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PubMed1974

Pacific islands for form federation.

An agreement expressing the desire to form themselves into a Federation of Planned Parenthood Associations of Pacific Islands and to become members of IPPF has been drawn up by island members present at a seminar which took place from 8 to 11 July 1974 in Apia. The seminar was conducted by Dr. Asi Faletoese, IPPF South East Asia and Oceania Regional Office resident officer in Apia with the assistance and cooperation of the Samoa Planned Parenthood Association. The Agreement was signed by representatives of Solomon Islabds Planned Parenthood Association, Gilbert and Ellice Islands Family Planning Association, American Samoa Planned Parenthood Association, Planned Parenthood Association of New Hebrides, Planned Parenthood Association of Tongo, Planned Parenthood Association of Tokelau Islands and Samoa, and the Planned Parenthood Association of Western Samoa. Brigadier Derek Sharp, the SEAO regional executive director, moved a vote of thanks to Dr. Asi for the good work he has done during the past two years in bringing us to this stage where so many of the Pacific Islands countries now have family planning associations and where such a wonderful spirit of cooperation exists between them. Outlining the guidelines set out for all regional offices by the IPPF budget and finance committee at their last meeting in London, Brigadier Sharp told would be members of the new Federation: "Because of budget limitations we will not be able to devote money to setting up an office in the Pacific area for the new Federation, but we will create an office within the existing staff of the SEAO Regional office in Kuala Laumpur to which each member association in the new Federation will correspond direct."

Developing Countries↗
PubMed1996

Expanded programme on immunization (EPI) immunization schedules in the WHO Western Pacific Region, 1995.

There are 36 countries/areas in this Region; Mongolia was transferred to the Western Pacific Region in 1995. No data are available from the Cook Islands, Nauru, and New Caledonia (Tables 1-3). BCG is used in all but 6 countries/areas (American Samoa, Australia, Guam, New Zealand, Northern Mariana Islands and Palau). Most countries/areas give BCG at birth; Japan gives it at 3 months, the Republic of Korea at 4 weeks, and Samoa at 5 years of age. Nine countries give 2 doses of BCG and 4 give 3 doses, up to 15 years of age. Mongolia gives 4 doses up to 18 years of age. Diphtheria-pertussis-tetanus (DPT) vaccine is used as a primary series of 3 doses in all countries/areas; 17 countries give 1 to 3 booster doses of DPT vaccine in the first year of life or later. Diphtheria-tetanus (DT) booster doses are given in Brunei Darussalam, Mongolia and New Zealand. Td is also given in New Zealand. Oral poliovirus vaccine (OPV) is used in a primary series of 3 doses simultaneously with DPT vaccine in all countries/areas. Eight countries/areas use an additional dose of OPV at birth (Cambodia, Fiji, Hong Kong, Kiribati, Lao People's Democratic Republic, Marshall Islands, Papua New Guinea and Tuvalu). A booster dose of OPV in the second year of life is used in 9 countries/areas and a booster dose of OPV is given to schoolchildren in 16 countries/areas. Measles vaccine is given in all countries/areas from 8-15 months of age usually in the form of monovalent measles vaccine, except in Macau. In 4 countries/areas, it is given in the form of measles-mumps-rubella (MMR) vaccine (Guam, Hong Kong, Palau and Singapore). The 2-dose policy is implemented in 4 countries/areas (American Samoa, New Zealand, Palau, and Samoa). In Australia and Palau, the second dose is given as MMR vaccine. The age at the second dose varies from 4 to 13 years of age. Rubella vaccine is given in 4 countries/areas to girls between 10 and 14 years of age (Fiji, French Polynesia, Japan and Macau). In Hong Kong, it is not specified if only girls receive rubella vaccine. In Australia and New Zealand, rubella vaccine is given to seronegative women immediately after delivery. Hepatitis B is used in all but 7 countries/areas (Cambodia, China, Guam, Kiribati, Lao People's Democratic Republic, Tokelau and Viet Nam). All countries which give hepatitis B vaccine use 3 primary doses in infancy, the first dose being given at birth in 23 countries/areas. In Australia and Japan, this vaccine is given to groups at risk. Tetanus toxoid (TT) is used for pregnant or nonpregnant women of childbearing age. It is used in 14 countries/areas, but in Australia and Palau the target group is schoolchildren. The schedules include 2-5 doses of TT.

