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PubMed2003

Reliability of the Geriatric Depression Scale for use among elderly Asian immigrants in the USA.

The increasing numbers of Asian and other immigrants in the United States have resulted in greater demands for research methodology sensitive to cross-cultural issues. A regional probability sample (n = 407) of Asian elderly immigrants of different nationalities (Chinese, Korean, Indian, Filipino, Vietnamese, or Japanese) residing in New York City was used to examine the reliability of the Geriatric Depression Scale (GDS). Using the 30-item GDS, about 40% of this representative sample of Asian elderly immigrants was considered to be depressed, indicating higher depression rates than in the previous studies of other Asian elderly samples in the US and in Asia. Results also showed that the 30-item GDS and 15-item GDS Short Forms were reliable measures to assess depression in community-dwelling Asian immigrant elders. Data strongly suggest that Asian elderly immigrants in the US are at risk of depression, indicating a need for the design of culturally sensitive mental health programs.

Aged↗
PubMed2004

Bias in completeness of birthplace data for Asian groups in a population-based cancer registry (United States).

Data on place of birth are routinely collected by population-based cancer registries in the United States and are used to study effects of immigration on cancer patterns in Asian migrants, who comprise about a quarter of the US immigrant population. However, the quality of this research, which has the potential for informing cancer etiology and control, is unclear because registry birthplace information is incomplete, and its accuracy has not been examined. We quantified misclassification of birthplace data for Asian cancer patients in the Greater Bay Area Cancer Registry in northern California by comparing registry birthplace information with self-reported birthplace from interview, and then identified sociodemographic and hospital characteristics associated with birthplace completeness and misclassification. Of the 1836 eligible Asian patients, 649 (35%) had unrecorded registry birthplace. For all except Vietnamese, these persons were less likely than those with recorded birthplace to be foreign-born (OR = 0.5, 95% CI = 0.4-0.7), to be diagnosed in public than private hospitals (OR = 0.7, 95% CI = 0.5-0.8) and in teaching than non-teaching hospitals (OR = 0.8, 95% CI = 0.6-1.1), and were more likely to have been diagnosed at a large regional health maintenance organization (OR = 1.7, 95% CI = 1.3-2.2) and after 1995 (OR = 1.6, 95% CI = 1.1-2.1). Among Asians with registry birthplace information (n = 1187), sensitivity and predictive value positive for birthplace exceeded 90% for both US- and foreign-born, except for Japanese (predictive value positive = 85.7%). Among US-born Asians, those misclassified as foreign-born were more likely than those correctly classified to prefer a non-English primary language (OR = 29.4, 95% CI = 1.9-459.9). These results suggest that cancer registry birthplace data for Asians should not be used if they continue to be differentially incomplete for a large proportion of the subjects.

Adult↗
PubMed2006

Asian American college women's body image: a pilot study.

The purpose of this study was to examine the effects of values acculturation and the influence of media on Asian American college women's overall body image. A sample of 59 Asian American women from two large universities completed self-report surveys, which included questions regarding values acculturation, media internalization, and overall body satisfaction. Results showed that Asian American women who identified more strongly with traditional Asian values reported higher levels of body image dissatisfaction. Further, Asian American women who reported higher internalization of media portrayals of beauty ideals reported higher body image dissatisfaction. Research and clinical recommendations are made to enhance psychologists' understanding of Asian American women's body image and acculturation.

Acculturation↗
PubMed2005

Intermediate-term comparison of trabeculectomy with intraoperative mitomycin-C between Asian American and Caucasian glaucoma patients: a case-controlled comparison.

