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Featured researches published by Karl Atkin.


American Journal of Public Health | 2012

Ethnic Density Effects on Physical Morbidity, Mortality, and Health Behaviors: A Systematic Review of the Literature

Laia Bécares; Richard Shaw; James Nazroo; Mai Stafford; Christo Albor; Karl Atkin; Kathleen Kiernan; Richard G. Wilkinson; Kate E. Pickett

It has been suggested that people in racial/ethnic minority groups are healthier when they live in areas with a higher concentration of people from their own ethnic group, a so-called ethnic density effect. Ethnic density effects are still contested, and the pathways by which ethnic density operates are poorly understood. The aim of this study was to systematically review the literature examining the ethnic density effect on physical health, mortality, and health behaviors. Most studies report a null association between ethnic density and health. Protective ethnic density effects are more common than adverse associations, particularly for health behaviors and among Hispanic people. Limitations of the literature include inadequate adjustment for area deprivation and limited statistical power across ethnic density measures and study samples.


BMJ | 2003

Representation of South Asian people in randomised clinical trials: analysis of trials' data

Su Mason; Mahvash Hussain-Gambles; Brenda Leese; Karl Atkin; Julia Brown

Excluding patients of ethnic minority groups from clinical trials is unethical,1 introduces substantial bias, and means that findings are based on unrepresentative populations.2 The National Institutes of Health Revitalization Act 1993 requires that all minority groups be represented in the sample in research projects supported by the National Institutes of Health, unless there is a clear and compelling justification not to do so. In the United Kingdom no such legislation exists. To determine the proportion of South Asian participants (the biggest minority ethnic group in Britain) included in clinical trials we investigated the ethnicity profile of six clinical trials recently conducted by the Northern and Yorkshire Clinical Trials and Research Unit, University of Leeds. All were phase III, multicentre, randomised, controlled trials and had recruited large numbers of participants and centres. Two were national breast cancer trials for which regional recruitment figures were available; two …


Heart & Lung | 2008

Causal attributions, lifestyle change, and coronary heart disease: Illness beliefs of patients of South Asian and European origin living in the United Kingdom

Aliya Darr; Felicity Astin; Karl Atkin

OBJECTIVE We examined and compared the illness beliefs of South Asian and European patients with coronary heart disease (CHD) about causal attributions and lifestyle change. METHODS This was a qualitative study that used framework analysis to examine in-depth interviews. SAMPLE The study comprised 65 subjects (20 Pakistani-Muslim, 13 Indian-Hindu, 12 Indian-Sikh, and 20 Europeans) admitted to one of three UK sites within the previous year with unstable angina or myocardial infarction, or to undergo coronary artery bypass surgery. RESULTS Beliefs about CHD cause varied considerably. Pakistani-Muslim participants were the least likely to report that they knew what had caused their CHD. Stress and lifestyle factors were the most frequently cited causes for CHD irrespective of ethnic grouping, although family history was frequently cited by older European participants. South Asian patients were more likely to stop smoking than their European counterparts but less likely to use audiotape stress-relaxation techniques. South Asian patients found it particularly difficult to make dietary changes. Some female South Asians developed innovative indoor exercise regimens to overcome obstacles to regular exercise. CONCLUSION Misconceptions about the cause of CHD and a lack of understanding about appropriate lifestyle changes were evident across ethnic groups in this study. The provision of information and advice relating to cardiac rehabilitation must be better tailored to the context of the specific needs, beliefs, and circumstances of patients with CHD, regardless of their ethnicity.


