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PubMedDate not supplied

Barriers to increasing native Hawaiian, Samoan, and Filipino nursing students: perceptions of students and their families.

This article presents the results of an innovative approach to increase the numbers of native Hawaiian, Samoan, and Filipino students who enroll in and complete the bachelor of nursing in science degree. The approach used 2 methods to obtain input. The first was a series of focus groups comprising current and potential students in the nursing program. The second method was a survey of community elders, parents, and high school students in schools with large enrollments of native Hawaiians, Samoans, and Filipinos. The results made clear that Asian Pacific Islanders are composed of distinct groups that have many diverse concerns that need to be addressed in the recruitment and retention phases. One surprise was the low interest in incorporating traditional healing into the curriculum. It was clear that high school students should be given information on nursing early and effectively because this is a key component of their interest in a nursing career.

Attitude↗
PubMed2004

Persistence of an extreme sex-ratio bias in a natural population.

The sex ratio is a key parameter in the evolution and ecology of a species. Selfish genetic elements that bias the sex ratio of affected individuals are well known and characterized, but their effect on populations has been considered limited, because either the element does not achieve high prevalence or the host rapidly evolves resistance to the distorting element, reducing its prevalence. We tested whether the host necessarily prevails by using a butterfly system where records from the early part of the 20th century reported extreme sex-ratio bias in nature. We reexamined this population and found the bias was present today, 400 generations after the original record, with a population sex ratio of 100 females per male. The sex-ratio bias was associated with the presence of a heritable male-killing Wolbachia infection in 99% of adult females, against which the host butterfly has failed to evolve resistance. The resultant dearth of males causes an average 57% reduction in the reproductive output of adult females. Persistence of the population despite the very high frequency of the sex-ratio distorter appears to be associated with the ability of males to mate >50 times in their life combined with a high intrinsic rate of increase of the species.

Animals↗
PubMed1990

Migration, changing gender roles and stress: the Samoan case.

The impact of migration and social change on male and female role expectations is examined in an urban Samoan community. Expanding role expectations and role conflicts in the urban context are linked to differential experiences of stress by gender, which are in turn examined with respect to the health outcomes of arterial pressure, a measure of physical health status, and a psychosomatic complaint index.

Adult↗
PubMedDate not supplied

Inter-population comparisons of catecholamine excretion.

Twenty-four hour urines were obtained from groups of male and female volunteers recruited from urban populations in developed and developing countries (UK, USA, Japan and Nigeria) an from agriculture-based Polynesian population (Tokelau Islands). The urines were collected on typical working days, with minimal disturbance to subjects' normal routines. High-performance liquid chromatography was used to determine catecholamine concentrations in each urine, providing a basis for calculation of total 24-hour excretion. Mean 24-hour excretion of noradrenaline and adrenaline was low in the Polynesians compared to the modern, urban groups, and low in women compared to men. Discussion of the results includes assessment of the possible influences of artefact, physical characteristics of the population samples, physical environment and social and psychological factors.

Age Factors↗
PubMed2005

Ole Taeao Afua, the new morning: a qualitative investigation into Samoan perspectives on mental health and culturally appropriate services.

OBJECTIVES: The first objective was to develop a culturally appropriate research method to investigate Samoan perspectives on mental health issues. The second objective was to apply this to identify cultural values and understandings important in the care and treatment of Samoan people with mental health problems. METHOD: Gender-specific focus groups consisting of Samoan elders and service providers were facilitated by Samoan researchers in the Samoan language. Systematic analysis of the transcripts, adapted to the cultural context, were conducted in Samoan and later translated into English. RESULTS: A culturally derived method, referred to as Fa'afaletui, reflecting Samoan communal values and familiar institutional structures within the community, allowed each focus group to come to a consensual view on issues discussed. The Samoan self was identified as an essential concept for understanding Samoan views of mental health. This self was described as a relational self and mental wellness as a state of relational harmony, where personal elements of spiritual, mental and physical are in balance. Mental ill health was sometimes linked to breaches of forbidden and sacred relationships, which could be addressed effectively only within protocols laid down in the culture. Additional stressors contributing to mental ill-health were identified as low income, unemployment, rising housing costs and the marginalization of Samoan cultural norms in New Zealand. Participants identified the need for a culturally based mental health service for Samoan people to address key cultural factors. CONCLUSIONS: The Fa'afaletui method is a new research method which is sensitive and responsive to Samoan cultural norms and is methodologically rigorous. Such an approach may be relevant for other Pacific Island cultures and other cultures, which have a strong emphasis on collectivity. The Samoan concept of self provides a theoretical foundation for understanding the mental health needs of Samoan people and a basis for developing appropriate services.

Culture↗
PubMed2005

Samoan and psychiatrists' perspectives on the self: qualitative comparison.

