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Anticoagulation control in different ethnic groups receiving vitamin K antagonist therapy for stroke prevention in atrial fibrillation

Zulkifly H, Cheli P, Lutchman I, Bai Y, Lip GYH, Lane DA

Thromb Res, 2020 08;192:12-20.
PMID: 32416364 DOI: 10.1016/j.thromres.2020.04.001

BACKGROUND: Efficacy and safety of vitamin K antagonists (VKAs) is optimised in atrial fibrillation (AF) patients when the International Normalised Ratio (INR) is 2.0-3.0. Anticoagulation control comparing different ethnic groups is limited, although epidemiological studies suggest poorer INR control in non-white cohorts.
METHODS: VKA control was assessed retrospectively by time-in-the-therapeutic range (TTR) (Rosendaal method) and percentage INR-in-range (PINRR) in 991 White, Afro-Caribbean and South-Asian AF patients [overall mean (SD) age 71.6 (9.4) years; 55% male; mean (SD) CHA2DS2-VASc score 3.4 (1.6)] over a median (IQR) follow-up of 5.2 (3.2-7.0) years.
RESULTS: Compared to Whites, mean (SD) TTR and PINRR were significantly lower in South-Asians [TTR 67.9% vs. 60.5%; PINRR 58.8% vs. 51.6%, respectively] and Afro-Caribbeans [TTR 67.9% vs. 61.3%; PINRR 58.8% vs. 53.1%, respectively], despite similar INR monitoring intensity. Logistic regression revealed non-white ethnicity [OR 2.62; 95% Confidence Interval [CI] (1.67-4.10) and OR 3.47 (1.44-8.34)] and anaemia [OR 1.65 (1.00-2.70) and OR 6.27 (1.89-20.94)] as independent predictors of both TTR and PINRR

Matched MeSH terms: Minority Groups
Intergroup perception as a compromise between in-group bias and fair-mindedness

Singh R, Sharmini, Choo I

J Soc Psychol, 2004 Aug;144(4):373-87.
PMID: 15279328

Previously, perceived competence of and attraction toward targets categorized by race showed in-group bias and no bias, respectively. Consequently, previous investigators regarded intergroup perception as a compromise between the norms of in-group bias and fair-mindedness. An alternative hypothesis for such findings is that attraction is not as relevant a dimension for intergroup discrimination as is competence. To test contrasting predictions of these hypotheses, the present authors asked participants from the majority and minority groups in Singapore (ns = 320) to evaluate either competence of or attraction toward one of the five targets. Consistent with the hypothesis that intergroup perception is a compromise, both dimensions yielded a uniform but weak in-group bias. The participants' equating of the in-group with one out-group further illustrated fair-mindedness. The authors discussed implications of the findings.

Matched MeSH terms: Minority Groups/psychology*
Collective psychological ownership and the rise of reactionary counter-movements defending the status quo

Selvanathan HP, Lickel B, Jetten J

Br J Soc Psychol, 2021 Apr;60(2):587-609.
PMID: 32949026 DOI: 10.1111/bjso.12418

Social movements pushing for social change are often met with reactionary counter-movements that defend the status quo. The present research examined this interplay by focusing on the role of racial majority group members claiming collective psychological ownership. We examined collective ownership that stems from being native to the land and from being founders of the nation. Study 1 found that in Malaysia, the Malay majority group endorsed more native ownership than Chinese and Indian minorities, which in turn predicted greater threat in response to protests demanding electoral reforms and subsequently greater support for a reactionary pro-government movement. Situated in the United States, Study 2 found that the more that White Americans endorsed founder ownership beliefs, the more they reported negative attitudes towards the Black Lives Matter protests, which in turn predicted more support for White nationalistic counter-protests. This effect was stronger among White people compared to people of colour. Study 3 examined both founder and native ownership in Australia. Founder (but not native) ownership beliefs predicted more negative attitudes towards Invasion Day protests, which subsequently predicted more support for counter-protests defending Australia Day celebrations. Implications of culture-specific beliefs about collective ownership for social movement research are discussed.

Matched MeSH terms: Minority Groups
Minorities and psychiatric hospitalization

Hartog J

Am J Psychiatry, 1980 Jul;137(7):869.
PMID: 7386683
Matched MeSH terms: Minority Groups*
Fulltext Recruitment and participation of a survey in a public-private primary care setting: experience from the QUALICOPC Malaysia

Husin M, Ab Rahman N, Wong XC, Mohamad Noh K, Tong SF, Schäfer W, et al.

