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PubMed1999

Hazards of smoking initiation among Asian American and non-Asian adolescents in California: a survival model analysis.

BACKGROUND: Information about the risk of smoking initiation among whites, African Americans, and Latino Americans has provided an important information base for smoking prevention programs among adolescents from these ethnic backgrounds. Unfortunately, there is a lack of such information for Asian Americans, a fast-growing ethnic minority group with much internal diversity. METHOD: This study used cross-sectional data from 20,482 subjects 12-17 years of age, randomly sampled in California, to describe and compare the risk of smoking initiation for adolescents by age among Asian American and other non-Asian ethnic groups, using survival analysis. Computer-aided telephone interview techniques were used in data collection. RESULT: The risk of early smoking initiation among Asian American adolescents is about a third of that of Caucasians. However, the risk among Asian Americans continues to increase throughout adolescence, while the same risk among Caucasians and African Americans plateaus around 14-15 years of age. Significant differences in the levels and patterns of smoking initiation among Asian American subgroups were observed, with Chinese Americans showing the lowest risk of smoking initiation and Filipino Americans the highest, Japanese and Korean Americans being in-between. CONCLUSION: Asian American adolescents may be especially at risk of smoking initiation later in adolescence, even though they are at lower risk early in adolescence. Smoking prevention programs for Asian Americans should continue throughout adolescence and early adulthood.

Adolescent↗
PubMed1979

A comparative study of hepatitis B viral markers in the family members of Asian and non-Asian patients with hepatitis B surface antigen-positive hepatocellular carcinoma and with chronic hepatitis B infection.

Serologic tests for evidence of hepatitis B virus (HBV) infection were performed on family members of Asian and non-Asian patients with either hepatitis B surface antigen (HBsAg)-positive hepatocellular carcinoma or chronic HBV infection. Asian family members had a significant increase of HBsAg (34% higher) and of antibody to HBsAg or of antibody to hepatitis B core antigen (50% higher) when they were compared with non-Asian family members. In the Asian group, viral markers were detected more frequently in blood relatives than in nonblood relatives of the index cases. Within this group, birthplace did not influence the frequency of antigenemia, since HBsAg was positive in 55 (44%) of 125 Asians born in Asia and in 36 (38%) of the 94 Asians who were born in the United States. Also, HBsAg positivity frequently was seen in offspring from HBsAg-positive carrier mothers as well as from HBsAg-positive carrier fathers whose spouses were either HBsAg-negative or who had antibody. The e antigen was found more often in individuals 30 years of age or younger than in older individuals. This study indicates that intrafamilial spread of HBsAg in Asian families plays an important role in the perpetuation of HBV infection and in the eventual development of chronic liver disease in this ethnic group.

Adolescent↗
PubMed2004

Outcome of renal transplantation in South Asian recipients is similar to that in non-Asians.

BACKGROUND: The United Kingdom has a large South Asian population, in which there is a high rate of renal disease and which forms a significant percentage of the renal transplant waiting list. Information about short- and long-term transplant outcomes in this ethnic group is limited, although it has been suggested that graft survival is poorer in this population compared with non-Asians. METHODS: The authors examined the outcome and determinants of medium-term (5-year) survival in 245 renal transplants, 53 of which were performed in South Asian patients between 1995 and 2002. RESULTS: Three-year survival with a functioning graft was 89% for the non-Asians and 85% for the South Asians. At 5 years, this deviated to 83% and 70%, respectively, for the two groups, but this did not reach statistical significance. Acute rejection rates were similar in the two groups. South Asian ethnicity was not a significant predictor of medium-term graft loss in the authors' study. CONCLUSIONS: In this cohort of patients, South Asian ethnic background did not confer a survival disadvantage after renal transplantation.

Adolescent↗
PubMed1995

Motivation and mathematics achievement: a comparative study of Asian-American, Caucasian-American, and east Asian high school students.