OBJECTIVES: To compare psychiatrists' perspectives on the meaning of self, in general adult public practice psychiatry in the Wellington region of New Zealand, with a Samoan view of self and to discuss the implications for the practice of psychiatry with Samoan people in New Zealand. METHOD: A focus group of psychiatrists was convened for three sessions. A Samoan view of self was presented to the participants. Transcripts of the focus groups were analysed using inductive content analysis and a process of cultural accountability was included in the research design. RESULTS: Individual and secular notions of self dominated the psychiatrists' perspectives and contrasted with the primacy of relational and spiritual notions of self in Samoan culture. Psychiatrists experienced a sense of cultural 'dissonance' on first exposure to the Samoan views. The Samoan notion of self was considered to challenge the universalist assumptions of Western psychiatric theories as understood by the participants. The Samoan relational notion of self had implications for clinical interviewing, understanding of phenomenology, formulation and treatment planning with Samoan patients and their families. CONCLUSIONS: Dedicated Samoan or Pacific Island mental health services would allow culture-specific concepts central to an understanding of mental health to be embedded in service delivery. The process used in this study and the notion of dialectical tension could be used in the cultural education of mental health clinicians. The cultural accountability process models an important aspect of such training.

Attitude↗
PubMed1978

Zinc anc copper status of Polynesian residents in the Tokelau Islands.

Analyses for zinc and copper were performed in samples of serum, hair, toenails, and a 24-hr urine from Polynesian men and women resident in the Tokelau Islands. Selection of subjects was according to rank of systolic blood pressure obtained in a previous survey. The only difference in zinc anc copper values between the men and the women was a higher hair zinc concentration observed for the men. Rank of blood pressure had no influence on the measurements for zinc or copper, although within blood pressure ranks the men again had a higher hair zinc concentration than the women. Analysis of Tokelauan foods showed that most contained very low concentrations of zinc anc also low concentrations of copper. Octopus was one of the few rich sources of zinc and copper. Estimated daily dietary intakes (excluding water) were 4.5 mg Zn and 1.5 mg Cu. The reliability of measurements in serum, urine, hair, and toenails for assessing zinc and copper status is questioned.

Adult↗
PubMed1987

Physical activity and plasma total- and HDL-cholesterol levels in Western Samoan men.

This study examines effects of physical activity on plasma total- and high-density lipoprotein (HDL) cholesterol and derived variables in Western Samoan men who differ in rural/urban residence and occupation. Rural agriculturalists have significantly higher HDL cholesterol and HDL:total ratio than men employed in either physically active or physically sedentary occupations in an urban setting. Total cholesterol levels do not vary significantly, but when the differences in HDL cholesterol are accounted for, the means for agriculturalists and active workers are significantly lower than those for sedentary workers who do not play sports. These differences in HDL- and non-HDL-cholesterol levels are consistent with measures of physical activity among the groups. Variation in physical activity due to residence and occupation in Western Samoan men is related to lipoprotein cholesterol levels, but not to total cholesterol levels, and some effects may be secondary to differences in body composition.

Adult↗
PubMed1991

Obesity in Samoans and a perspective on its etiology in Polynesians.

For Samoans, modernization produces obesity and adiposity and concomitant increases in cardiovascular disease risk factors and outcomes. Massive adiposity and high prevalence of obesity characterizes modernizing adult Samoans. Mean body mass index (in kg/m2) at ages 25-54 y is 30-32 for males and 32-36 for females. Prevalence of overweight in female adults is 46% in traditional Western Samoans and 80% in migrants in Hawaii. Five-year longitudinal data show striking weight and fat gain, especially in younger adults and females. An evolutionary perspective on Polynesian adiposity is based on scenarios of the fates of sailors on the voyages of discovery and of settlers in the pioneer island villages. Efficient metabolisms producing rapid adipose-tissue growth could have increased survival among the first Polynesians. Rapid dietary and physical activity changes caused by modernization interacting with such population genetic predispositions may lead to the documented massive adiposity.

Acculturation↗
PubMed1996

Cancer among American-Samoans: site-specific incidence in California and Hawaii.