Adolescent↗
PubMed1998

Migration and acculturation among Samoans: some sources of stress and support.

Daily excretion of the stress hormone, epinephrine, has been employed to study potential stressors associated with acculturation and migration. Young men and women from Samoan communities in Hawaii (HI), American Samoa (AS) and Western Samoa (WS) which differ in exposure to American culture were included. Psychosocial factors associated with elevations in hormone excretion were assumed to be stressors, while associations with reduced excretions were assumed to be supportive or buffers. Hormone excretion levels were similar in all locations, but there were different associations which could be attributed to migration and acculturation. Among all migrants (HI) ethnic networks were apparent stressors, while a high degree of community involvement was stressful for migrant women. In sites of culture contact (HI, AS) certain adult members of the extended family were supportive, as was a superior knowledge of Samoan cultural concepts. For women in Samoa (WS, AS) community involvement was supportive. In contrast for men in WS and AS, but not in HI, being of mixed ancestry or having close family of mixed ancestry was stressful. It is concluded that hormone analysis can provide meaningful clues concerning social stressors in acculturating or migrant communities. Also that migration or acculturation do not necessarily result in increased levels of stress.

Acculturation↗
PubMed1982

Mortality related to cardiovascular disease and diabetes mellitus in a modernizing population.

Excessive adiposity is associated with elevated rates of middle-aged mortality, particularly that related to cardiovascular disease (CVD) and diabetes mellitus (DM). One purpose of this study was to determine whether the population of American Samoa demonstrated the expected elevation of mortality rates related to these two causes. Accordingly for all American Samoan death records (N = 1588) during the period 1962-74, both crude and age-standardized rates were calculated and interpopulation comparisons of DM and CVD were made. The second purpose of this research was to determine if elevated CVD mortality was associated with the islands' recent trend toward modernization. For this purpose 902 deaths of persons aged 30 or more were analyzed to determine change in CVD mortality over time and differences by degree of participation in modern life. The CVD-related mortality rate for Samoa was 82.1 per 100,000, compared to 368.6 reported for the United States in 1962. After age standardization the Samoan rate increased to 242.5, still below that of the United States. The Samoan DM-related mortality rate was 13.9 per 100,000 compared to a United States rate of 15.9 in 1959. After age adjustment, the respective rates were 32.2 and 13.4 (1957-59), the Samoan rate being more than double that of the United States. Female CVD mortality in Samoa increased from 196.2 in the period 1963-66 to 363.0 in 1971-74, while male rates remained essentially unchanged (417.3 and 429.0 respectively). CVD mortality among males living in more modernized areas of the island was 46.5% higher than that for male residents of more traditional areas (343.5 and 234.5 respectively); among females, however, the rate was highest for those living in traditional areas (398.7). CVD mortality for males classified to the "sedentary' occupational category was 50% greater than that for males in the "active'.

Cardiovascular Diseases↗
PubMedDate not supplied

Modernization, migration and obesity among Samoan adults.

Modernization and migration have biological as well as social effects on people. In this study, 2657 Samoan adults from Western Samoa, American Samoa and Hawaii were surveyed in an attempt to examine the relationships between modernization, migration and obesity. The Samoan men showed an increase in the frequency of obesity with increasing modernity of residence or occupation. While the women in American Samoa had the highest frequency of obesity of any subsample, Samoan women also demonstrated a pattern of higher adiposity in more modern jobs. Young women tended to show a negative relationship between obesity frequency and education, with college-educated women having the lowest average levels of adiposity. Time since migration to Hawaii was not found to exert a major effect on frequency of obesity.

Adolescent↗
PubMed2004

Distribution of genome-wide linkage disequilibrium based on microsatellite loci in the Samoan population.