This study examined the motivation and mathematics achievement of Asian-American, Caucasian-American, and East Asian students. Subjects were 304 Asian-American, 1,958 Caucasian-American, 1,475 Chinese (Taiwan), and 1,120 Japanese eleventh graders (mean age = 17.6 years). Students were given a curriculum-based mathematics test and a questionnaire. Mathematics scores of the Asian-American students were higher than those of Caucasian-American students but lower than those of Chinese and Japanese students. Factors associated with the achievement of Asian-American and East Asian students included having parents and peers who hold high standards, believing that the road to success is through effort, having positive attitudes about achievement, studying diligently, and facing less interference with their schoolwork from jobs and informal peer interactions. Contrary to the popular belief that Asian-American students' high achievement necessarily takes a psychological toll,they were found not to report a greater frequency of maladjustive symptoms than Caucasian-American students.

Acculturation↗
PubMed2000

Anchor epicanthoplasty combined with out-fold type double eyelidplasty for Asians: do we have to make an additional scar to correct the Asian epicanthal fold?

The epicanthal fold along with a lack of a superior palpebral fold, excessive fat, and laxity of pretarsal skin represent the ethnic characteristics and a traditional sense of beauty in the Asian upper eyelid. But, too prominent an epicanthal fold may ruin an otherwise beautiful eye; furthermore, it becomes a restriction that makes the out-fold type double eyelidplasty, one of the two main types of double eyelidplasty, impossible. If a double eyelid as an out-fold type is desired, a concomitant epicanthoplasty should be performed with the possibility of hypertrophic scarring of the medial canthal area in Asians. To address the Asian epicanthal fold without danger of hypertrophic scarring, the authors developed an anchor epicanthoplasty technique that leaves no additional scar when combined with a double eyelidplasty. This technique is based on the concept of trimming of muscle and soft tissue under the Asian epicanthal fold and downward medial advancement and anchoring of the medial canthal skin to the deep tissue. The technique consists of five procedures based on the assumed causes of the Asian epicanthal fold: (1) augmentation rhinoplasty, (2) downward medial advancement of the medial upper lid skin, (3) removal of the superficial insertion of the medial canthal ligament and selective removal of the orbicularis oculi muscle, (4) subcutaneous contouring of the thick nasal skin, and (5) anchoring of the medial end of the incision to the deep tissue. During the past 12 years (1988 to 1999), 67 anchor epicanthoplasty procedures have been performed. Twenty-eight cases were followed up for more than 3 months, and all of the patients were satisfied with the results. There were only a few minor complications, which could be corrected with minimal revision. As an ancillary procedure to a double eyelidplasty, this anchor epicanthoplasty can reduce the Asian epicanthal fold and make a double fold as an out-fold type without an additional scar. In terms of hypertrophic scarring and compatibility with out-fold type double eyelidplasty, this anchor epicanthoplasty is the best method for correcting Asian epicanthal fold compared with other preexisting procedures. Other advantages of this technique are a wide range of applications and no compromise of medial, canthal skin to interfere with other epicanthoplasty techniques. Some disadvantages of this technique are technical difficulty and the possibility of active bleeding.

Adolescent↗
PubMed2005

High-density lipoprotein subclass distribution in individuals of Asian Indian descent: the National Asian Indian Heart Disease Project.

Individuals of Asian Indian descent have significantly higher cardiovascular event rates as compared with other ethnic groups. The authors investigated the prevalence of metabolic disorders linked to coronary artery disease in an Asian Indian male population compared with non-Asian Indian males. Standard lipid measurements did not discriminate between groups, and the Asian Indian group exhibited less of the high coronary artery disease risk small low-density lipoprotein trait. Despite less of the small low-density lipoprotein trait in the Asian Indian group and no difference in high-density lipoprotein cholesterol, the Asian Indian group had a significantly higher prevalence (p < 0.0002) of low high-density lipoprotein 2b, implying impaired reverse cholesterol transport. This observation remained significant in the subgroup of patients with high-density lipoprotein cholesterol over 40 mg/dL, a region felt not to reflect impaired reverse cholesterol transport. Low high-density lipoprotein 2b combined with the higher lipoprotein(a) in the Asian Indian group may help explain the high prevalence of coronary artery disease in this ethnic population.

Cholesterol↗
PubMed1984

Occurrence of cancer in Asians and non-Asians.