PURPOSE: Compare the efficacy and survival of trabeculectomy with intraoperative mitomycin-C (MMC) between Asian American and Caucasian patients in the same clinical setting. METHODS: In total, 29 Asian American patients (29 eyes) with trabeculectomies were matched case to case with 29 Caucasian patients (29 eyes) retrospectively. Matching criteria included age, glaucoma subtype, and preoperative intraocular pressure (IOP), gender, surgeon, ocular history, and glaucoma medications. Criteria of success included: (1) Final IOP>5 and <22 mmHg, (2) IOP reduction>or=20%, or final IOP<or=10 mmHg, and (3) without additional glaucoma surgery, loss of light perception, or complication. RESULTS: Mean follow-up durations of Asian American and Caucasian group were 40.11+/-22.5 months and 38.8+/-17.7 months, respectively (P=0.81). At the final visits, IOP decreased from 18.7+/-6.1 to 10.9+/-4.0 mmHg (P<0.0001) in the Asian American group, and from 19.0+/-5.5 to 11.0+/-3.8 mmHg (P<0.0001) in the Caucasian group. There were no significant differences between the two groups in IOP levels at 6 months, 1 year, and final visits. The probabilities of trabeculectomy survival (continuing to meet definition of success criteria) at 12 and 48 months were 75.9 and 56.6% in the Asian American group and 82.8 and 66.6% in the Caucasian group, respectively. (P=0.46) There were no significant differences for rates of surgical success, failure, complication, vision decrease, hypotony, and cataract development. Patients who had episodes of hypotony had a higher rate of diagnosis of low-tension glaucoma subtype (P=0.02). CONCLUSIONS: In a case-controlled comparison of an intermediate-term follow-up of trabeculectomy with intraoperative MMC, Asian American patients have a similar efficacy and survival probability as Caucasian patients.

Adult↗
PubMed1999

The p22 phox polymorphism C242T is not associated with CHD risk in Asian Indians and Chinese.

BACKGROUND: Oxygen free radicals such as superoxide anion have been implicated in the pathogenesis of atherosclerosis and coronary heart disease (CHD). The nonglycosylated 22 kDa alpha-subunit of the NADH/NADPH oxidase (p22 phox) of the vasculature acts as the final electron transporter in the generation of superoxide anion. Recently, a common polymorphism (C242T) at codon 72 in the p22 phox gene has been reported to be associated with CHD risk. STUDY DESIGN: We examined the role of the C242T polymorphism with the risk of CHD in a biracial sample of Asian Indians and Chinese from Singapore. The sample comprised angiographically confirmed CHD patients (126 Asian Indians and 151 Chinese) and age- and sex-matched healthy control subjects (154 Asian Indians and 167 Chinese). RESULTS: The frequency of the T allele was significantly higher in Asian Indian control subjects than in Chinese control subjects (0.38 vs. 0.09; P < 0. 0001). However, there was no difference in the frequency of this allele between case patients and control subjects either in Chinese (0.10 vs. 0.09) or Asian Indians (0.38 vs. 0.40). This polymorphism was also not associated with plasma lipid and apolipoprotein levels in any group. CONCLUSIONS: The p22 phox codon 72 polymorphism is not associated with the risk of CHD in the present samples of Asian Indians and Chinese.

Alleles↗
PubMed1999

Does Asian race affect hepatitis B virus recurrence or survival following liver transplantation for hepatitis B cirrhosis?

To assess whether Asian race is an independent variable affecting survival and hepatitis B virus (HBV) recurrence after liver transplantation, the results of 27 consecutive liver transplants performed between June 1994 and April 1997 for HBV cirrhosis were analysed. In the group of 13 Asians, 38% had associated hepatocellular carcinoma and 62% had positive hepatitis B virus early antigen (HBeAg) or elevated HBV-DNA before transplant. Prophylactic hepatitis B immunoglobulin (HBIG) was administered perioperatively and long term at 4-6 weekly interval. Four patients with elevated HBV-DNA received lamivudine before transplantation. The 3 year actuarial patient survival rate was 100% in both Asian and non-Asian patients. Twenty-six patients remained seronegative for hepatitis B virus surface antigen after transplantation. The incidence of post-transplant HBV recurrence was similar: 0% in Asians compared with 7% in non-Asians. There was no recurrence in the group of 12 patients who were HBV-DNA or HBeAg negative pretransplant.

