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Experimental infection of pigs and cattle with eggs of Asian Taenia saginata with special reference to its extrahepatic viscerotropism.

Asian Taenia saginata, tentatively called Taenia saginata taiwanensis, has been described to be infected in its metacestode stage only in the liver of intermediate host animals. Experimentally, however, we found that the metacestodes of the Asian Taenia saginata are also infected in other viscera than the liver of pigs (Landrace-Duroc-Hampshire) 4 days to 4 months postinoculation (PI). Viscerotropism of cysticercosis was apparent because a majority (70.7%) of the non-calcified cysticerci were found in the livers while a minority were found in extrahepatic organs such as the omentum (19.2%), lungs (8.1%) and serosa of colon (2.0%). When experimentally infected to cattle, Asian T. saginata cysticerci were also observed calcified in the livers. On the other hand, classical Taenia saginata metacestodes infected the muscles and viscera of the Holstein-Friesian cattle whereas no infection was observed in experimental pigs. Extrahepatic metacestodes of Asian T. saginata, which were obtained from an experimental pig were confirmed to be infective to a male volunteer. This extrahepatic viscerotropism of Asian T. saginata metacestodes in experimental pigs explains well the transmission modes of Asian T. saginata among people considering the eating habits.

Animals↗

Asian nursing students in the United States.

It is obvious that there is a great need to familiarize faculty and students with the Asian culture and heritage and to sensitize them to the difficulties and problems that Asian nursing students encounter in their adjustment to the university nursing program in the United States. Recommendations and strategies to achieve the above goals are: (1) Organizing cross-cultural courses for Asians and non-Asians to familiarize them with different cultures, (2) sensitizing faculty and counselors to the detrimental effects of existing nursing programs on international students, and (3) helping Asian nursing students better adjust to the American culture by providing English tutorial classes, support groups and host families that will act as socializing agents during the student's adjustment process. Through such educational and support programs, it is hoped that Asian nursing students will experience fewer difficulties which in turn will make their studies more meaningful and applicable.

Acculturation↗

A study of colo-rectal carcinoma in the Asian and European populations in the city of Leicester from 1981 to 1991.

For many years clinical reports have suggested that colo-rectal cancer is uncommon in the Asian population resident in England and a report in 1990 confirmed this in Asians living in Bradford. This study aims to establish the incidence of colo-rectal cancer in the Asian population resident in the city of Leicester during the 11 y period 1 January 1981-31 December 1991. The relative frequency of colo-rectal carcinoma in Asians compared to Europeans over the period studied was 0.16 (Asian/European, 95% confidence interval (CI) 0.04-0.75). This difference was statistically significant and further analysis showed that there was a real trend with an increased relative frequency amongst the younger age groups. Although there was a significantly lower incidence of colo-rectal carcinoma in the Asian population in Leicester city over the period studied it is unknown whether this is due to environmental or genetic factors. During the next decade it is likely to become clearer as to whether this difference will persist or whether there will be an increase in the incidence of colo-rectal carcinoma in Asians in Leicestershire.

Adolescent↗

Predicting color kinetics during red Asian ginseng (Panax ginseng) preparation.

A red Asian ginseng preparation was prepared as follows: fresh Asian ginseng (Panax ginseng) roots were first steamed for half an hour to several hours, and then the steamed roots were dried into died roots (red Asian ginseng, 10% moisture content, on a dry basis). During steaming, the color of ginseng (white) turned yellow and brown during subsequent steaming. Color is an important index for grading red Asian ginseng. In this study, the effects of drying time and temperature on the surface color formation (L, a/b) of the Asian ginseng, and the color formation (L, a/b) of the red Asian ginseng powder were investigated. The value of L decreased, while the value of a/b increased as drying proceeded; the value of L was slightly influenced by the drying temperature, but the value of a/b was markedly influenced. With respect to the color of the final product (red ginseng), the value of L was slightly influenced by steaming time and temperature, while the value of a/b was increased as steaming time and drying temperature increased. Based on the nth-order rate equation and Arrhenius equation, a kinetic model for describing these effects was established, and the results were satisfactorily fitting.

Algorithms↗

Evaluation of Lp[a] and other independent risk factors for CHD in Asian Indians and their USA counterparts.