Cancer registration data for a defined geographical area, covering a seven year period, were modified to include the variable "Asian ethnic origin." The data were then used to test the hypothesis that a difference would be found between Asians and non-Asians in the pattern of cancer by site. Whereas the incidence of cancer of all sites appeared to be significantly lower in Asians (p less than 0.05), after taking account of this, and adjusting for the very different age distributions of the two populations, a highly significant difference (p less than 0.0005) was found between the two groups in the distribution of cancer between sites. Although, given the size and young age structure of the Asian population, absolute numbers of cases were small, a significant excess of Asian cases (compared with the expected) occurred for cancer of the tongue, oral cavity, pharynx, and oesophagus. For most sites there were fewer Asian cases than would be expected, particularly so for the stomach, testis, and skin. The results indicate the need for formal epidemiological study to test specific aetiological hypotheses which may account for these apparent differences.

Asia↗
PubMed2005

Molecular genetic confirmatory testing from newborn screening samples for the common African-American, Asian Indian, Southeast Asian, and Chinese beta-thalassemia mutations.

beta-Thalassemia is a serious health problem in the United States, especially in California, due to increased Asian immigration. Neonatal screening by using high-performance liquid chromatography (HPLC) or isoelectric focusing (IEF) may lead to confusion due to interactions of various hemoglobinopathies with beta-thalassemia. Our purpose was to develop single-tube multiplexed PCR assays using original neonatal screening specimens to identify the mutations responsible for beta-thalassemia in order to expedite diagnostic confirmation. Primers were designed for two to six common ethnic-specific mutations using the amplification refractory mutation system (ARMS). This multiplex ARMS approach was standardized using DNA samples with known mutations for beta-thalassemia in those of Asian (Southeast Asian, Chinese, and Asian Indian) and African-American descent. Specimens from African-American neonates were tested for two mutations (-88 and -29); Asian Indians for five mutations (IVSI-1, IVSI-5, codons (Cd) 41/42, Cd 8/9, and 619-bp deletion); Chinese, Taiwanese, and Southeast Asians for seven mutations (Cd 41/42, Cd 17, -28, IVSII-654, Cd 71/72, IVSI-5, and IVSI-1). We identified each of these beta-thalassemia mutations in multiplexed ARMS from positive control samples. We tested 25 anonymized dried blood specimens from neonates who had been diagnosed with beta-thalassemia and who also belonged to these ethnic groups. We detected a mutation specific to the neonate's ethnic group using the ARMS approach in nearly all specimens, and the results were confirmed by sequencing. Multiplexed ARMS for ethnic-specific beta-thalassemia mutations from the original newborn screening dried blood specimens is a rapid and efficient approach for diagnostic confirmation.

Asian People↗
PubMed2002

Asian and Asian-American college students' awareness of osteoporosis.

STUDY OBJECTIVE: To quantify Asian and Asian-American college students' knowledge of osteoporosis and preventive health behaviors. DESIGN: Sixty-four-question survey SETTING: University of Minnesota. SUBJECTS: One hundred sixty-eight male and female Asian and Asian-American students, mean age 21 +/- 3.4 years. MAIN RESULTS: About half of the students consumed 0-1 servings/day of dietary calcium, 42% consumed 2 cups/day or more of caffeinated beverages, 8% smoked cigarettes, and 61% exercised 2.5 hours/week or less. At least 1 serving/day of phytoestrogen was consumed by 80% of the students. Only 11% of students answered at least 75% of osteoporosis fact questions correctly. Women (p = 0.011) and the United States-born participants (p = 0.006) were more apt to change their health behaviors to prevent or treat osteoporosis than men and Asia-born participants. Thirty-eight percent of Hmong participants attributed osteoporosis to fate, chance, or luck whereas Vietnamese participants were more likely to attribute osteoporosis to diet. Most participants (63%) did not know whether their culture objected to estrogen replacement therapy, and 42% said menopause was a natural occurrence for which pharmacologic treatment should not be administered. CONCLUSIONS: Many Asian and Asian-American college students did not practice health behaviors to prevent osteoporosis, and most lacked sufficient knowledge about the condition.

Adult↗
PubMed2006

Prevalence of microalbuminuria and hypertension in South Asians and white Europeans with type 2 diabetes: a report from the United Kingdom Asian Diabetes Study (UKADS).