Prim Health Care Res Dev, 2020 11 20;21:e51.
PMID: 33213564 DOI: 10.1017/S1463423620000511

AIM: The purpose of this paper is to describe the recruitment strategies, the response rates and the reasons for non-response of Malaysian public and private primary care doctors in an international survey on the quality, cost and equity in primary care.
BACKGROUND: Low research participation by primary care doctors, especially those working in the private sector, is a challenge to quality benchmarking.
METHODS: Primary care doctors were sampled through multi-stage sampling. The first stage-sampling unit was the primary care clinics, which were randomly sampled from five states in Malaysia to reflect their proportions in two strata - sector (public/private) and location (urban/rural). Strategies through endorsement, personalised invitation, face-to-face interview and non-monetary incentives were used to recruit public and private doctors. Data collection was carried out by fieldworkers through structured questionnaires.
FINDINGS: A total of 221 public and 239 private doctors participated in the study. Among the public doctors, 99.5% response rates were obtained. Among the private doctors, a 32.8% response rate was obtained. Totally, 30% of private clinics were uncontactable by telephone, and when these were excluded, the overall response rate is 46.8%. The response rate of the private clinics across the states ranges from 31.5% to 34.0%. A total of 167 answered the non-respondent questionnaire. Among the non-respondents, 77.4 % were male and 22.6% female (P = 0.011). There were 33.6% of doctors older than 65 years (P = 0.003) and 15.9% were from the state of Sarawak (P = 0.016) when compared to non-respondents. Reason for non-participation included being too busy (51.8%), not interested (32.9%), not having enough patients (9.1%) and did not find it beneficial (7.9%). Our study demonstrated the feasibility of obtaining favourable response rate in a survey involving doctors from public and private primary care settings.

Matched MeSH terms: Minority Groups*
Fulltext Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand

Pocock NS, Chan Z, Loganathan T, Suphanchaimat R, Kosiyaporn H, Allotey P, et al.

PLoS One, 2020;15(4):e0231154.
PMID: 32251431 DOI: 10.1371/journal.pone.0231154

BACKGROUND: Cultural competency describes interventions that aim to improve accessibility and effectiveness of health services for people from ethnic minority backgrounds. Interventions include interpreter services, migrant peer educators and health worker training to provide culturally competent care. Very few studies have focussed on cultural competency for migrant service use in Low- and Middle-Income Countries (LMIC). Migrants and refugees in Thailand and Malaysia report difficulties in accessing health systems and discrimination by service providers. In this paper we describe stakeholder perceptions of migrants' and health workers' language and cultural competency, and how this affects migrant workers' health, especially in Malaysia where an interpreter system has not yet been formalised.
METHOD: We conducted in-depth interviews with stakeholders in Malaysia (N = 44) and Thailand (N = 50), alongside policy document review in both countries. Data were analysed thematically. Results informed development of Systems Thinking diagrams hypothesizing potential intervention points to improve cultural competency, namely via addressing language barriers.
RESULTS: Language ability was a core tenet of cultural competency as described by participants in both countries. Malay was perceived to be an easy language that migrants could learn quickly, with perceived proficiency differing by source country and length of stay in Malaysia. Language barriers were a source of frustration for both migrants and health workers, which compounded communication of complex conditions including mental health as well as obtaining informed consent from migrant patients. Health workers in Malaysia used strategies including google translate and hand gestures to communicate, while migrant patients were encouraged to bring friends to act as informal interpreters during consultations. Current health services are not migrant friendly, which deters use. Concerns around overuse of services by non-citizens among the domestic population may partly explain the lack of policy support for cultural competency in Malaysia. Service provision for migrants in Thailand was more culturally sensitive as formal interpreters, known as Migrant Health Workers (MHW), could be hired in public facilities, as well as Migrant Health Volunteers (MHV) who provide basic health education in communities.
CONCLUSION: Perceptions of overuse by migrants in a health system acts as a barrier against system or institutional level improvements for cultural competency, in an already stretched health system. At the micro-level, language interventions with migrant workers appear to be the most feasible leverage point but raises the question of who should bear responsibility for cost and provision-employers, the government, or migrants themselves.