Conventional risk factors for coronary heart disease (CHD) do not completely account for the observed increase in premature CHD in people from the Indian subcontinent or for Asian Indians who have immigrated to the USA. The objective of this study was to determine the effect of immigration to the USA on plasma levels of lipoprotein [a] (Lp[a]) and other independent risk factors for CHD in Asian Indians. Three subject groups were studied: group 1, 57 subjects living in India and diagnosed with CHD (CHD patients); group 2, 46 subjects living in India and showing no symptoms of CHD (control subjects); group 3, 206 Asian Indians living in the USA. Fasting blood samples were drawn to determine plasma levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein [LDL cholesterol (LDL-Chol)], high density lipoprotein [HDL cholesterol (HDL-Chol)], apolipoprotein B-100 (apoB-100), and Lp[a]. Apolipoprotein [a] (apo[a]) size polymorphism was determined by immunoblotting. Plasma TG, apoB-100, and Lp[a] concentrations were higher in CHD patients than in control and USA groups. CHD patients had higher levels of TC and LDL-Chol and lower HDL-Chol than control subjects. However, the USA population had higher levels of TC, LDL-Chol, and apoB-100 and lower HDL-Chol than control subjects. Plasma Lp[a] levels were inversely correlated with the relative molecular weight of the more abundant of each subject's two apo[a] isoforms (MAI), and CHD patients showed higher frequencies of lower relative molecular weights among MAI. Our observed changes in lipid profiles suggest that immigrating to the USA may place Asian Indians at increased risk for CHD. This study suggests that elevated plasma Lp[a] confers genetic predisposition to CHD in Asian Indians, and nutritional and environmental factors further increase the risk of CHD. This is the first report implicating MAI size as a predictor for development of premature CHD in Asian Indians. Including plasma Lp[a] concentration and apo[a] phenotype in screening procedures may permit early detection and preventive treatment of CHD in this population.

Adult↗

Health Care Reform: A Caucus of Asian American Health Workers' Perspective.

PURPOSE OF THE PAPER: The purpose of this paper is to offer an American Public Health Association (APHA)/Caucus of Asian American Health Workers' (CAAHW) perspective on health care reform. Dr. William Chen, the CAAHW Chair had asked the author, a Caucus member to present the Caucus' perspective on health care reform as part of a special session that was held during the 1993 APHA annual meeting in San Francisco. This paper is based on the oral presentation made. SUMMARY OF METHODS UTILIZED: The author reviewed the September 7, 1993 draft of the President's Health Care Reform proposal, other related papers, and the literature on Asian and Pacific Islander American health care needs. This was followed by a discussion of major issues and concerns with the CAAHW Chair and key members. This paper has undergone review by the Caucus chair and his reviewers whom he selected and thus is endorsed as the CAAHW's perspective on health care reform. PRINCIPAL FINDINGS: The CAAHW applauds President Clinton for his leadership in introducing much­needed reform in the U.S. health care system. However, the CAAHW wants to point out that access to medical care is not equivalent to utilizing and benefiting from services. Three issues of special concern to Asian Pacific Islander Americans are: (1) cultural sensitivity and relevancy of health services; (2) adequacy of racial/ethnic specific health data; and (3) due representation and input to key health policy­making and administrative bodies. CONCLUSIONS: The CAHW supports universal health insurance for all Americans and is particularly concerned that cultural sensitivity and appropriateness be assured for all populations. RELEVANCE TO ASIAN PACIFIC ISLANDER AMERICAN POPULATIONS: This paper calls attention to Asian Pacific Islander Americans as the nation's fastest growing minority that is largely foreign­born and extremely heterogenous and the need for culturally sensitive services. KEY WORDS: Asian Pacific Islander Americans; health care reform; health policy; cultural sensitivity.

Journal Article↗

Bone fragility in Asian and Caucasian men.

Hip and vertebral fractures are a public health problem in men of Asian and Caucasian origin. Inferences regarding gender and racial/ethnic differences in fracture rates must be made cautiously as problems in case ascertainment and classification of hip fractures, and problems in defining what constitutes a vertebral 'fracture' have not been solved. However, methodological issues probably do not entirely account for the heterogeneity of fracture patterns. There is likely to be a wide variation in fracture rates from country to country in Asia as reported in studies in Europe. The reasons for this heterogeneity are unknown. Caucasian men lose similar amounts of bone as Caucasian women during ageing from the endosteal surface of the bone. Net bone loss is less in men than women because men form more periosteal bone during ageing than do women. The extent of periosteal and endosteal bone modelling and remodelling have not been studied in Asian men and women. Nor have there been hypothesis-driven studies designed to compare periosteal apposition and endosteal bone loss in Asian males compared to Caucasian males. Sex hormone deficiencies contribute to abnormalities in skeletal size and mass during growth, remodelling imbalance and bone loss during ageing in men. The larger peak bone size and greater periosteal apposition with ageing in men compared to women is most likely to be androgen-dependent in Caucasians and Asians. Androgen deficiency may also partly account for reduced bone formation and negative bone balance at the basic multicellular unit (BMU). Oestrogen deficiency during growth is associated with reduced bone mass and increased leg length in males and females. Oestrogen deficiency during ageing may account for trabecular bone loss in men by increasing remodelling rate. There have been no anti-fracture efficacy studies done in Asian males. Studies on the pathophysiology of osteoporosis in males have given insight into the pathophysiology of osteoporosis in females. Similarly, collaborative research efforts between groups around the world will facilitate comparative studies in Asian and Caucasian communities. The results of this work will provide important insights into the pathophysiology of bone fragility in both groups.