Microalbuminuria is more common in South Asian individuals compared to white Europeans. The aim of this study was to determine the relationship between blood pressure and microalbuminuria in a cohort of patients with type 2 diabetes in these two ethnic groups. These further data were analysed from 552 patients (311 South Asian patients and 241 white Europeans) who had microalbuminuria screening data collected. Prevalence of microalbuminuria was significantly higher in South Asian compared with white European patients (31% versus 20%, p=0.007). Among patients with normal, untreated blood pressure, the proportion who had microalbuminuria was three times higher among South Asian patients compared with the white European group (30.7% versus 10.1%, p=0.049, relative risk = 3.1 [1.0-9.5]). In addition, despite their higher cardiovascular risk, South Asian patients were less likely to be prescribed a statin or antihypertensive drug treatment. In conclusion, thresholds and targets for treatment of cardiovascular risk factors in South Asians may need to be lower than those for white Europeans, and targeted intervention will be required to achieve this.

Adult↗
PubMed1995

Brief symptom inventory scores of Asian, Asian-American, and European-American college students.

Brief Symptom Inventory scores of Asian, Asian-American, and European-American university students were examined. It was hypothesized that Asian-Americans with low-medium levels of acculturation would show levels of distress similar to those found with Cheng, Leong, and Geist's sample of international Asian college students, whereas Asian-American research participants with higher levels of acculturation would report levels of distress more similar to European-American college students. The results indicated support for the influence of level of acculturation on the reporting of distress on the BSI and further indicated the need for future research on Asian-Americans to examine gender effects in addition to acculturation.

Acculturation↗
PubMed1996

Plasminogen activator inhibitor (PAI-1) activity is elevated in Asian and Caucasian subjects with non-insulin-dependent (type 2) diabetes but not in those with impaired glucose tolerance (IGT) or non-diabetic Asians.

In order to study the plasminogen activator inhibitor activity (PAI-1) in subjects at different risk of non-insulin-dependent diabetes and ischaemic heart disease we examined 89 subjects with diet controlled NIDDM (49 Caucasian, 40 Asian), 29 with impaired glucose tolerance (IGT) (13 Caucasian, 16 Asian), and 149 with normal glucose tolerance (67 Caucasian, 82 Asian). Diabetes was diagnosed by WHO criteria and highly specific, monoclonal antibody-based assays were used to measure insulin, intact proinsulin, and des 31,32 proinsulin. Subjects with NIDDM were significantly more obese, had more central distribution of obesity, higher fasting plasma specific insulin concentrations (NIDDM median 74 pmol l-1 vs IGT 41 pmol l-1, p < 0.01 and vs normals 34 pmol l-1, p < 0.001) and higher PAI-1 activity than normals and those with IGT (NIDDM 23.0 +/- 6.9 vs IGT 16.8 +/- 5.0, p < 0.001 and vs normals 17.1 +/- 6.9 AU ml-1, p < 0.001). However, PAI-1 activity was not significantly different between Asian and Caucasian normals (17.5 +/- 7.3 vs 16.5 +/- 6.4 AU ml-1, p = ns) and diabetic (22.8 +/- 7.3 vs 23.1 +/- 6.6 AU ml-1, p = ns) subjects. In addition to relationships with obesity and plasma triglyceride, PAI-1 activity, after controlling for age, sex, body mass index, and waist-hip ratio, was related to fasting insulin (partial r = 0.22, p < 0.001), intact proinsulin (partial r = 0.36, p < 0.001), and des 31,32 proinsulin concentrations (partial r = 0.33, p < 0.001) as measured by highly specific assays. The association of PAI-1 with diabetes was weakened but remained statistically significant (p = 0.042) after controlling for age, sex, ethnicity, obesity, plasma triglyceride, and all insulin-like molecules. We conclude that, although PAI-1 activity is raised in subjects with diet-treated NIDDM, it is normal in subjects with IGT and non-diabetic Asians, populations at high risk of NIDDM and ischaemic heart disease. Raised PAI-1 activity may play an important role in the pathogenesis of macrovascular disease in subjects with NIDDM, but is unlikely to explain excess risk of ischaemic heart disease in Asians and those with impaired glucose tolerance.