Palliative Medicine | 2008

Improving the effectiveness of interventions in palliative care: the potential role of qualitative research in enhancing evidence from randomized controlled trials

Kate Flemming; Joy Adamson; Karl Atkin

Evaluating interventions in palliative care using randomized controlled trials (RCTs) has helped advance the specialty and create an evidence base for the delivery of care. RCTs, however, are notoriously difficult to conduct in palliative care, raising a variety of practical, ethical and moral dilemmas. Mixed-methods research, which combines qualitative research and RCTs, offers a potential solution to these problems. This paper begins by examining the theoretical basis for combining the two approaches, before reviewing the specific role qualitative research could play in planning, conducting and implementing trials. The paper then goes on to explore how palliative care research currently uses the mixed-methods approach, by searching the trials included in six Cochrane Systematic Reviews (n = 146) on the incorporation of qualitative research. Only one trial undertook qualitative research. These findings reflect some of the challenges facing mixed-methods research, which include lack of experience in a research team, the problems of obtaining funding and difficulties in publishing. The paper concludes that while combining qualitative and quantitative research is not a panacea for methodological problems in palliative care research, with careful planning and integration, the approach may enhance the clinical and ethical utility of trial findings, which in turn will improve patient care.


European Journal of Cardiovascular Nursing | 2008

Family Support and Cardiac Rehabilitation: A Comparative Study of the Experiences of South Asian and White-European Patients and Their Carer's Living in the United Kingdom:

Felicity Astin; Karl Atkin; Aliya Darr

Background: Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change. Aims: To explore the nature of family support available to a sample of South Asian and White-European cardiac patients and to highlight similarities and differences between these groups with regard to cardiac rehabilitation and lifestyle modification. Methods: Using a qualitative approach, semi-structured interviews (in 1 of 6 languages) were conducted by researchers with; 45 South Asian patients and 37 carers and 20 White-European patients and 17 carers. Interviews were conducted in a home setting, up to eighteen months after discharge from hospital following myocardial infarction, coronary artery bypass surgery or unstable angina. Results: The main themes that emerged related to the provision of advice and information, family support and burden, dietary change and exercise regimes. Conclusions: Several cultural and ethnic differences were identified between patients and their families alongside similarities, irrespective of ethnicity. These may represent generic characteristics of recovery after a cardiac event. Health professionals should develop a cultural repertoire to engage with diversity and difference. Not every difficulty a person encounters as they try to access appropriate service delivery can be attributed to ethnic background. By improving services generally, support for South Asian populations can be improved. The challenge is to know when ethnicity makes a difference and mediates a persons relationship with service support and when it does not.


Social Science & Medicine | 1998

Genetic screening and haemoglobinopathies: Ethics, politics and practice

Karl Atkin; Waqar I. U. Ahmad

The increasing availability of information on the human genetic makeup presents both individuals and society with difficult decisions. This paper explores the ethical and practical issues raised by genetic screening for sickle cell and thalassaemia major, by examining the emerging tension between allowing people to make informed choices, on the basis of genetic information, and prevention of haemoglobinopathies. Within this broad context, the paper also explores the more practical issues of providing genetic screening for haemoglobinopathies, such as the meaning of counselling and screening for the general population; the psychological and social implications for people identified as carriers; and the organisation and delivery of services. It concludes that screening is not always informed by a commitment to informed decision making.


Social Science & Medicine | 2009

Ethnic density effects on maternal and infant health in the Millennium Cohort Study

Kate E. Pickett; Richard J. Shaw; Karl Atkin; Kathleen Kiernan; Richard G. Wilkinson