Adolescent↗
PubMed1997

Asian-American patient ratings of physician primary care performance.

OBJECTIVE: To examine how Asian-American patients' ratings of primary care performance differ from those of whites. Latinos, and African-Americans. DESIGN: Retrospective analyses of data collected in a cross-sectional study using patient questionnaires. SETTING: University hospital primary care group practice. PARTICIPANTS: In phase 1, successive patients who visited the study site for appointments were asked to complete the survey. In phase 2, successive patients were selected who had most recently visited each physician, going back as far as necessary to obtain 20 patients for each physician. In total, 502 patients were surveyed, 5% of whom were Asian-American. MAIN RESULTS: After adjusting for potential confounders, Asian-Americans rated overall satisfaction and 10 of 11 scales assessing primary care significantly lower than whites did. Dimensions of primary care that were assessed include access, comprehensiveness of care, integration, continuity, clinical quality, interpersonal treatment, and trust. There were no differences for the scale of longitudinal continuity. On average, the rating scale scores of Asian-Americans were 12 points lower than those of whites (on 100-point scales). CONCLUSIONS: We conclude that Asian-American patients rate physicians primary care performance lower than do whites, African-Americans, and Latinos. Future research needs to focus on Asian-Americans to determine the generalizability of these findings and the extent to which they reflect differences in survey response tendencies or actual quality differences.

Academic Medical Centers↗
PubMed2005

Aesthetic facial surgery for the asian male.

Cosmetic surgery of the Asian face has become increasingly popular in the Far East and the West. The Asian male identity has undergone an evolution in Western media toward a more positive change. The standards of beauty have also changed, being defined by more multicultural models and styles of dress than before. To undertake cosmetic surgery of the Asian face, particularly of the Asian male, requires a different psychological understanding of the individual as well as an entirely different surgical technique in most cases. This brief article does not delve into the technical details of each procedure but concentrates on the salient differences in how to approach the Asian male patient for each of the different procedures, including Asian blepharoplasty, augmentation rhinoplasty, lip reduction, dimple fabrication, otoplasty, facial contouring and aging face procedures, and hair restoration.

Aging↗
PubMedDate not supplied

Substance abuse treatment: cultural barriers in the Asian-American community.

Asians constitute the largest growing minority in the United States. However, inaccurate perceptions and stereotypes continue to mask a full understanding of the state of knowledge regarding their alcohol and other drug abuse. Much of the existing research has continued this trend by categorizing Asians as "others" or persisting in its attempts to explain low incidence rates by investigating metabolic phenomena. More recent community-based studies have shown alarming incidence rates of specific substance abuse among different Asian ethnic groups. Asian heterogeneity and cultural barriers have also contributed to the lack of knowledge regarding substance abuse prevalence rates. Issues related to taboo, denial, and loss of face further mask understanding of the extent of the problem. Institutional barriers and the lack of community infrastructure make treatment efforts difficult in serving a myriad of Asian groups. For most Asians undergoing treatment, cultural factors need to be considered, including the involvement of the family as well as the risk related to its transition under immigration and the following acculturation patterns. An example of a specific treatment program and activity is discussed in relationship to the cultural factors indicated above. Finally, recommendations are specified for future treatment policy, research, and services.

Asian↗
PubMedDate not supplied

Social influences as explanations for substance use differences among Asian-American and European-American adolescents.

The present study examines the social influences in the Asian-American and European-American adolescent environment to provide a greater understanding of effect of ethnic differences on the prevalence of substance abuse. Participants were 957 Asian-American and 3705 European-American seventh grade adolescents. It was found that Asian-American students were less likely to use alcohol and cigarettes, and had a more abstinence-promoting environment than European-American adolescents. This difference in Asian-American adolescents appeared to be the result of less adult and peer influence to use alcohol or cigarettes, less offers of alcohol, and an increased likelihood of having an intact family when compared to European-American adolescents. Additionally, Asian-American adolescents reported having fewer friends and spending less time with their friends than European-American adolescents. It was concluded that social influences play an important role in explaining why Asian-American adolescents have lower rates of substance use.

