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This paper considers the support networks of older people in populations with a preponderance of multigenerational households and examines the most vulnerable network types in terms of loneliness and isolation. Current common typologies of support networks may not be sensitive to differences within and between different cultures. This paper uses cross-sectional data drawn from 590 elders (Gujaratis, Punjabis and Sylhetis) living in the United Kingdom and South Asia. Six variables were used in K-means cluster analysis to establish a new network typology. Two logistic regression models using loneliness and isolation as dependent variables assessed the contribution of the new network type to wellbeing. Four support networks were identified: ‘Multigenerational Households: Older Integrated Networks’, ‘Multigenerational Households: Younger Family Networks’, ‘Family and Friends Integrated Networks’ and ‘Non-kin Restricted Networks’. Older South Asians with ‘Non-kin Restricted Networks’ were more likely to be lonely and isolated compared to others. Using network typologies developed with individualistically oriented cultures, distributions are skewed towards more robust network types and could underestimate the support needs of older people from familistic cultures, who may be isolated and lonely and with limited informal sources of help. The new typology identifies different network types within multigenerational households, identifies a greater proportion of older people with vulnerable networks and could positively contribute to service planning. [ABSTRACT FROM PUBLISHER]

Background Migrants from the Indian subcontinent comprise the largest minority group in the UK. With the process of migration come alterations in lifestyle and eating habits. The present study aimed to disseminate the valuable information, experiences and challenges faced by researchers who conduct studies with ethnic minority groups in the area of diet and nutritional surveys, with an emphasis on migrant South Asians. Methods The findings reported are the result of research carried out during 2008-2012, involving 1100 face-to-face dietary recalls conducted in the UK among South Asian children (aged 1.5-11 years; n = 300) and adults (≥30 years; n = 100). Results Factors to consider when planning and carrying out diet and nutrition survey studies among migrant South Asians were identified and include the employment of culture-specific tools, visual aid reinforcement and the involvement of key community members and translators to facilitate recruitment and data collection. One of the best practices found when working with minority groups was the use of incentives and tangible benefits to reward study participants. It was also found that constant communication and follow-up of the study participants improved the quality of the data and the likelihood of maintaining links with community members for future studies. Conclusions From the results of in-house studies and a revision of practices reported in earlier literature, two 24-h face-to-face dietary recalls are recommended as the optimal method for the dietary assessment of migrant South Asians. To complement this assessment, ethnic-specific food frequency questionnaires such as that developed and successfully implemented among South Asians in the present study must be employed. [ABSTRACT FROM AUTHOR]

The objective of this study was to define 'quality' of headache care, and develop indicators that are applicable in different settings and cultures and to all types of headache. No definition of quality of headache care has been formulated. Two sets of quality indicators, proposed in the US and UK, are limited to their localities and/or specific to migraine and their development received no input from people with headache. We first undertook a literature review. Then we conducted a series of focus-group consultations with key stakeholders (doctors, nurses and patients) in headache care. From the findings we proposed a large number of putative quality indicators, and refined these and reduced their number in consultations with larger international groups of stakeholder representatives. We formulated a definition of quality from the quality indicators. Five main themes were identified: (1) headache services; (2) health professionals; (3) patients; (4) financial resources; (5) political agenda and legislation. An initial list of 160 putative quality indicators in 14 domains was reduced to 30 indicators in 9 domains. These gave rise to the following multidimensional definition of quality of headache care: 'Good-quality headache care achieves accurate diagnosis and individualized management, has appropriate referral pathways, educates patients about their headaches and their management, is convenient and comfortable, satisfies patients, is efficient and equitable, assesses outcomes and is safe.' Quality in headache care is multidimensional and resides in nine essential domains that are of equal importance. The indicators are currently being tested for feasibility of use in clinical settings. [ABSTRACT FROM AUTHOR]

This paper considers the support networks of older people in populations with a preponderance of multigenerational households and examines the most vulnerable network types in terms of loneliness and isolation. Current common typologies of support networks may not be sensitive to differences within and between different cultures. This paper uses cross-sectional data drawn from 590 elders (Gujaratis, Punjabis and Sylhetis) living in the United Kingdom and South Asia. Six variables were used in K-means cluster analysis to establish a new network typology. Two logistic regression models using loneliness and isolation as dependent variables assessed the contribution of the new network type to wellbeing. Four support networks were identified: ‘Multigenerational Households: Older Integrated Networks’, ‘Multigenerational Households: Younger Family Networks’, ‘Family and Friends Integrated Networks’ and ‘Non-kin Restricted Networks’. Older South Asians with ‘Non-kin Restricted Networks’ were more likely to be lonely and isolated compared to others. Using network typologies developed with individualistically oriented cultures, distributions are skewed towards more robust network types and could underestimate the support needs of older people from familistic cultures, who may be isolated and lonely and with limited informal sources of help. The new typology identifies different network types within multigenerational households, identifies a greater proportion of older people with vulnerable networks and could positively contribute to service planning. [ABSTRACT FROM AUTHOR]