on comments and criticisms that were available. The revision of the hypothesis tries to distinguish between the two explanations, one involving reduced minority fertility based on structural factors and another involving high minority fertility due to subcultural factors. The revised hypothesis also includes the introduction of new concepts such as ascribed and perceived minority status. The minority which is conscious of its minority status is referred to as the perceived minority and the one which is not conscious of its status is called an ascribed minority. The reconceptualization of the hypothesis also emphasizes the measurement of key theoretical concepts including the new concepts introduced. The revised hypothesis has been used to explain the family size differences of Chinese and Japanese in Canada. The results suggest stronger support for the minority status hypothesis among the Chinese indicating further declines in their fertility due to structural factors and similar weaker support among the Japanese is due to their perceived mobility

Impact of “Sambhav” Program (Financial Assistance and Counselor Services) on Hepatitis C Pegylated Interferon Alpha Treatment Initiation in India

Abstract Background: Financial constraints, social taboos and beliefs in alternative medicine are common reasons for delaying or not considering treatment for hepatitis C in India. The present study was planned to analyze the impact of non-banking interest free loan facility in patients affected with hepatitis C virus (HCV) in North India. Methods: This one year observational, retrospective study was conducted in Department of Gastroenterology (January 2012-December 2013), Dayanand Medical College and Hospital Ludhiana, to evaluate the impact of program titled “Sambhav” (which provided non-banking financial assistance and counselor services) on treatment initiation and therapeutic compliance in HCV patients. Data of fully evaluated patients with chronic hepatitis, and/or cirrhosis due to HCV infection who were treated with Peginterferon alfa and ribavirin (RBV) combination during this duration (2012- 2013) was collected from patient medical records and analyzed. In the year 2012, eligible patients who were offered antiviral treatment paid for treatment themselves, while in 2013, ‘Sambhav’ program was launched and this provided interest free financing by non-banking financial company (NBFC) for the treatment of HCV in addition to free counselor services for disease management. The treatment initiation and compliance rates were compared between the patients (n = 585) enrolled in 2013 who were offered ‘Sambhav’ assistance and those enrolled in 2012 (n = 628) when ‘Sambhav’ was not available. Results: Introduction of Sambhav program improved the rates of treatment initiation (59% in 2013 vs. 51% in 2012, P=.004). Of the 585 eligible patients offered ‘Sambhav’ assistance in 2013, 233 patients (39.8%) applied but 106/233 (45.4%) received assistance. Antiviral therapy was started in 93/106 (87.7%) of these patients, while only 52 (42.5%) of 127 patients whose applications were rejected underwent treatment. Compliance to antiviral therapy also improved with the introduction of ‘Sambhav’ program (87.7% vs. 74.1%, P=.001). Conclusion: ‘Sambhav’ program had significant impact on the initiation of antiviral therapy by overcoming the financial hurdles. The free counselor services helped to mitigate social taboos and imparted adequate awareness about the disease to the patients. Initiatives like ‘Sambhav’ can be utilized for improving healthcare services in developing countries, especially for chronic diseases

A simple phenotypic classification for celiac disease

Background/AimsCeliac disease is a global health problem. The presentation of celiac disease has unfolded over years and it is now known that it can manifest at different ages, has varied presentations, and is prone to develop complications, if not managed properly. Although the Oslo definitions provide consensus on the various terminologies used in literature, there is no phenotypic classification providing a composite diagnosis for the disease.MethodsVarious variables identified for phenotypic classification included age at diagnosis, age at onset of symptoms, clinical presentation, family history and complications. These were applied to the existing registry of 1,664 patients at Dayanand Medical College and Hospital, Ludhiana, India. In addition, age was evaluated as below 15 and below 18 years. Cross tabulations were used for the verification of the classification using the existing data. Expert opinion was sought from both international and national experts of varying fields.ResultsAfter empirical verification, age at diagnosis was considered appropriate in between A1 (<18) and A2 (≥18). The disease presentation has been classified into 3 types–P1 (classical), P2 (non-classical) and P3 (asymptomatic). Complications were considered as absent (C0) or present (C1). A single phenotypic classification based on these 3 characteristics, namely age at the diagnosis, clinical presentation, and intestinal complications (APC classification) was derived.ConclusionsAPC classification (age at diagnosis, presentation, complications) is a simple disease explanatory classification for patients with celiac disease aimed at providing a composite diagnosis