Matched MeSH terms: Minority Groups/psychology
Fulltext Intergroup Contact Effects via Ingroup Distancing among Majority and Minority Groups: Moderation by Social Dominance Orientation

Kauff M, Schmid K, Lolliot S, Al Ramiah A, Hewstone M

PLoS One, 2016;11(1):e0146895.
PMID: 26751203 DOI: 10.1371/journal.pone.0146895

Five studies tested whether intergroup contact reduces negative outgroup attitudes through a process of ingroup distancing. Based on the deprovincialization hypothesis and Social Dominance Theory, we hypothesized that the indirect effect of cross-group friendship on outgroup attitudes via reduced ingroup identification is moderated by individuals' Social Dominance Orientation (SDO), and occurs only for members of high status majority groups. We tested these predictions in three different intergroup contexts, involving conflictual relations between social groups in Germany (Study 1; N = 150; longitudinal Study 2: N = 753), Northern Ireland (Study 3: N = 160; Study 4: N = 1,948), and England (Study 5; N = 594). Cross-group friendship was associated with reduced ingroup identification and the link between reduced ingroup identification and improved outgroup attitudes was moderated by SDO (the indirect effect of cross-group friendship on outgroup attitudes via reduced ingroup only occurred for individuals scoring high, but not low, in SDO). Although there was a consistent moderating effect of SDO in high-status majority groups (Studies 1-5), but not low-status minority groups (Studies 3, 4, and 5), the interaction by SDO was not reliably stronger in high- than low-status groups. Findings are discussed in terms of better understanding deprovincialization effects of contact.

Matched MeSH terms: Minority Groups*
Providing choices for a marginalized community. A community-based project with Malaysian aborigines

Kaur P

Plan Parent Chall, 1994;?(1):23-5.
PMID: 12345736

PIP:
In 1991, the Family Planning Association (FPA) of the Malaysian state of Perak initiated a community-based development project in the remote Aborigine village of Kampung Tisong. The community consists of approximately 34 households who survive on an average income of about US $37. Malnutrition is pervasive, even minor ailments cause death, more serious afflictions are prevalent, and the closest government clinic is 20 kilometers away and seldom used by the Aborigines. 70% of the children have access to education, but parental illiteracy is a serious educational obstacle. The goals of the FPA program are to 1) promote maternal and child health and responsible parenthood, 2) provide health education, 3) encourage women to seek self-determination, and 4) encourage the development of self-reliance in the community as a whole. The first step was to survey the community's culture, beliefs, and health status with the help of the Aborigines Department and the village headman. After a series of preliminary meetings with other agencies, the FPA began to provide activities including health talks, health courses and demonstrations, medical examinations and check-ups, and first aid training. Environmental protection and sanitation measures were included in the educational activities, and following the traditional "mutual aid system," a small plot of land was cleared for vegetable production. Vegetable gardens and needlecraft will become income-producing activities for the women. Attempts to motivate the women to use family planning have been hindered by the fact that the health of 2 women deteriorated after they began using oral contraceptives. Positive changes are occurring slowly and steadily, however, and the FPA has been instrumental in having the settlement included in a program for the hardcore poor which will provide new housing and farming projects.

Matched MeSH terms: Minority Groups*
Fulltext Mental health and risk behaviors among secondary school students: A study on ethnic minorities

Cheah YK, Kee CC, Lim KH, Omar MA

Pediatr Neonatol, 2021 11;62(6):628-637.
PMID: 34353744 DOI: 10.1016/j.pedneo.2021.05.025

BACKGROUND: Mental health disorders are highly correlated with risk behaviors. The objective of the present study is to examine the relationship between risk behaviors and mental health among school-going students with a focus on ethnic minorities.
METHODS: The National Health and Morbidity Survey (NHMS) 2017 (n = 8230) was used for analyses. It was a nationwide survey conducted in Malaysia. The dependent variables were measured by three risk behaviors (cigarette smoking, alcohol drinking and use of illicit drugs). Probit regressions were utilized to examine the effect of mental health on the probability of smoking, drinking and using illicit drugs. Demographic and lifestyle factors were used as the control variables. Truancy was identified as a mediating variable.
RESULTS: Anxiety, depression and suicidal ideation affected cigarette smoking, alcohol drinking and use of illicit drugs through mediation of truancy. After controlling for demographic and lifestyle factors, students with anxiety, depression and suicidal ideation were more likely to smoke, drink and use illicit drugs compared with their peers without any mental health disorders. Furthermore, the likelihood of consuming cigarettes, alcohol and illicit drugs was found to be higher among students who played truant than those who did not.
CONCLUSION: Mental health plays an important role in determining participation in risk behaviors among ethnic minority students in Malaysia. Public health administrators and schools have to be aware that students who suffer from mental health disorders are likely to indulge in risk behaviors.

