Rationale Cognitive deficits are now recognised as a major symptom of schizophrenia with a number of studies reporting profound deficits in cognitive function in both chronic and first episode patients. Recent advances in cognitive remediation therapy have provided the opportunity for patients to improve their cognitive function and therefore improve their functional outcome. Aim The aim of the present study was to investigate cognitive deficits using the Cambridge Neuropsychological Test Automated Battery (CANTAB®) in first episode psychosis and chronic schizophrenia patients. In the first episode population the effect of ethnicity on cognition was also examined. In the chronic schizophrenia study comparisons between severity of deficits with first episode psychosis patients were also made. The effects of cognitive remediation therapy were also examined in a sample of first episode patients. Methods A total of 35 patients and 30 healthy controls were recruited into the first episode study, 17 patients and 17 controls into the chronic schizophrenia study and 11 patients into the cognitive remediation study. The first episode psychosis patients were recruited from the Bradford and Airedale Early Intervention Service and the chronic patients from the Leeds Partnership NHS Foundation Trust. The control subjects were matched as closely as possible in terms of intelligence and demographics to the patient groups. The Wechsler Test of Adult Reading (WTAR) was used to estimate subjects pre-morbid IQ. The severity of symptoms was assessed using the Positive and Negative Syndrome Scale (PANSS). All subjects who took part in the study completed a comprehensive battery of neuropsychological tests from the CANTAB®. Patients in the cognitive remediation study participated in group therapy sessions using X-cog®. Results There were no significant differences found between There were no significant differences found between patients and controls in relation to intelligence or demographics in all studies. The effect of ethnicity was shown to be not significant in the first episode study. Results show that patients performed significantly worse than controls across all iv cognitive domains tested in all studies. A correlation between negative symptoms and executive function was found in both first episode and chronic schizophrenia patients. Comparisons between first episode psychosis and chronic schizophrenia patients in cognition showed no significant differences, however significant differences were found in levels of negative symptoms and age between the two groups with chronic patients scoring higher on negative symptoms and being older. In the cognitive remediation study a significant improvement was observed in patients in the domain of executive function and a reduction in negative symptoms following completion of the intervention. Conclusion First episode and chronic schizophrenia patients display significant cognitive deficits across all domains when tested using the CANTAB®. Some of these deficits appear to be independent of the length of the illness but dependent on negative symptoms. This study demonstrates that cognitive deficits exist across all patient groups regardless of age, gender, pre-morbid IQ, years in education and ethnicity. Cognitive remediation therapy has also been shown to be effective in improving cognitive functioning in patients.

This study aimed to broaden the understanding of young South Asian women's experiences/relationships and participation in leisure physical activities at universities in the United States. Using a phenomenological design, semi-structured interviews of 20-30 minutes duration were conducted with 5 South Asian women about their relationships and experiences when participating or attempting to participate in physical activity while attending university in the US. The following criteria were set for participants to be included in this study: they should be between the ages of 18 and 24, non-US citizens from a South Asian country, attend a university in the US, and engage in other physical activities. The interviews were audio recorded via Zoom and then the audio data were transcribed verbatim and then coded to identify the major barriers commonly experienced by participants. Results indicated that many girls and women perceived the US as a "safer" place with excellent infrastructure, ample opportunities to engage in physical activities, and convenient access to gyms, which encourage them (women) to remain active. Most participants were hesitant to participate in physical activities because of the culturally non-responsiveness of the system. This research study was done in a shorter time span with a small sample size. Further research should explore more deeply the experiences of South Asian women regarding their physical activities in the US with larger groups of samples that may be a better representative of the South Asian population.

This systematic review examined literature spanning the last 10 years from Canada, the U.K., the U.S.A., Australia, and New Zealand. Findings highlight the significant gap in comparative literature examining (structural) racism as a determinant of South Asian healthcare access, utilization, and outcomes, and identifies areas of future research to address South Asian health equity concerns. / Background: Race, or specifically racism, has been well-established as a critical determinant of health, though current healthcare practices and policies in Western countries do not adequately address these issues. South Asians are the largest minority group in Canada, and they face disproportionate rates of chronic illnesses, mental health conditions, and barriers to care globally. However, their experiences in healthcare settings and the impact of race and racism on their health equity remain unexplored. This systematic review examined whether race affects healthcare access, utilization, and outcomes of South Asians compared to White-majority populations in Western countries. Methods: Embase, PsycInfo, Ageline, and CINAHL, were searched following PRISMA guidelines, as well as Google Scholar. Articles from 2013-2022 were included if they discussed racism, discrimination, or disparities/inequalities in South Asian physical and mental health, healthcare access, and utilization, outcomes compared to White populations in Canada, the U.K., the U.S.A., Australia, and New Zealand. The Mixed Methods Appraisal Tool (MMAT) was used to assess methodological quality. Data was synthesized narratively. Results: The review included 89 studies from Canada (n=19), the U.K. (n=51), the U.S.A. (n=17), and Australia (n=2), with most studies (n=76) utilizing cross-sectional or cohort designs and examining physical health outcomes (n=50). Study samples predominantly included Indians, Pakistanis, and Bangladeshis over other subgroups. Notably, there was no overall increase in comparative studies over the last decade; however, the U.K. observed an 85% increase compared to an 82% and 64% decrease in Canada and the U.S.A., respectively. The review also identified limited research on experiences within healthcare settings and mental health outcomes, sexual/reproductive health, and all health outcomes for children/youth. Few studies directly discussed the impacts of structural or organizational racism or discrimination on outcomes, though some commented on individual racism as well. Instead, studies relied on the social determinants of health as proxies for structural racism, such as education and income. Conclusion: This review highlights the significant lack of comparative research on the impact of structural, organizational, and individual racism on the healthcare access, utilization, and outcomes of South Asians compared to White-majority populations in Western countries. The review emphasizes the need for more primary, comparative research that quantifies and contextualizes South Asian experiences in obtaining healthcare services. Future research must employ rigorous and representative sampling methods, diverse study designs, and quantitative and qualitative measures that capture implicit, covert, and overt racism in healthcare among South Asians. Additionally, studies should measure factors such as religion, housing, language, and racialized institutional policies, in addition to the typically examined social determinants of health. Finally, this review highlights the need to collect and report disaggregated race and ethnicity health data with input from community leaders, and stratify these data by South Asian subgroups to avoid homogenization of distinct cultures and differential experiences in healthcare systems. Overall, acknowledging racism in healthcare and institutional policies is essential to effectively dismantle these issues and ensure health equity for South Asians. / Thesis / Master of Public Health (MPH)