Whole genome-wide scanning for susceptibility loci based on linkage disequilibrium (LD) has been proposed as a powerful strategy for mapping common complex diseases, especially in isolated populations. We recruited 389 individuals from 175 families in the US territory of American Samoa, and 96 unrelated individuals from American Samoa and the independent country of Samoa in order to examine background LD by using a 10 centimorgan (cM) map containing 381 autosomal and 18 X-linked microsatellite markers. We tested the relationship between LD and recombination fraction by fitting a regression model. We estimated a slope of -0.021 (SE 0.00354; p<0.0001). Based on our results, LD in the Samoan population decays steadily as the recombination fraction between autosomal markers increases. The patterns of LD observed in the Samoan population are quite similar to those previously observed in Palau but markedly contrast with those observed in a non-isolated Caucasian sample, where there is essentially no marker-to-marker LD. Our analyses support the hypothesis of a recent bottleneck, which is consistent with the known demographic history of the Samoan population. Furthermore, population substructure tests support the hypothesis that self-identified Samoans represent one homogenous genetic population.

Chromosomes, Human, X↗
PubMed2000

Knowledge of and attitudes about cancer among American Samoans.

The objective of this study was to determine cancer-related knowledge and attitudes among American Samoans, a population seldom studied by cancer researchers. Such information is necessary to develop culturally sensitive cancer control interventions. Specially trained personnel conducted face-to-face interviews with randomly selected respondents in the US Territory of American Samoa; Oahu, HI; and Los Angeles, CA, using a survey based on the National Health Interview Survey Cancer Control Supplement and focus group findings. The survey included questions concerning knowledge of risk factors for cancers (breast, cervical, colon, lung, stomach, and prostate), family resources (health insurance coverage, employment status, and family income), and demographic characteristics. Participants could complete the survey in English or Samoan. Analysis of data included the chi-squared test and logistic regression analysis. Participants included 1,834 noninstitutionalized English- or Samoan-speaking women and men (609 from American Samoa, 610 from Hawaii, and 615 from Los Angeles). The majority of residents had some positive attitudes about cancer prevention and treatment but often also had misconceptions about risk factors for cancer. Logistic regression analysis revealed that site of residence was an important predictor of attitudes. For example, being residents of American Samoa or Hawaii predicted that the respondents would rather not know that they had cancer (odds ratio [OR], 1.5, 2.1, respectively); that cancer can be caused by aitu, or spirits (OR, 1.9, 2.1, respectively); that cancer is a punishment from God (OR, 2.0, 2.2, respectively); and that cancer can be cured by fofo, or traditional Samoan healers (OR, 2.0, 3. 1, respectively). This study documented cancer-related knowledge and attitudes among American Samoans and set the stage for culturally sensitive interventions aimed at improving cancer control in this population. It also identified many issues that should be addressed in such interventions.

Adult↗
PubMed1982

Differing profiles of periodontal disease in two similar South Pacific island populations.

The periodontal condition of a cross-section of individuals aged between 15-59 years was characterised from clinical and radiographic observations of dental calculus, gingival inflammation, the level of the gingival attachment , alveolar bone loss, teeth missing or requiring extraction for periodontal reasons. The common characteristics of the profile in Tonga and W. Samoa were a high prevalence of the factors common to periodontal disease: calculus and gingival inflammation; a progressive apical movement of the gingival attachment; and alveolar bone loss. All these criteria showed a positive age dependency with calculus (particularly subgingival calculus) and gingival inflammation being very commonly associated with all tooth types at an early age, less than 30 years. Tooth loss observed was presumed to be previously associated with periodontal disease because the prevalence of dental caries was very low in both populations. Substantial differences were observed in the number of missing teeth between Tongan and Samoan populations, the Tongan subjects having a high rate of tooth loss. From radiographic interpretations of the periodontal conditions fewer subjects in Tonga were assessed as having no disease, and there was a higher prevalence of progressive destructive disease in Tonga than in W. Samoa. The proportion of subjects in both countries with no disease decreased rapidly with age. There was no evident explanation of the greater severity of disease in Tonga than in W. Samoa. The prevalence of microbial plaque, calculus and gingival inflammation was very high in all subjects at all ages particularly over 30 years in both populations.

Adolescent↗
PubMed2001

Breast cancer screening among American Samoan women.