BACKGROUND: There is a paucity of data about cancer among American-Samoans, the largest Pacific Islander group after Hawaiians. This study provides the first data on the incidence and relative risk for all cancers among American-Samoans on the US mainland and in Hawaii. METHODS: The University of Southern California Cancer Surveillance Program and the Hawaii Tumor Registry, two population-based cancer surveillance programmes, provided archival data on American-Samoans residing in Los Angeles Country. California and in Hawaii, respectively. RESULTS: There were significant differences in the incidence and age-adjusted site-specific relative risk of cancers between American-Samoans, Hawaiians, and Anglos (non-Hispanic whites). In Hawaii, American-Samoans diagnosed with cancer compared with Hawaiians had a higher age-adjusted site-specific relative risk for cancers of the nasopharynx (especially males), liver, prostate, thyroid, and blood (especially females) and a lower relative risk for cancers of the colon, rectum (especially males), lung (especially females) and breast. Furthermore, compared with Anglos diagnosed with cancer in Hawaii, American-Samoans had a higher relative risk for cancers of the nasopharynx (especially males), stomach, liver, lung (especially males), corpus uteri, thyroid and blood, and a lower relative risk for cancers of the colon, skin, breast, testes, cervix uteri, bladder (especially males), and lymph nodes. A relatively similar profile of cancer distribution and relative risk was observed among American-Samoans and Anglos diagnosed with cancer in California. CONCLUSIONS: The data provide baseline information which has important implications for future cancer control research and prevention in this population.

Adolescent↗
PubMed1995

Pregnancy outcomes of Pacific islanders in Hawaii.

Percentages of low birth weight are low in American Indian and Mexican-American populations despite a high prevalence of traditional risk factors. Data derived from 1979-1990 Hawaii vital record files were used to examine birth weight, infant mortality, and their correlates in Samoan and Hawaiian residents of Hawaii to assess whether traditional risk factors are adequate predictors of low birth weight and whether low birth weight is an adequate measure of infant mortality risk in Polynesian populations. Despite very low educational attainment, high proportions of unmarried status, and inadequate prenatal care use, low and very low birth weight percentages were less than the US average. High birth weight was common. Unmarried status and primiparity after age 17 increased low birth weight risk, while high educational attainment and Samoan ethnicity decreased the risk. Adequate prenatal care was not associated with reduced low birth weight risk. Higher than expected neonatal mortality, particularly among normal birth weight infants, and high postneonatal mortality among Hawaiian infants suggest that poverty and maternal chronic disease, rather than low birth weight, may be the primary mediators of infant mortality risk in some populations. The need for clearer specification of risk factors and caution in generalized risk assessment in diverse populations is emphasized.

Adolescent↗
PubMed2004

Short-term intercultural psychotherapy: ethnographic inquiry.

This article examines the challenges specific to short-term intercultural treatments and recently developed approaches to intercultural treatments based on notions of cultural knowledge and cultural competence. The article introduces alternative approaches to short-term intercultural treatments based on ethnographic inquiry adapted for clinical practice. Such approaches allow clinicians conducting short-term intercultural treatments to foreground clients' indigenous conceptions of selfhood, mind, relationship, and emotional disturbance, and thus to more fully grasp their internal, interpersonal, and external worlds. This article demonstrates the uses of clinically adapted ethnographic inquiry in three short-term intercultural cases.

Adolescent↗
PubMed2000

Don't go!

Director of nursing (DON) turnover can be high, particularly in rural areas. To address it at your facility, learn the conditions that influence DON turnover.

Attitude of Health Personnel↗
PubMed1990

Tropical pulmonary eosinophilia.

Tropical pulmonary eosinophilia is an unusual pulmonary disorder caused by occult filariasis. Presentation can be varied and can mimic asthma, pulmonary tuberculosis, or atypical pneumonia. We have reported a case of tropical pulmonary eosinophilia mimicking lymphangitic carcinomatosis.

Breast Neoplasms↗
PubMed2003

Long term antibody response to hepatitis B vaccination beginning at birth and to subsequent booster vaccination.

BACKGROUND: Few studies have examined the long term persistence of antibody after hepatitis B immunization beginning at birth and the response to a subsequent challenge with a booster dose of vaccine. METHODS: Two groups of children received hepatitis B vaccine on a schedule of birth and 1 and 6 months of age. Group 1 received recombinant vaccine and a booster dose at 5 years of age. Group 2 received plasma-derived vaccine and a booster dose at 9 years of age. Group 1 children were tested for antibody after the primary vaccine series. All children were tested for antibody before administration of the booster dose and at 2 and 4 weeks and 1 year after the booster. In addition all children were tested for markers of hepatitis B virus infection. RESULTS: Antibody testing conducted after the primary series for children in Group 1 (n = 70) showed that 90% had protective antibody concentrations at 13 months of age, and testing before the booster dose showed that 41% had protective antibody concentrations. All children with protective antibody concentrations after the primary series had an anamnestic antibody response to the booster dose. In Group 2 (n = 41) 39% of children had protective antibody concentrations before the booster dose, and 93% had an anamnestic antibody response to the booster dose. One year after the booster dose there were 26-fold and 11-fold declines in antibody concentration in Groups 1 and 2, respectively. CONCLUSIONS: A primary vaccination series with either plasma-derived or recombinant hepatitis B vaccine affords long term protection for children when vaccinated beginning soon after birth.

American Samoa↗