Studies have suggested that members of ethnic minority groups might be healthier when they live in areas with a high concentration of people from their own ethnic group - in spite of higher levels of material deprivation typically found within such areas. We investigated the effects of area-level same-ethnic density on maternal and infant health, independent of area deprivation and individual socioeconomic status, in five ethnic minority groups. The study was a cross-sectional analysis within the UK Millennium Cohort Study and included mothers in five ethnic minority groups (Black African n=367, Bangladeshi n=369, Black Caribbean n=252, Indian n=462 and Pakistani n=868) and their 9-month-old infants. Outcome measures included: low birth weight, preterm delivery, maternal depression, self-rated health and limiting long-standing illness. Compared to those who live in areas with less than 5% of people from the same-ethnic minority population, Indian and Pakistani mothers were significantly less likely to report ever being depressed in areas with high same-ethnic density. There was a protective effect of ethnic density for limiting long-term illness among Bangladeshi mothers at 5-30% density and Pakistani mothers at all higher densities. Ethnic density was unrelated to infant outcomes and maternal self-rated health, and unrelated to any outcomes in Black African and Black Caribbean mothers and infants, possibly because no families in these groups lived at higher levels of same-ethnic density. Results were similar whether we examined smaller or larger residential areas. We conclude that, among ethnic minority mothers and infants in England, the relationship of ethnic density to health varies by ethnicity and outcome. For some measures of maternal health, in some ethnic groups, the psychosocial advantages of shared culture, social networks and social capital may override the adverse effects of material deprivation.


Current Sociology | 2008

Decision-Making and Ante-Natal Screening for Sickle Cell and Thalassaemia Disorders: To What Extent do Faith and Religious Identity Mediate Choice?

Karl Atkin; Shenaz Ahmed; Jenny Hewison; Josephine M. Green

When making decisions about prenatal diagnosis, couples not only draw on their understanding of the condition but also broader aspects of their cultural identity. This article looks at how faith and religion mediate attitudes towards screening, prenatal diagnosis and termination of pregnancy for sickle cell and thalassaemia disorders. The article specifically reports on a qualitative study, which used focus groups from a variety of faith communities (Muslim, Sikh, Hindu and Christian), at risk of haemoglobin disorders, living in England. Our findings suggest that the decision about whether or not to have diagnostic testing generally related to attitudes towards the termination of pregnancy. The consequences of the condition were as important as religious beliefs to most people. More generally, faith beliefs emerged as negotiable and contingent: realized within a broader moral framework. Religion was felt not to be prescriptive and reproductive decisions were seen as personal. When making decisions, people utilize faith within a broader context of individual, family and social relationships.


Journal of Nursing Management | 2009

Mapping the introduction of Assistant Practitioner roles in Acute NHS (Hospital) Trusts in England

Karen Spilsbury; Lucy Stuttard; Joy Adamson; Karl Atkin; Gunilla Borglin; Dorothy McCaughan; Hugh McKenna; Ann Wakefield; Roy Carr-Hill

AIMS This mapping study describes current or planned introduction of assistant practitioner roles in English National Health Service Acute Hospital Trusts. BACKGROUND In the last decade there has been a growth in nursing support workforce numbers and their scope of practice. An important United Kingdom support worker development is the Assistant Practitioner role. METHOD A national census was carried out (April 2007) via an emailed questionnaire to Directors of Nursing. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using thematic analysis. RESULTS Eighty-five per cent (143/168) of Directors of Nursing, from all 10 English Strategic Health Authorities, responded. Forty-six per cent (n = 66) of Trusts had introduced assistant practitioners and 22% (n = 31) were planning to implement the role before 2009. There is wide variation in assistant practitioner numbers across and between Strategic Health Authorities, Trusts and clinical areas. Resistance to the role existed in 32% (n = 46) of Trusts. Reasons for resistance included no perceived need for the role, lack of evidence of effectiveness, financial constraints and professional and patient safety concerns. IMPLICATIONS FOR NURSING MANAGEMENT These findings, which contribute to the international evidence-base on health care support workers roles, provide nurse managers with numbers of assistant practitioners and their deployment. This is useful for Nurse Managers making workforce decisions.


Sociology of Health and Illness | 2002

Young South Asian deaf people and their families: negotiating relationships and identities

Karl Atkin; Waqar I. U. Ahmad; Lesley Jones

One of three papers (others in Social Science & Medicine and Disability & Society), ESRC funded (£93K). WA was PI. Builds on WAs work funded by DH and JRF. Led to interviews on BBC, including See Hear and Asian Network. WA invited to become Trustee of a major Deaf organisation.

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Simon Dyson

De Montfort University

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