Age Distribution↗

Broadband ultrasound attention reference database for southeast Asian males and females.

INTRODUCTION: The objective of this study was to establish the broadband ultrasound attenuation (BUA) measurements of the calcaneum for Southeast Asian males and females. A database was used to draw the reference curve for the Southeast Asian male and female population. MATERIALS AND METHODS: The database included 366 healthy females and 236 healthy males. We measured the BUA values of the left heel using the Contact Ultrasound Bone Analyser (CUBA) clinical system. RESULTS: The mean difference between Southeast Asian males and Caucasian males was 9.3 dB MHz-1 and that for females was 5.0 dB MHz-1. The standard deviations (SDs) for Southeast Asian female and male normative values were 17.43 and 20.10, respectively. This is comparable with the SD for the McCue Caucasian female and male normative data of 16.54 and 17.45 respectively. CONCLUSION: The study shows that the Southeast Asian population has a significantly lower normative value than the Caucasian population. This BUA reference database obtained will allow for more accurate determination of Southeast Asian patients at risk of osteoporosis.

Adult↗

[Public perceptions of the risk of Asian dust storms in Seoul and its metropolitan area].

OBJECTIVES: In spite of the recent increased concern for Asian dust storms, there are few studies concerning how dangerous the general public recognizes these dust storms to be. This study examined the public's perceptions of the risk of the Asian dust storms and also the source of the information concerning the risk. METHODS: A telephone interview survey using a standardized questionnaire was done for the adults living in Seoul and its metropolitan area from May 15th, 2003 to May 16th, 2003. The contents of the questionnaire were the sociodemographic characteristics, the perceptions of risk to the Asian dust storms, and the coping strategy of the study participants. RESULTS: The study participants get their information on Asian dust storms mainly from TV newscasts and they have a good knowledge of them. They regard it as one of the most dangerous health risks, along with dioxin. They think that it is associated with allergic rhinitis, conjunctivitis and bronchial asthma, etc. Of the 500 study participants, 201(40.2%) persons suffered bodily discomforts during the Asian dust storm period. CONCLUSIONS: Although there are uncertainties about the health risks of Asian dust storms, the public thinks these dust storms are very dangerous to health in many ways. This negative perception will not disappear easily. To fill the gap of the public's perceptions of the risk and the objective evidence of its health effects, more studies about its health effects and the methods to reduce exposure are required.

Adult↗

Improving growth status of Asian refugee children in the United States.

OBJECTIVE: To analyze the trend and pattern of the nutrition status of Southeast Asian refugee children and other low-income children in the United States. DESIGN: Descriptive analysis of the growth data from the Pediatric Nutrition Surveillance System of the Centers for Disease Control, Atlanta, Ga, from 1980 through 1989. SUBJECTS: Children under 5 years of age from low-income families enrolled in public health clinics in 12 selected states. MEASUREMENTS AND MAIN RESULTS: Asian refugee children experienced a progressive and significant decline in the prevalence of low birth weight, low height-for-age, and low weight-for-age, while these nutritional indexes remained stable for low-income white, black, and Hispanic children. By 1989, the growth status of Asian children was near that of other ethnic groups. CONCLUSIONS: The marked improvement of growth status among Asian refugee children over a short period suggests that the poor growth status often observed among recently immigrated Asian children is primarily related to nutritional and health factors, rather than genetic factors. In assessing the growth of Asian or immigrant children, it would be helpful to take their family and early childhood background into account.

Black or African American↗

Nutrient intake of low-income Southeast Asian pregnant women.

Dietary nutrient intakes of 91 Cambodian, 37 Laotian, and 59 Vietnamese low-income pregnant women attending a university teaching hospital outpatient clinic in Southern California were measured. The nutrient intakes of the Southeast Asian groups were compared with one another as well as with the intakes of a group of 165 low-income non-Southeast Asian pregnant women of similar height, weight, and age from the same outpatient clinic population. Computerized analysis of the 24-hour recall data showed that there were few differences in nutrient intake between the Southeast Asian groups, except that the Cambodian group consumed significantly less fat, riboflavin, vitamin D, and calcium than the Vietnamese group. However, there were a number of differences between the nutrient intakes of the Southeast Asian groups and those of the non-Southeast Asian group. These included significantly lower intakes of fat, riboflavin, folate, vitamins D and E, calcium, phosphorus, potassium, and magnesium and significantly higher intakes of thiamin, niacin, sodium, and selenium. These findings suggest that low-income Southeast Asian pregnant women have some good dietary habits that dietitians need to reinforce and other dietary habits that need improvement.