Matched MeSH terms: Minority Groups
Malaysia can't thrive while it excludes minority talent

Phang IY

Nature, 2005 Sep 15;437(7057):318.
PMID: 16163325
Matched MeSH terms: Minority Groups*
Transcultural aspects of community psychiatry

Hartog J

Ment Hyg, 1971 Jan;55(1):35-44.
PMID: 5549644
Matched MeSH terms: Minority Groups
Fulltext Drug utilisation evaluation study on patients with diabetes mellitus among Rohingya refugees in IMARET mobile clinic

Ahmad Rashidi Mohamed Tahir, Nurasmaa Agussaiful, Shairyzah Ahmad Hisham, Aneesa Abdul Rashid, Ahmad Yusuf Yahaya, Navin Kumar Devaraj

Malaysian Journal of Medicine and Health Sciences, 2020;16(1):51-57.
MyJurnal

Introduction: Since 1978, Rohingya refugees have fled from their native nation, Myanmar to escape ethnic prose- cution. They comprise of the Muslim minority ethnic group originating from the Rakhine state in Myanmar. In many host countries, they may have difficulty to access health care services. The Islamic Association of Malaysia (IMAM) Response and Relief Team (IMARET) have taken many initiatives to provide healthcare services to the refugees through their volunteer-led mobile clinics. Therefore, this study aims to evaluate the utilisation of drugs among type 2 diabetes mellitus (T2DM) patients visiting this clinic. Methods: This was a cross-sectional study among Rohingya refugees with T2DM that visited the IMARET mobile clinics from August until November 2017. Convenient sampling method was used. Data were collected through patient’s interview, review of the patient’s prescriptions and their HbA1c readings. Results: A total of 29 T2DM patients were included in this study. The majority were female (75.9%) and aged below 65 years old (75.9%). The most commonly prescribed anti-diabetic agent was metformin (72.2%), followed by glibenclamide (22.2%) and gliclazide (5.6%). Metformin as a monotherapy (31%) was the most frequent treatment prescribed. More patients had controlled T2DM (62.1%) compared to those with uncontrolled DM. We found 90.9% of patients who were treated according to the recommended DM guidelines achieved a good blood glucose control (p=0.02). Conclusion: In Rohingya refugees having T2DM who were treated in the IMARET mobile clinic, the percentage having good control DM status is higher in those whose treatment regimen adheres to the clinical practice guidelines.

Matched MeSH terms: Minority Groups
Fulltext Critical factors in quality of life: a qualitative explorations into the experiences of Malaysian with heart failure

Nor Firdous Mohamed, Nor Azwany Yaacob, Aizai Azan Abdul Rahim, Oteh Maskon, Mohamed Hatta Shaharom, Othman Lebar

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):52-62.
MyJurnal

Introduction: Heart failure (HF) prevalence is increasing in Malaysia and brings about significant poor outcomes especially on the patients’ wellbeing. Despite the devastating physical symptoms of HF experienced by patients, other social consequences on patients are often not discussed by their health care professionals. Hence, this qual- itative study aims to explore and understand the quality of life (QOL) for patients in Malaysia of various ethnicity who have been diagnosed with heart failure. Methods: Nineteen (n = 19) patients with recurrent HF were recruited via purposive sampling. One-to-one semi-structured interviews were conducted after patients’ informed consent was obtained. The aforementioned sessions were audio-recorded and transcribed verbatim. Finally, the transcribed data was analysed through Braun and Clarke’s framework for thematic analysis. Results: The findings revealed that Malaysians with HF reported either positive or negative experiences related with QOL which had an effect on their well-being. Four main themes emerged included physical, psychological, social, and spirituality. Interestingly, cul- tural and beliefs consideration were important to understand these QOL themes of HF patients as a whole, especially in Malaysia’s multi-ethnic communities. Conclusion: Informants were able to give vivid descriptions of living with HF experiences and the way it affected their QOL due to the disruptive and uncertain nature of HF in four major themes. However, the individual themes of QOL in HF patients need to be comprehended in detail including the local cultural perspectives, particularly by health professionals who deal with HF patients of minority ethnicities, in order to improve treatment and health outcomes.