BACKGROUND: Little is known about breast cancer screening practices or predictors of age-specific screening for Samoan women. METHODS: Through systematic, random sampling procedures, we identified and interviewed 720 adult (> or =30 years) Samoan women residing in American Samoa, Hawaii, and Los Angeles. Multivariate logistic regressions were performed to determine independent predictors for recent age-specific screening. RESULTS: Only 55.6% of women (> or =30 years) had ever had a CBE and 32.9% of women (> or =40 years) had ever had a mammogram. Furthermore, only 24.4 and 22.4% of Samoan women (> or =40 years) residing in Hawaii and Los Angeles, respectively, had an age-specific mammogram within the prior year. Independent predictors of age-specific CBE screening included age, education, health insurance, ambulatory visit, and being a resident of Hawaii or Los Angeles; those for mammography included ambulatory visit and awareness of screening guidelines. CONCLUSION: Population-based estimates of age-specific breast cancer screening among Samoan women are lower than the national objectives and those reported for other minorities. Targeted efforts that address doctor-patient communication on preventive behavior, improved access to health care services (especially in American Samoa), and focused educational awareness programs are needed to improve the dismal screening rates observed in this indigenous population.

Adult↗
PubMed1999

Dietary intake of modernizing Samoans: implications for risk of cardiovascular disease.

OBJECTIVE: To describe the dietary intake of American and Western Samoans, with emphasis on nutrients conventionally related to risk factors for cardiovascular disease. DESIGN: Cross-sectional dietary survey. Intake estimates were based on 24-hour recall interviews. SUBJECT: Community-based samples of 946 men and women (455 American Samoans, 491 Western Samoans) aged 25 to 55 years. STATISTICAL ANALYSES: Tests of differences in means (t tests) and proportions (chi 2 tests). Correlation and multivariate linear regression analyses were conducted to describe correlates of energy and nutrient intakes. RESULTS: Few differences were noted between the energy and nutrient intakes of men and women, but substantial differences were found between residents of American Samoa and those of the less modernized country of Western Samoa. American Samoans consumed significantly more energy as carbohydrate (47% vs 44%) and protein (18% vs 13%) and less as fat (36% vs 46%) and saturated fat (16% vs 30%). Energy-adjusted intakes of cholesterol and sodium were higher among American Samoans. These differences persisted after adjustment for age, gender, years of education, occupation, and categories of a 10-point material lifestyle score. Samoans in the lowest category of material lifestyle had significantly lower energy-adjusted intakes of protein, cholesterol, and sodium and higher intakes of saturated fat than those in the upper 2 categories. Additional analyses described the contribution of specific foods to the intakes of energy and macronutrients. CONCLUSIONS/APPLICATIONS: The observed energy and nutrient intake patterns are consistent with previously reported levels of obesity and risk factors for cardiovascular disease among Samoans and suggest dietary modification for those at highest risk. Dietetics practitioners who counsel Samoan and other Pacific Islander clients should be aware of these intake patterns, which seem particularly malleable to levels of personal income. More generally, results from this study illustrate that the food choices of certain ethnic groups may be profoundly affected by the process of modernization within a country or by migration to a more economically developed locale.

Adult↗
PubMed2001

Beliefs and attitudes of Samoan women toward early detection of breast cancer and mammography utilization.

BACKGROUND: Among Pacific Islanders in Hawaii, the breast has been the foremost cancer site. Among Samoans, it is a leading cancer site along with sites for respiratory cancers. A recent study reported that cancer has been diagnosed at relatively advanced stages in younger Samoans. METHODS: An exploratory, qualitative design was used with a semi-structured, open ended, talk story interview with Samoan women aged 40 years and older who spoke English and who had no personal history of breast cancer. The coding of interviews was validated with a faculty member unrelated to the study. Interviews were stopped at 15 participants once thematic patterns were saturated. Content analysis was performed. Triangulation to validate results was performed with research assistants and one participant. RESULTS: Participants ranged from 40-73 years of age, had lived in the U.S. 3-40 years, and most were married, born in Samoa or American Samoa, and had health insurance. Their education ranged from ninth grade to some college. Their health promotion activities included eating right, exercising, immunizing their children, and visiting their physician for an annual examination. Most had had positive or neutral experiences with western health care. Most reported that they would use Samoan medicine if available. Priorities reported were health, family, and education. Women considered the care and health of their families their responsibility. All had negative perceptions of cancer. Most had had mammograms. Reported major barriers to mammography were fear, not a priority, and pain. Reported major motivators were physician recommendation, prevention, and fear. Over half of the women reported concern over their breasts being touched either by themselves or by others. CONCLUSIONS: The study participants had strong beliefs that cancer meant death and, therefore, no cure. Samoan women emphasized the health and education of their families and their role in family health care. Therefore, health care providers should promote health and breast screening by emphasizing that family health care also means caring for oneself. Although Samoan women reported that they used western health care, most women also were willing to use traditional Samoan medicine if it was available. Their understanding the causes of cancer included currently accepted explanations and uncommonly accepted views of causation. Correcting misinformation, teaching, addressing fears (motivators as well as barriers), using female health providers for screening, conveying respect for privacy and person, reinforcing that examination of the breast is not sexual, and gently handling breasts during examinations are important considerations for the prevention of breast cancer in Samoan women.