Adolescent↗
PubMed2003

Calcium intake of Asian, Hispanic and white youth.

OBJECTIVE: To examine calcium intake and food sources among Asian, white and Hispanic youth, in order to develop and target interventions to improve calcium intake. METHODS: Cross-sectional survey with two 24-hour dietary recalls one week apart. Calcium intake was evaluated in 167 male and female adolescents of Asian, Hispanic and white ethnicity, ages 10-18 years, from six states. Main outcome measures were mean daily calcium intake (mg/day). STATISTICAL ANALYSES PERFORMED: t tests, Chi-square and analysis of variance for differences by age, ethnicity and gender, multiple regression of factors influencing calcium intake. RESULTS: Overall median calcium intake was 938 mg/day with 868 mg/day for Asians, 1180 mg/day for whites and 896 mg/day for Hispanics. Daily milk intake was the primary predictor of calcium intake with Asian ethnicity and female gender each showing a negative association to calcium intake in multiple regression models. CONCLUSIONS: Milk intake was the primary factor positively influencing calcium intake, while Asian ethnicity and female gender negatively influenced calcium intake. Thus, interventions to improve calcium intake should focus on improving milk intake of Asians and females.

Adolescent↗
PubMed2001

Disclosure of HIV status: cultural issues of Asian patients.

Disclosure of human immunodeficiency virus (HIV) status is a difficult emotional task creating opportunities for both support and rejection. For Asian patients there may be additional self-imposed barriers to disclosure that are rooted in cultural values. The purpose of this article is to describe how Asian cultural values of harmony and avoidance of conflict affect the disclosure experiences of HIV-positive Asian American and immigrants. Effective practice guidelines have been developed based on this information. Based on in-depth interviews with 16 HIV-positive Asian men, three focal issues were identified that serve as barriers to disclosure to family members: protection of family from shame, protection of family from obligation to help, and avoidance of communication regarding highly personal information. Additionally, patients felt disclosure was inhibited by the lack of HIV education to which families living overseas may have access. This is compounded by their lack of access to translated materials that they could send to family members. Similar to past disclosure research with non-Asian samples, the findings suggest that gay Asian men seek emotional support from gay friends. They would consider disclosing to relatives only when health reasons necessitated it. It is essential that helping professionals be attentive to the dishonor that patients may experience through disclosure and the stigma associated with being gay. Patients who are considering making a disclosure may need assistance with thinking through ways to provide HIV/acquired immune deficiency syndrome (AIDS) education to those family members that have little knowledge in this area. This may include translating or locating informational brochures translated into the family's language.

Adult↗
PubMed2006

Asian adolescents have a higher trunk:peripheral fat ratio than Whites.

Body fat, especially in the upper body, has been associated with increased risk of chronic disease among adults. Factors associated with these traits among ethnically diverse populations are not well studied. We examined factors influencing body fat and weight among Asian and White adolescent girls from the female adolescent maturation longitudinal study (initial exam plus 2-y follow-up examination) in Hawaii. The objective of this study was to identify and compare influences on and differences in body size and fat distribution among Asian and White adolescent girls. Subjects were identified among age-eligible members of a large HMO. Of the 214 girls recruited for Exam 1, 107 girls returned for Exam 2. The girls' age, ethnicity, a 3-d diet record, and physical activity recall were obtained by questionnaire at both times, and Tanner pubic hair stage and anthropometry were clinically measured by trained staff at both exams. The ethnic proportion of the study sample was 57% Asian and 43% White. Each girl's ethnicity was based on the ethnic proportion of each biologic parent. The percentage of body fat was measured by Lunar Prodigy dual energy X-ray absorptiometry (DXA) at the follow-up exam only. Among various measures of skeletal size and adiposity, only leg length (inversely) and DXA trunk:peripheral fat ratio (directly) were associated with proportion of Asian ethnicity, after adjusting for age, Tanner pubic hair stage, physical activity, and energy intake. In a multivariate analysis focusing on the trunk:peripheral fat ratio, this measure of central obesity was positively associated with proportion of Asian ethnicity (P = 0.001) and bi-iliac breadth (P = 0.002), and negatively associated with birth weight (P = 0.021), after adjustment for Tanner pubic hair stage, physical activity, energy intake, biacromial breadth, and height. In conclusion, Asian adolescents have a higher trunk:peripheral fat ratio than Whites. Adolescent bi-iliac breadth (positively) and birthweight (negatively) are associated with more body fat on the trunk vs. periphery during adolescence.