Matched MeSH terms: Minority Groups
Fulltext A 3-year cross-sectional study on breast cancer among sandakan indigenous women: do they present earlier?

Wong K. H.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):35-35.
MyJurnal

Introduction: Breast cancer is the commonest cancer in Malaysia, predominantly among women under age of 60 and they often presented late. Borneo is home to multi-racial indigenous with heterogeneous background and breast cancer profile can be absolutely unique. This study aims to examine the demographic characteristics and stage at presentation in Sandakan women with newly diagnosed breast cancer. Methods: This is a cross-sectional, retrospec-tive study involving those women who were newly diagnosed with breast cancer from January 2016 to December 2018 in Duchess of Kent Hospital, Sandakan identified via hospital cancer registry and patient records. Only breast cancer with epithelial origin was included. Age, ethnicity and stages at presentation of breast cancer were analysed. Logistic regression was used to study their relationships. Results: 110 women were newly diagnosed as breast cancer. Mean age was 53.5 (SD 12.7), the youngest at 30 and the eldest at 97. Majority (64.6%) were local indigenous wom-en, constituted by 25.4% Sungai, 14.1% Kadazan-Dusun, 12.7% Bugis and the minorities. Chinese women are the main local non-indigenous (32.7%) followed by 2.7% Malay. 52.1% presented at late stages (stage III/IV). Subgroup analysis of T-staging revealed 41.7% had advanced symptoms (T3/T4). Indigenous group was more likely to present at younger ages (OR 12.0; 95%CI 1.5-93.8) and with advanced symptoms (OR 3.1; 95%CI 1.2-8.0). Conclusion: Awareness on breast cancer remains inadequate particularly among indigenous women. Difficult healthcare accessi-bility and incline towards traditional medicine could attribute to late presentation. Outreach awareness programmes are warranted in addition to mobile screening services.

Matched MeSH terms: Minority Groups
Fulltext Clinical presentation of congenital adrenal hyperplasia in selected multiethnic paediatric population

Thambiah, Subashini Chellapah, Zalinah Ahmad, Zarida Hambali, Malina Osman, Munia Mohd Zain, Fuziah Md Zain, et al.

Malaysian Journal of Medicine and Health Sciences, 2015;11(1):77-83.
MyJurnal

A clinical descriptive study was done to determine the sociodemographic, laboratory and clinical characteristics of patients with congenital adrenal hyperplasia (CAH) referred to Hospital Putrajaya, a tertiary endocrine centre in Malaysia. Electronic laboratory data of 51 CAH patients were obtained. The demographics and clinical details of the study population were acquired from a questionnaire completed by parents of participants. There were 25 males (49%) and 26 females (51%), of which, 58.8% were Malays. Median age of participants was 4 years whilst median age at diagnosis of CAH was two years. Parental consanguinity was documented in three patients (5.9%). Patients originated from Johor (19.6%), Selangor (19.6%), Negeri Sembilan (17.6%) and Kedah (13.7%). Majority of patients were diagnosed after one week of life (80.4%) although more females were diagnosed under the age of one week compared to males (p=0.041). Most females presented with ambiguous genitalia (42.3%) [p=0.001] whereas 72% of males presented with salt wasting (p=0.003). No significant associations between race and all other variables, though interestingly three Malay patients presented with ambiguous genitalia and hypertension. Equal gender distribution noted as expected in an autosomal recessive condition, although not in keeping with other Asian countries. Early diagnosis in females attributed to obvious genital ambiguity at birth. Varied clinical presentation, although in minority, necessitates genetic studies for prompt diagnosis and treatment. Considering that majority of patients presented with salt wasting and the age at diagnosis was delayed, the introduction of a neonatal screening programme is essential in Malaysia.

Matched MeSH terms: Minority Groups
Fulltext Pengurusan bersepadu bencana banjir di penempatan Orang Asli Kg. Peta:pengalaman pejabat kesihatan daerah mersing

Mohtar, A., Neefa Bibi, B., Badri, Y.