Analysis of Variance↗
PubMed1996

Patients' knowledge of anatomical location of major organs within the human body: a comparison between Asians and non-Asians.

OBJECTIVE: This study was designed to ascertain lay knowledge of the anatomical location of major organs within the human body amongst the Asian and non-Asian population in Leicester and to explore the relationships of this knowledge to level of education and social class. METHOD: The study was based on a cross sectional random sample stratified by from the FHSA Nominal Index Register and data was collected using a personally administered questionnaire in the preferred language of the respondent. Subjects marked the position of the major organs (heart, lungs, kidneys, bladder, liver, brain and stomach) on an image of the human body. The answers were judged against a correct 'response area' produced from a survey of 20 GPs. RESULTS: The overall response rate to the survey was 88.5% with 449 Asians and 447 non-Asians participating. After adjustment for age, sex, education and social class differences, non-Asians were significantly more likely to correctly identify the position of the lungs (P = 0.01) and less likely than Asians to correctly identify the position of the stomach (P < 0.0001). There were no differences found in the knowledge of the position of the other organs. Higher educational attainment was significantly associated with the ability to locate the kidneys (P = 0.0052) and the liver P = 0.0001) and higher social class was associated with greater ability to locate the position of the lungs P = 0.01). CONCLUSIONS: Patients show considerable lack of knowledge of the position of major organs within the body. Health professionals will need to address this before embarking upon health promotion.

Adolescent↗
PubMed2005

Promoting organ donation and transplantation among South Asians in the United Kingdom: the role of social networks in the South Asian community.

The percentage of South Asians on the kidney transplant waiting list in the United Kingdom is 3 times their percentage in the general population. Obviously, organ donation and transplantation among South Asians in the United Kingdom needs improvement. In recent years, ethnically targeted campaigns in the mass media have specifically attempted to attract donors from the South Asian communities. A number of pilot studies have been done to evaluate the effectiveness of these initiatives in providing information about organ donation to South Asians. Results indicate that detailed information related to transplantation was learned mainly by people within the community receiving transplants and was transmitted through various informal community networks rather than through the resources provided by the Department of Health. This article provides an overview of who South Asians are and how these community networks were established. Transplant professionals must devise effective strategies to access these community networks, thereby raising the consciousness of transplantation among South Asians in the United Kingdom.

Attitude to Health↗
PubMedDate not supplied

Disparities in cancer treatment outcomes among asian americans: implications for the asian american network for cancer awareness, research and training.

PURPOSE: The purpose of this paper is to describe the scope of concern of Asian Americans in cancer treatment. METHODS: AANCART, the Asian American Network for Cancer Awareness, Research and Training, is a project whose goal includes promoting the well-being of Asian Americans through educating the public, increasing data on cancer, and helping health care providers better treat their Asian American patients. FINDINGS: In many instances, Asian Americans have the highest cancer rate compared with other ethnic groups. Knowledge gaps exist for both the patient and the health professional, preventing proper assessment of the patient's needs. CONCLUSIONS: Asian Americans are difficult to reach because of bipolar population distributions, cultural barriers, and lack of patient care data. With the efforts of AANCART, this racial group should be able to reduce some of the cancer treatment disparities that currently exist.

Journal Article↗
PubMed2001

STATT: a titrate-to-goal study of simvastatin in Asian patients with coronary heart disease. Simvastatin Treats Asians to Target.