Adult↗
PubMed1987

Population forecasts for South Pacific nations using autoregressive models, 1985-2000.

"This paper uses an autoregressive statistical model to forecast population for Fiji, Western Samoa, Tonga, Solomon Islands, and Vanuatu and compares these forecasts with those obtained from other methods. The growth rate of population is predicted to continue to fall in Fiji and Tonga, rise a little for Western Samoa, and rise considerably in Vanuatu and the Solomon Islands. The implications of the forecasts for recent government development plans are also discussed."

Demography↗
PubMed1993

Acculturation and symptoms: a comparative study of reported health symptoms in three Samoan communities.

A health questionnaire, which included a 91 item list of symptoms was administered to three groups of young Samoan adults. These young adults resided in a traditional Samoan village in Western Samoa (n = 50), several villages in modernizing American Samoa (n = 50) and in urban Honolulu, Hawaii (n = 52). Each yes response to a symptom was followed by an expanded interview providing details. The yes answer frequency and the contents of the expanded answers were examined with respect to site of residence. Western Samoan responses differed from the other sites in a number of areas suggesting possible differences related to the process of modernization. These response differences suggest four areas in which the stressors of modernization may have health influences: (1) wage employment outside of the family, (2) increased size of support networks by including non-family members and non-Samoans (3) the greater availability of alcohol, and (4) changes in the perceptions of food.

Acculturation↗
PubMed1998

Perceptions of body size in Pacific Islanders.

OBJECTIVE: To assess attitudes to body size and obesity in Samoans, a Pacific island group characterised by very high levels of obesity and traditionally strong positive cultural views of large bodies. DESIGN: Cross sectional study of Samoan adults in Samoa and New Zealand. SUBJECTS: 84 female and 77 male Samoans in Samoa and 41 female and 24 male Samoans in Auckland, New Zealand, aged 25-55 y. MEASUREMENT: Body mass index (BMI), standardised survey questionnaires of perceptions of bodyweight and health, diet and exercise, and perception of body sizes on a continuous scale. RESULTS: Although Samoans in both countries display high population levels of obesity, ideal body sizes are slim and body dissatisfaction and attempted weight losses were apparent. However, women and men above normal weight did not characteristically perceive themselves as obese, were as positive about their body size, weight and health, and obese women were no more likely to be attempting to lose weight than their slimmer peers. CONCLUSIONS: The traditional Samoan veneration of large bodies is not apparent as ideal body sizes are slim. An important difference in values with Western industrialised societies is the absence of a strongly negative view of obesity.

Adult↗
PubMed2002

Human leptin locus (LEP) alleles and BMI in Samoans.