Malaysian Journal of Community Health, 2009;15(3):87-97.
MyJurnal

Introduction : Mersing, a district in north-east Johore was also affected by the recent worst flood in 100 years that striked Johore. Orang Asli settlements were among the worst affected by the flood in Mersing due to their location along the river. For Kg. Peta, not only flooded, the communications as well as the access roads were also tarnished. This settlement situated very deep interior about 100 km from Mersing town and next to Endau- Rompin National Park. Besides the distance, the geography and the communication issues make the flood operation even more difficult. Even then, the welfare of this minority group was never been neglected. Our Medical and Health Teams made a move in but unfortunately were also been trapped in between the flood waves.
Methodology : It was a qualitative finding. The data for this report were collected from various means. Some data were collected through informal interview among the staffs that being trapped, head villager and the dwellers, local head departments of government and non-government organizations. Others were from the relevant photographs, formal flood returns as well as through the observation.
Finding : The existence of very good involvement, cooperation and coordination from various agencies was the main factor that ensures all the villagers of Kg. Peta received our services despite of many difficulties or challenges. During this disaster, no outbreak of infectious disease or death from the settlement was reported. The welfare and the needs of all who affected and those involved in the flood operation were taken care off. Therefore, we believed that without good support and cooperation from others, we will not be able to deliver our services and their welfare especially when health was concerned will be deprived. The objectives of this write up were to share our experience in managing flood in very remote area and to show the importance of good integration between agencies in disaster management.

Matched MeSH terms: Minority Groups
Fulltext Nutrition knowledge among Malaysian elderly

Norimah A.Karim, Nik Shanita Safii, Safiah Mohd Yusof, Norazliana Mohd Noor, Zawiah Ahmad, Tee, E Siong

Jurnal Sains Kesihatan Malaysia, 2008;6(2):43-54.
MyJurnal

This paper reports the nutrition knowledge of Malaysian elderly, as part of a nationwide study to evaluate the status of nutrition knowledge, attitude and practice (KAP) of food and nutrition among various communities in Malaysia. A total of 906 elderly, age ranging between 60 to 96 years old, with mean age 67.4 ± 6.7 years representing all states in Malaysia participated in the study. An interview administered questionnaire was used to assess the nutrition knowledge and to collect demographic data of the elderly. Subjects were in the 60-65 years (51%) and more than 65 years (49%) age category. There were 46% Malays, 32% Chinese, 6% Indians while the remaining 16% comprised of other minority groups in Malaysia such as Iban, Kadazan, Melanau, Orang Asli and others. More than half of the elderly (54%) had no formal education, 36% completed primary schooling and only 9% finished secondary education. Overall 73% elderly were categorized as having poor nutrition knowledge, 18% moderate and only 9% good. The minority groups had the highest percentage of poor nutrition knowledge (91%) while the Chinese had the highest percentage of good nutrition knowledge (11%). More female (78%) than male (67%) had poor nutrition knowledge, in contrast to more male (10%) than female (8%) with good nutrition knowledge. Chi square test showed that there was a significant correlation between educational status and nutrition knowledge. This was reflected in the results which showed that 81% elderly with no formal education were categorized in the poor nutrition knowledge group. Majority of the elderly did not know about foods to be consumed most (88%), or to be eaten least (87%). Only a quarter to a third of the elderly responded correctly to questions on nutrient function and content. The question on foods with high salt was well responded by the elderly (65%). It is quite discouraging to show that a majority of Malaysian elderly had poor nutrition knowledge. This study indicated that appropriate nutrition education interventions need to be implemented to improve the shortcomings of nutrition knowledge among the Malaysian elderly.

