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PubMed1999

The impact of modernisation on the diets of adults aged 20-40 years from Samoan church communities in Auckland.

The objective of this study was to describe the food and nutrient intakes of adults in three Samoan church communities located in Auckland, New Zealand. The study had a cross-sectional design and measured usual dietary intake in 437 participants, aged 20 years and over, using a self-completed, 89-item quantitative food frequency questionnaire. Median daily energy and nutrient intakes were calculated and compared by gender and age groups. Men obtained a significantly (p < 0.05) lower proportion of their energy from breads and cereals, fruits and vegetables and fats and oils than women. Compared to those aged 40+ years, those aged < 40 obtained a significantly (p < 0.01) lower proportion of their energy from meat, pulses and eggs, fruit and vegetables, and starchy staples. A significantly (p < 0.01) higher proportion of their energy intake came from takeaways, soft drinks, snacks and dairy products. Nutrient analysis revealed that those aged < 40 years obtained significantly (p < 0.001) more energy from fat and sugar, and less energy from protein (p < 0.001) than the older group. They also had significantly lower intakes, per 1000 kilocalories, of a wide selection of vitamins and minerals. A dietary transition has occurred for New Zealand Samoans, reflecting a shift from traditional to modern dietary patterns and a decline in the nutritional quality of the diet.

Adult↗
PubMed2001

Genetic effect of two APOA repeat polymorphisms (kringle 4 and pentanucleotide repeats) on plasma Lp(a) levels in American Samoans.

Elevated plasma lipoprotein(a) [Lp(a)] level has been established as an independent risk factor for atherosclerosis and coronary heart disease. Considerable ethnic group differences in the distribution of plasma Lp(a) levels have raised public health concerns. Recently, we have reported that Samoans have the lowest plasma Lp(a) levels of any population group. In the present investigation, we report the contribution of two apolipoprotein(a) (APOA) polymorphisms, the kringle 4 type 2 (K4) repeat and the pentanucleotide repeat (PNR), in affecting plasma Lp(a) levels in an American Samoan sample (n = 309). The K4 repeats ranged in size from 15 to 40. The common alleles contained repeats ranging from 26 to 36 with allele frequencies between 5.5% to 9.7%, and these accounted for 82% of all alleles. An inverse relationship between K4 repeat number and plasma Lp(a) level was observed for single-banded (r = -0.59, p = 0.0001) and double-banded phenotypes (r = -0.50, p = 0.0001). This polymorphism explained 60% of the variation in plasma Lp(a) level in American Samoans. For the PNR polymorphism, five different repeat alleles and eight different genotypes were identified; the most common allele was eight repeats. The *8 PNR allele was associated with a wide range of K4 repeats, the *9 PNR allele with larger K4 repeats (25-40), and the *10 PNR with smaller K4 repeats (15-24). Analysis of variance (ANOVA) revealed that the PNR polymorphism accounts for 2.1% of the variability in plasma Lp(a) levels in this sample, when the K4 repeat polymorphism was taken into account. Our data show that common polymorphisms in the APOA gene are major determinants of plasma Lp(a) variation in American Samoans.

Adult↗
PubMed1981

Massive obesity in a migrant Samoan population.

Peoples of the Pacific Islands tend to become overweight when they migrate or are exposed to modernization in situ. Recent evidence suggests that Samoans are particularly susceptible, exhibiting a high prevalence of obesity and hypertension following migration to Hawaii. We report the preliminary results of a survey of height, weight, blood pressure, and fasting plasma glucose (FPG) among an urbanized Samoan community the the San Francisco Bay Area. Although the participants' average height fell between the 25th and 50th percentile of the US population, about one-half our sample exceeded the 95th percentile for weight. The extreme overweight was accompanied by elevated blood pressure and, in females, by elevated FPG. The massive adult weight of migrants from the Pacific Islands carries serious public health implications for areas that support large migrant communities.

Adult↗
PubMed1996

Expression of anger by Samoan adults.

A modified version of Spielberger's 1988 Anger Expression Inventory including four Samoan culture-specific anger terms was administered to 593 adult American and Western Samoans, 25 to 55 years, to assess intrasample age, sex, and location differences and to examine its cross-cultural utility by an exploratory factor analysis. American Samoans men's and women's scores showed greater difficulty controlling anger than Western Samoan men and women, American Samoan males scored higher on Anger-Out and Samoan anger expression than Western Samoan men, and Western Samoan women scored higher on Anger-Out and higher on Samoan anger expression than Western Samoan men. Factor analysis showed that Spielberger's original factor structure was replicated in all subpopulations except American Samoan women. Control of anger, a Samoan cultural core value, appears to be more difficult in modern American Samoans of both sexes compared with the more traditional Western Samoans. Among American Samoan women, we speculate that role expansion may be responsible for their heterogeneous factor structure of anger expression.