Absorptiometry, Photon↗
PubMed2000

Obstructive sleep apnea syndrome: a comparison between Far-East Asian and white men.

OBJECTIVES: To investigate the possible differences between Far-East Asian men and white men in obstructive sleep apnea syndrome (OSAS). STUDY DESIGN: Prospective nonrandomized controlled study. METHODS: This study compared consecutive Far-East Asian men with OSAS (n = 50) with two selected groups of White men with OSAS (n = 50 in each group). One group of white men was controlled for age, respiratory disturbance index (RDI), and minimum oxygenation saturation (LSAT). Another group was controlled for age and body mass index (BMI). Cephalometric analysis was performed on all subjects. RESULTS: The majority of the Far-East Asian men were found to be nonobese (mean BMI, 26.7 +/- 3.8) but had severe OSAS (mean RDI, 55.1 +/- 35.1). When controlled for age, RDI, and LSAT, the white men were substantially more obese (mean BMI, 29.7 +/- 5.8, P = .0055). When controlled for age and BMI, the white men had less severe illness (RDI, 34.1 +/- 17.9, P = .0001). Although the posterior airway space and the distance from the mandibular plane to hyoid bone were less abnormal in the Far-East Asian men, the cranial base dimensions were significantly decreased. CONCLUSIONS: The majority of the Far-East Asian men in this study were found to be nonobese, despite the presence of severe OSAS. When compared with white men, Far-East Asian men were less obese but had greater severity of OSAS. There may be differences in obesity and craniofacial anatomy as risk factors in these two groups.

Adult↗
PubMed2000

Racial differences in pancreatic cancer: comparison of survival and histologic types of pancreatic carcinoma in Asians, blacks, and whites in the United States.

SEER data for histologically confirmed carcinomas of the pancreas for 1973-1995 from Hawaii, San Francisco, and Seattle (n = 10,621) were analyzed to compare the survival and types of carcinomas in various racial groups. These geographic sites were selected because each included a sizable number of Asian patients. The median survival after diagnosis in unadjusted data was longer in Asian patients than in whites. After adjustment for age at diagnosis and year of diagnosis, only the survival advantage of Asian women over whites and blacks persisted as a statistically significant difference. Racial differences were no longer statistically significant when further adjustments were made for stage, grade, and morphology. The proportion of papillary carcinomas or mucinous cystadenocarcinomas was higher in Asians than in whites and blacks (p = 0.02), and patients with these neoplasms had a longer median survival than did patients with ductal adenocarcinoma (12 vs. 3.3 months). The fraction of Asian patients with lower stages and grades of carcinomas also was higher than among white and black patients. Longer survival of Asian compared with white and black patients with pancreatic carcinoma is at least partly explained by their higher proportion of less aggressive carcinomas at the time of diagnosis.

Adult↗
PubMed2005

Prevalence, awareness, treatment, and control of hypertension among Black Surinamese, South Asian Surinamese and White Dutch in Amsterdam, The Netherlands: the SUNSET study.