BACKGROUND: Most published studies on the use of lipid-lowering agents to treat hypercholesterolemia have focused on Western populations, with few data on Asian populations. OBJECTIVE: The Simvastatin Treats Asians to Target (STATT) study used a titrate-to-goal protocol to evaluate the efficacy and tolerability of simvastatin 20 to 80 mg/d in the treatment of Asian patients with coronary heart disease. METHODS: This was a multicenter, open-label, uncontrolled, 14-week study in patients with coronary heart disease and serum low-density lipoprotein cholesterol (LDL-C) levels of 115-180 mg/dL and triglyceride levels of < or = 400 mg/dL. The dose of simvastatin was titrated from 20 to 80 mg/d to achieve the National Cholesterol Education Program (NCEP) LDL-C target of < or = 100 mg/dL. The primary efficacy measure was the percentage of patients achieving the NCEP target. Among secondary measures were the percentage of patients achieving European Society of Cardiology/European Atherosclerosis Society/European Society of Hypertension target LDL-C levels of < or = 115 mg/dL and the percentage change from baseline in lipid parameters. Tolerability was assessed in terms of the overall incidence of adverse experiences and the incidences of the most commonly reported adverse experiences. RESULTS: The intent-to-treat analysis included 133 Asian patients (93 men, 40 women; mean age, 59.5 years), of whom 125 completed 14 weeks of therapy. Their mean blood pressure was 130.2/79.4 mm Hg. Overall, 104 (78.2%) patients treated with simvastatin achieved LDL-C levels < or = 100 mg/dL at week 14, and 125 (94.0%) achieved this target at some point during the study. Similarly, 122 (91.7%) patients achieved an LDL-C level < or = 115 mg/dL at week 14, and 130 (97.7%) achieved this target at some point during the study. Treatment with simvastatin had favorable effects on the lipid profile, producing significant percentage changes from baseline in all parameters (P < 0.001). Simvastatin was well tolerated across the dose range. Overall, 40 patients (30.1%) had > or = 1 clinical adverse experience. Only 14 (10.5%) had adverse experiences that were possibly, probably, or definitely related to study drug; none of these experiences were considered serious. The most common adverse experiences (> or = 3% incidence) were abdominal pain (6%); chest pain (5%); dizziness (4%); and asthenia/fatigue, fibromyalgia, headache, insomnia, and upper respiratory tract infection (3% each). No new or unexpected adverse experiences were seen at the higher doses. CONCLUSIONS: Simvastatin was effective and well tolerated at doses of 20, 40, and 80 mg/d in Asian patients with coronary heart disease. Titration enabled the majority to achieve target LDL-C levels of < or = 100 mg/dL.

Aged↗
PubMed2005

Child physical abuse: prevalence, characteristics, predictors, and beliefs about parent-child violence in South Asian, Middle Eastern, East Asian, and Latina women in the United States.

The present study examined the prevalence, characteristics, beliefs, and demographic predictors of parent-child physical violence among South Asian, Middle Eastern, East Asian, and Latina women in the United States. Two hundred fifty-one college-educated women from a middle to high SES (South Asian/Middle Eastern, n = 93; East Asian,n = 72; Latina,n = 86) completed a self-report survey on childhood experiences and beliefs regarding physical abuse. Seventy-three percent of the South Asian and Middle Eastern sample, 65% of the East Asian sample, and 78% of the Latina sample reported experiencing at least one type of physical abuse. Significant differences in characteristics and perpetrators of abuse were found across groups. Demographic factors did not predict physical abuse. Experiencing physical abuse was the only predictor for acceptance of physical discipline and as a parental privilege or right across groups. Implications of alternate cultural models of family violence based on beliefs and exposure to violence are discussed.

Adult↗
PubMed2006

Use of mental health-related services among immigrant and US-born Asian Americans: results from the National Latino and Asian American Study.

OBJECTIVES: We examined rates of mental health-related service use (i.e., any, general medical, and specialty mental health services) as well as subjective satisfaction with and perceived helpfulness of care in a national sample of Asian Americans, with a particular focus on immigration-related factors. METHODS: Data were derived from the National Latino and Asian American Study (2002-2003). RESULTS: About 8.6% of the total sample (n=2095) sought any mental health-related services; 34.1% of individuals who had a probable diagnosis sought any services. Rates of mental health-related service use, subjective satisfaction, and perceived helpfulness varied by birthplace and by generation. US-born Asian Americans demonstrated higher rates of service use than did their immigrant counterparts. Third-generation or later individuals who had a probable diagnosis had high (62.6%) rates of service use in the previous 12 months. CONCLUSIONS: Asian Americans demonstrated lower rates of any type of mental health-related service use than did the general population, although there are important exceptions to this pattern according to nativity status and generation status. Our results underscore the importance of immigration-related factors in understanding service use among Asian Americans.

Adolescent↗