Adult↗
PubMed1977

Clinical experience with Samoans in Auckland, New Zealand.

Samoans constitute the second largest ethnic Polynesian minority group in New Zealand. Generally, this is a socially and culturally deprived group from a European viewpoint. Causative factors of social and emotional stress and coping mechanisms are described. A number of culturally determined syndromes are encountered clinically. These are categorized. A practical, clinical approach to the Samoan patient is suggested.

Adolescent↗
PubMed2005

Hermeneutic notions augment cultural safety education.

Nurses are beginning to demand educational approaches that confront racism, rather than teach cultural diversity. One example of the latter approach is the introduction of kawa whakaruruhau, or cultural safety, in nursing and midwifery education in New Zealand. In the nursing and midwifery context of kawa whakaruruhau, nurses and midwives recognize, respect, and nurture the unique cultural identity of New Zealand's indigenous people, the tangata whenua, and safely meets their needs, expectations, and rights. In this article, I integrate literature pertaining to the implementation of cultural safety with the findings of a hermeneutic project that described the experience of nursing people from cultures other than one's own, and argue that the Gadamerian notions of "horizon," "prejudice," and "play" can be used to facilitate understanding of the tensions and contradictions inherent in cross-cultural practice. In addition, I recommend strategies that enable students to explore the prejudices, paradoxes, and possibilities experienced personally and professionally. As Gadamer noted, the art is in seeing what is questionable. There is also art in knowing how to question in a manner that makes new understanding possible.

Adaptation, Psychological↗
PubMed2001

Attitudes regarding tuberculosis among Samoans.

The research reported here examines knowledge, attitudes, and practices related to tuberculosis (TB) among Samoan immigrants through the use of a focus group. Samoan health workers to discuss participants' explanatory models regarding TB convened a focus group of eight Samoan living in Hawaii. The participants expressed a belief in the extreme contagiousness of TB. This leads to social stigma and isolation. Most agreed that biomedical treatment is necessary. Traditional herbal medicine was seen as adjunct to biomedical treatment. Focus group participants were found to subscribe to largely biomedical explanatory models regarding TB, but belief in traditional medicine also persists. TB was believed to be more transmissible than it actually is. TB continues to be a stigmatized disease.

Attitude to Health↗
PubMed2001

The pre-hospital experiences of Samoan families who have had a child admitted to hospital with pneumonia: a qualitative investigation.

AIMS: The aims of this investigation were to describe the pre-hospital experiences; health actions and attitudes towards health services of Samoan families who have had a child hospitalised with pneumonia. This information will inform policy makers, health professionals and the Samoan community in order for them to improve and create health care services that are appropriate for Samoan families. METHOD: Twelve Samoan families, each with a child admitted to the Starship Children's Hospital with pneumonia, were interviewed in an open-ended in-depth interview style. Interviews lasted thirty to forty-five minutes and were undertaken in the preferred language of the caregiver (English or Samoan). RESULTS: For most caregivers continuity of care in the community was poor. Reasons for this included structural and personal barriers to health care services and mistrust of doctors. Mistrust influenced caregivers to go elsewhere for care and therefore care became fragmented. The theory of delayed presentation was not supported. Caregivers were quick to act on symptoms and behaviours that they believed were different from normal and worse than non-urgent symptoms. Those who 'self-referred' to the hospital had in fact visited a doctor in the community at least once prior to admission. They had then made their own decision to present to the hospital. Reasons for self-referral included mistrust of health professionals in the community and structural and personal barriers to services. A break down in communication between caregivers and health professionals was an important personal barrier to services. Caregivers did not feel that pneumonia was an appropriate illness to be treated solely with traditional methods. Caregivers who consulted traditional practitioners had also consulted at least one doctor in the community. CONCLUSION: Although Pacific children are less likely than other children to present to the emergency department with the documentation from a general practitioner, in many cases they have been to see one. A lack of continuity of care was caused by a break down in communication between the caregiver and the health professional rather than there being an inability by caregivers to recognise the symptoms of pneumonia and therefore a delay in presentation. This breakdown in communication could be one explanation for the differences in illness severity and hospitalisation for pneumonia among children in different ethnic groups. Considering their reasons for doing so, caregivers who self-referred attended the emergency department appropriately. The use of traditional health methods did not impair access to Western medicine for these children with pneumonia.

Adolescent↗