This qualitative study explores Second Generation South Asian American (SG SAA) Hindus' ideals, values, and meanings associated with gender, and how these ideals affect their attitudes towards unwanted sexual contact of women/girls. SG SAAs are an understudied population that report high levels of stress due to bicultural identity issues and ethnic discrimination, and yet are unlikely to display help-seeking behaviors. This study explores some of the cultural factors behind this phenomenon, particularly in terms of topics such as unwanted sexual contact (including sexual harassment, coercion, incest, and rape). Using an internet-based convenience sampling method, the researcher collected data using an anonymous online questionnaire with multiple open-ended questions. After using qualitative data analysis software, the researcher interprets and discusses the results by drawing on psychological and anthropological literature on gender in contemporary Hindu culture, identity in diaspora, and cultural/structural violence. The researcher explains how the results reveal the participants' internalized messages about women's value and expectations, particularly in regards to sexuality and family roles. Expected to be independent as well as submissive, modern as well as traditional, female SG SAA Hindus are faced with impossible expectations that erase their subjectivity and silence their voices. The negative ramifications of this are explored, particularly as the participants' describe the messages they learned about Hinduism and the blaming of female victims of sexual abuse. The study contextualizes SG SAAs in terms of contemporary Hindu cultures, and illuminates the ways that certain Hindu gender role expectations and attitudes have oppressed women, punished victims of unwanted sexual contact, and perpetuated cultures of silence, secrecy, and shame. The researcher calls for re-interpretations and re-visioning of contemporary Hindu cultures, not only to end alleviate cycles of abuse, but also to address this population's unique bicultural identity issues. Future research and widespread education is needed to explore the clinical implications of this study, and to develop culturally specific interventions for this silenced population.

Rabindranath Tagore (1861-1941) is often considered the most important literary figure in modern Bengali history. He lived through the transformation of Bengali culture and society from colonial to anticolonial to post-colonial times. Tagore was a playwright, novelist, philosopher, and songwriter. He wrote and composed nearly 2,500 songs, called Rabindrasangeet. My interlocutors ascribe Tagore’s songs with a particular affective strength that has become a medium for the construction of diasporic identity. In this dissertation, I explore the lives of three generations of women – from precolonial Bengal, post-independence Bengal, and the modern diaspora – and the types of movement they have experienced. I identify a rupture between the familiar and the immediate that accompanies their movement, and characterize this rupture as creating space for multiple identities, reflections, and intimacies, and the continuous building, dismantling, and rebuilding of culture. I argue that the genre of Rabindrasangeet forms and reforms in the diaspora through embodied processes of micro-level performance. Through friendships, kinships, inter-generational relationships, and technologically mediated connections, Rabindrasangeet remains present. It is a tool for self-making, and used to convey unspoken feelings in a gendered world.

This paper’s focus on South Asian and Asian-American women in relation to Battered Woman Syndrome (BWS) originates from a limited amount of research on the self-helping behaviors of these women–especially those who have immigrated from the countries of Nepal, Bangladesh, India, Pakistan, and Bhutan–as compared to other cultures (Sripada, 2020). The current literature surrounding BWS identifies lesser reporting on South Asian and Asian-American women with ethnic backgrounds from these regions (Kasturirangan, 2004). A journal by Yoshioka (2005) proposes that we consider the “world view” or intersectionality when considering domestic violence and to which many women are restricted as a result of a lack of access to resources. There are also current iterations of instruments being used that drive the discrepancy in cultural values. This literature review aims to identify those gaps in battered woman syndrome literature by analyzing cultural factors to help account for lowered disclosure rates.

High levels of sedentary behaviour (SB) and low levels of physical activity (PA) in primary school children are a health concern especially for the South Asians (SA) because of increased cardiovascular risk. The study investigated ethnic differences in movement behaviours among primary school children in three studies: 1) inclinometer and accelerometer measured movement behaviours in White British (WB) vs. SA 6-8-year-old children; 2) qualitative studies with children, parents and teachers explored barriers and facilitators to reducing SB; and, 3) accelerometer measured movement behaviours in children aged 8-11-years. The inclinometer outcomes were: total SB, SB from bouts >30 minutes and breaks in SB, while accelerometry considered: SB, light PA and moderate to-vigorous PA and counts per minute. 525 children, eight parents and six teachers participated. No ethnic differences were identified in inclinometer outcomes except for SB breaks. SA children had 25 fewer breaks compared to WB. Accelerometry identified higher SB for SA children vs. WB in study one but no ethnic differences in study three; a pattern for higher SB/lower PA for SA children vs. WB was consistent in studies. Reasons for engagement in SB included: knowledge and beliefs about SB, child characteristics, cultural norms, parenting, educational system and the built environment. A large proportion of movement behaviour interventions components were related to education and policy. Children’s levels of SB were similar to office workers regardless of ethnicity. Interventions to reduce SB need to consider SB breaks and PA, especially for SA children who were less active and more sedentary than WB.

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