OBJECTIVE: To assess ethnic differences in prevalence, levels of awareness, treatment and control of hypertension among Dutch ethnic groups and to determine whether these differences are consistent with the UK findings. DESIGN: Cross-sectional survey. SETTING: South-east Amsterdam, The Netherlands. PARTICIPANTS: A random sample of 1383 non-institutional adults aged 35-60 years. Of these, 36.7% were White, 42% were Black and 21.3% were South Asian people. MAIN OUTCOME MEASURES: Prevalence of hypertension, rates of awareness, treatment, and control of hypertension. RESULTS: The Black and South Asian subjects had a higher prevalence of hypertension compared with White people. After adjustments for age, the odds ratios (95% confidence interval) for being hypertensive were 2.2 (1.4-3.4; P < 0.0001) and 3.8 (2.6-5.7; P < 0.0001) for Black men and women, respectively, and 1.7 (1.0-2.6; P = 0.039) and 2.8 (1.8-4.5; P < 0.0001) for South Asian men and women, compared with White people. There were no differences in awareness and pharmacological treatment of hypertension between the groups. However, Black hypertensive men 0.3 (0.1-0.7; P < 0.01) and women 0.5 (0.3-0.9; P < 0.05) were less likely to have their blood pressure adequately controlled compared with White people. CONCLUSION: The higher prevalence of hypertension found among Black and South Asian people in The Netherlands is consistent with the UK studies. However, the lower control rates and the similar levels of awareness and treatment of hypertension in Black Surinamese contrast with the higher rates reported in African Caribbeans in the UK. The rates for the South Asians in The Netherlands were relatively favourable compared to similar South Asian groups in the UK. These findings underscore the urgent need to develop strategies aimed at improving the prevention and control of hypertension, especially among Black people, in The Netherlands.

Adult↗
PubMed1998

An evaluation of bone mineral density in Australian women of Asian descent.

Asian women have been reported to have lower bone mineral density (BMD) than Caucasians, but this could be due to body habitus rather than ethnicity. The purpose of the present study was to determine whether Australian women of Asian descent have intrinsically dissimilar BMD compared to Australian women of Caucasian origin. We compared Australian Asian (n = 36) and Caucasian (n = 304) women who were referred for bone densitometry and in whom disorders or medications known to interfere with bone metabolism were excluded. Covariables including age, postmenopausal status, years since menopause (YSM), alcohol and smoking consumption, family history, current exercise levels, height, weight, body mass index (BMI) and Asian origin were analysed by multivariate linear regression to determine the independent predictors of BMD in the spine, hip and distal radius. The BMD in the spine (R2 = 0.31), hip (R2 = 0.27) and distal radius (R2 = 0.31) were associated with YSM (all sites), postmenopausal status, weight and smoking (spine and hip), BMI (spine and wrist), family history (hip) and height (wrist). The BMD at these sites were similar for Asian and Caucasian women after adjusting for these variables. Thus, Asian-Australians have similar BMD to Caucasian-Australians after adjusting for potential confounding variables. Bone mineral density is independently related to a number of clinical and lifestyle-related factors, but not ethnicity.

Absorptiometry, Photon↗
PubMed2005

Acculturation and eating disorders in Asian and Caucasian Australian adolescent girls.

The present study aimed to compare the attitudes and psychopathology of eating disorders between Asian and Caucasian adolescent girls; and investigate the relationship between acculturation and the attitudes and psychopathology of eating disorders in subgroups of Asian girls. Two groups of non-clinical adolescent girls in Perth, Western Australia, were compared using a survey method. There were 17 Asian and 25 Caucasian adolescent girls, aged 14-17 drawn from private high schools in Perth who were screened using the Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI-2), and an acculturation index. The psychopathology scores for eating disorders of the Asian group were significantly higher than that of the Caucasian group in terms of total EDI-2 score, Interpersonal Distrust, Maturity Fears, Impulse Regulation and Social Insecurity subscales. Eating attitudes measured by Dieting subscale of the EAT-26 was significantly different. Within the Asian group, the less acculturated girls had higher scores on the EAT-26 and the EDI-2 than the more acculturated. Less acculturated Asian girls appeared to have unhealthier attitudes and psychopathology toward eating.

Acculturation↗