OBJECTIVES: Because of their location in known candidate gene regions for obesity the associations between six microsatellite markers (D2S2170, D2S144, D2S1268, D2S1788, D2S1348 and a tetranucleotide repeat in the 3' UTR of the LEP locus) and body mass index (BMI) were studied in adult Samoans. DESIGN: The study was designed to detect differences in the proportion of alleles at the six microsatellite markers between two groups of adult Samoans at the extremes of the longitudinal BMI distribution. SUBJECTS AND MEASUREMENTS: The 181 unrelated Samoan participants were 25-55 y of age, reported that all four grandparents were Samoan, resided in American Samoa (AS) or Samoa (S) and were without diagnosed hypertension or type 2 diabetes. Initial statistical analysis was based on chi(2) tests of independence between marker allele frequencies and BMI status at each marker. The association of individual alleles with BMI status was tested by aggregating a marker's allelic data into a two-by-two contingency table and applying a two-tailed version of Fisher's exact test, with a Bonferroni correction to account for the multiple testing implicit in the procedure. RESULTS: There were no significant differences in allele frequencies at any of the markers between AS and S, as expected from our prior population genetic analyses. Only the LEP gene 3'-tetranucelotide repeat was associated (P<0.006) with BMI status. The distribution of the marker alleles at the LEP locus was significantly associated with the BMI groups (P<0.01), due to the low frequency of allele 226 in the high BMI group. The same pattern of association was found in sub-group analyses with low BMI individuals from AS and high BMI individuals from S. CONCLUSION: These findings indicate that the leptin 3'-tetranucleotide repeat is associated with high BMI in adult Samoans, with allele 226 having a low frequency in the high BMI group.

3' Untranslated Regions↗
PubMed1990

The interplay of culture and symptoms: menstrual symptoms among Samoans.

Menstrual symptomatology has received much attention in recent years but little attention has been given to the interplay of culture with these symptoms. Interview data from male and female Samoans in rural Western Samoa, rapidly modernizing American Samoa, and modern Hawaii are used to explore the role of culture and culture change in explaining variations in reports of menstrual symptomatology and menstrual distress. I suggest that culture plays a significant role in the recognition, evaluation, and expression of menstrual symptoms, and thus culture must be considered along with biological and psychosocial variables in the evaluation of symptomatological differences, including differences in number and kind.

Attitude to Health↗
PubMed2001

Type 2 diabetes and three calpain-10 gene polymorphisms in Samoans: no evidence of association.

Although genomewide scans have identified several potential chromosomal susceptibility regions in several human populations, finding a causative gene for type 2 diabetes has remained elusive. Others have reported a novel gene, calpain-10 (CAPN10), located in a previously identified region on chromosome 2q37.3, as a putative susceptibility gene for type 2 diabetes. Three single-nucleotide polymorphisms (SNPs) (UCSNP43, UCSNP19, and UCSNP63) were shown to be involved in increased risk of the disease among Mexican Americans. We have tested the association of these three SNPs with type 2 diabetes among the Samoans of Polynesia, who have a very high prevalence of the disease. In the U.S. territory of American Samoa, prevalence is 25% and 15% in men and women, respectively, whereas, in the independent nation of Samoa, prevalence is 3% and 5% in men and women, respectively. In our study sample, which consisted of 172 unrelated affected case subjects and 96 control subjects, we failed to detect any association between case subjects and control subjects in allele frequencies, haplotype frequencies, or haplotype combinations of UCSNP43, -19, and -63. Also, our data showed no evidence of linkage, among 201 affected sib pairs, in the region of chromosome 2 that contains these SNPs. Three plausible scenarios could explain these observations. (1) CAPN10 is a susceptibility gene only in particular ethnic groups; (2) our study lacks power to detect the effects of CAPN10 polymorphisms (but our sample size is comparable to that of earlier reports); or (3) the underlying biological mechanism is too complex and requires further research.

Adult↗
PubMed1987

Lactose malabsorption in Polynesian and white children in the south west Pacific studied by breath hydrogen technique.

Lactose malabsorption was studied by a breath hydrogen technique in 139 Samoan and 68 white schoolchildren. The Samoans were studied in four locations, two in Western Samoa and two in New Zealand, and the white children in both the Cook Islands and New Zealand. The prevalence of malabsorption varied with location: for Samoans it ranged from 41% to 60% in Western Samoa and 0% to 35% in New Zealand; white children had rates of 27% in the Cook Islands and 5% in New Zealand. Environmental factors rather than genetic factors are likely to play the main part in initiating if not perpetuating lactose malabsorption. In both races lactose malabsorption had no effect on the acceptance of, consumption of, and number of gastrointestinal symptoms caused by milk and milk biscuits. Children who had symptoms after consuming a particular dairy product were more likely to say they disliked it than those who reported no symptoms.

Adolescent↗