Matched MeSH terms: Minority Groups
Organizational barriers and ethnicity in the Scottish NHS

Sheffield J, Hussain A, Coleshill P

J Manag Med, 1999;13(4-5):263-4.
PMID: 10787497

The NHS faces a crisis in terms of staffing and recruitment. Many of the ethnic minority GPs in inner city areas throughout the UK are coming up to retirement age, and there is an insufficient supply of trainees to fill estimated vacancies. Over 2,000 nursing vacancies exist across the UK, and recruitment to the profession and retention within the profession are poor. Nurses have been recruited from overseas for the past 40 years, and are currently being recruited from Finland, Malaysia, and the West Indies, whilst doctors are being sought in India, Pakistan and Africa. Overseas recruitment is not a new phenomenon, and numerous studies have been carried out to examine equal opportunities and racial discrimination within the NHS. The aim of this paper was to examine ethnicity and equal opportunities within the Scottish NHS and record the levels of organisational awareness of ethnicity and equal opportunities' issues. The paper also examines the link between health service delivery to ethnic minorities and internal cultural attitudes to staff.

Matched MeSH terms: Minority Groups*
Global mental health experiences of single mothers: A mixed methods research synthesis

Vo T, Canty L

J Adv Nurs, 2023 Jan;79(1):68-82.
PMID: 36226874 DOI: 10.1111/jan.15461

AIM: The aim of this research is to synthesize findings from primary studies (quantitative and qualitative) that investigated the global mental health experiences of single mothers to provide a deeper understanding to better care and respond to the support needs of single mothers.
DESIGN: Hayvaert et al.'s mixed methods research synthesis approach.
DATA SOURCES: The search process in the following databases, CINAHL, PsycINFO, and Scopus resulted in eight high-quality studies (5 qualitative and 3 quantitative) published between June 2016 and July 2021.
REVIEW METHODS: Descriptive statistics and instrument scores were provided in summary form. Themes were analysed using Krippendorff's content analysis. A joint display was provided to reveal a complementary relationship between two different data sets.
RESULTS: A total of 348 single mothers participated. Amongst the pooled sample, women identified as: Japanese (n = 174), Israeli (n = 147), Black African (n = 18), African American (n = 9), Native American (n = 5), Burundian-Australian (n = 8), UK British (n = 12), Asian (n = 3), South Korean (n = 7), Indian (n = 2), Malaysian (n = 44), Hispanic/Latina (n = 1) and Eastern European (n = 3). Four themes were identified: (1) Learning to let go of the past, (2) It takes a whole village: Importance of social support, (3) Seeking a self-reliant life: Challenges with balancing career & childcare and (4) Finding strength within: Personal growth. Only one intervention utilizing creative group counselling was found to significantly decrease depression (p = .008), anxiety (p = .005), and stress (p = .012) whilst increasing self-compassion (p = .013).
CONCLUSION: It is important for clinicians who care for single mothers, particularly if they recently immigrated, are multiparous, and an ethnic minority to encourage engagement in peer-initiated counselling and obtain mental health care as necessary.
IMPACT: This study identified and addressed the mental health issues that single mothers face worldwide. This is also the first mixed methods research synthesis to report single mothers' ethnicity in nursing and midwifery literature. Thus, findings from this mixed methods research synthesis can help nurses worldwide build culturally-concordant programs in their respective community organizations and partners (e.g. community health centres, mother-child enrichment clubs), inform health policies, and promote safer spaces for many single mothers, particularly for those who will immigrate to the Global North (i.e. UK, US, Canada) and become an ethnic minority.

Matched MeSH terms: Minority Groups
Fulltext Demographic and socioeconomic factors associated with access to public clinics

Makmor T., Khaled, T., Ahmad Farid O., Nurul Huda M.S.

JUMMEC, 2018;21(1):28-33.
MyJurnal

Introduction: Providing adequate and equal access to healthcare is a key goal towards achieving universal health coverage. However, social and demographic inequalities in accessing health care services exist in both developed and developing countries. This study examined the demographic and socio-economic factors associated with the lack of access to public clinics in the Greater Kuala Lumpur area.
Materials and Methods: The study employed a survey involving 1032 participants. Data were collected using self- administered questionnaires distributed between October and December 2015 in the Greater Kuala Lumpur area.
Results: Of the 1032 participants, 535 were public clinic users. A quarter (25.8%) of the users stated that they did not have access to public clinics in their residential area. A multiple logistic analysis showed that the elderly, the women, those from ethnic minority groups, those of lower family income, and the private sector workers were more likely not to have access to public clinics than their counterparts.
Conclusions: The existing level of accessibility to public clinics could be improved by increasing the number of clinics. Clinics should be established to focus more on reaching the elderly, the women, the ethnic minority groups, the poorer families, and the private sector employees.

Matched MeSH terms: Minority Groups

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