Adult↗

Pre-conception counselling in Asian women with non insulin dependent diabetes and impaired glucose tolerance.

Asian patients comprise greater than 8% of our diabetic clinic. Retrospective analysis of the case notes of 22 Asian patients and 20 white patients with NIDDM or impaired glucose tolerance (IGT) attending our combined diabetic/antenatal clinic during 1985-1987 confirmed the reported advantages of pre-conception counselling. Those Asian patients with NIDDM or IGT had higher corrected birthweight than a parity matched Asian control group (3,472.3 +/- 595 g v 2,798.6 +/- 672.3 g p less than 0.001). Those Asian patients who had preconception counselling had, however, significantly smaller babies (3,270.8 +/- 445.1 g v 3,714.4 +/- 727.1 g p less than 0.05). An increase in foetal and maternal complications has been documented in cases of gestational diabetes, but the glucose levels that predict an increased risk have not been clearly defined. In the Asian patients with NIDDM/IGT there was one neonatal death and two congenital abnormalities, although these mothers did not have significantly higher glycosylated haemoglobin levels. HbA1 was not a good diagnostic test for glucose tolerance. Subjects with any degree of glucose intolerance should be managed as carefully as established diabetics and preconception counselling for high risk groups may be beneficial.

Adult↗

Dietary habits of Asian diabetics in a general practice clinic.

Initial dietary advice for Asian diabetics attending a general practice diabetic clinic was given in Asian languages. Between 2 and 3 years later a questionnaire interview was conducted to assess the effectiveness of the advice given. Forty of the 59 Asian diabetic patients in the practice attended for interview. The majority continued to use sugar or 'gur' (jaggery), Asian sweets, and Asian snacks (which have a high fat content). Fat and oil consumption per person per month was also high. Failure to achieve dietary objectives seemed to result from lack of sufficient emphasis on the types of foods usually consumed and an inadequate understanding of eating and cooking habits of Asians. We conclude that for dietary advice to be successful, emphasis must be placed on specific types of food eaten together with an understanding of the sociocultural implications of eating practices in ethnic groups.

Adult↗

The importance of limited exposure to ultraviolet radiation and dietary factors in the aetiology of Asian rickets: a risk-factor model.

Regional variation in the prevalence of Asian rickets was examined in Coventry, Bradford and Glasgow. Records of 152 weeks of daylight outdoor exposure were obtained from 104 Glasgow Asian children, 53 of whom had been treated for rickets. Records of seven-day weighed dietary intake were obtained from 84 Asian children, 43 of whom had been treated for rickets. There was a marked north-south gradient in the prevalence of Asian rickets. In all cases of severe rickets with deformity the child was vegetarian. Severe rickets was associated with lower intake of meat, higher intake of chapati and lower daylight outdoor exposure values than in normal children. Multivariate analysis employing a combination of these variables provided good separation between rachitic and normal groups. A risk-factor model is proposed which suggests that regional variation in the prevalence of rickets among Asian communities in Britain is mainly determined by the effects of latitude and the nature of the urban environment on available ultraviolet radiation. Where UV radiation is restricted, individual propensity to rickets within a given Asian community is mainly determined by dietary factors.

Adolescent↗

Delayed bottle weaning and iron deficiency in southeast Asian toddlers.

We undertook this study to determine if culturally influenced feeding practices are associated with iron deficiency in infants and toddlers from low-income families. We obtained a dietary survey, illness history, hematocrit, and zinc protoporphyrin-to-heme ratio (ZPP/H) from 35 Southeast Asian children and 73 children of other ethnicities between ages 5 and 30 months. We confirmed iron deficiency by serum ferritin measurement in children with ZPP/H > 80 mmol/mol or evaluated them after a 3-month iron treatment. Sixty percent of the Southeast Asian children had elevated ZPP/H ratios, compared with 14% of children of other ethnicities. Follow-up studies confirmed iron deficiency in 12 of 21 Southeast Asian children with elevated ZPP/H; 75% (eight) of those with confirmed iron deficiency were 24 to 30 months of age. We found that toddler feeding practices differ between Southeast Asians and other ethnic groups. All 17 Southeast Asian toddlers were still bottle fed at their second birthday, compared with 10 of 21 same-age children of other ethnicities. Persistence of bottle feeding after 2 years of age was highly associated with elevation of ZPP/H in Southeast Asian children but not in other children. Clinicians need to be aware of this problem and carefully monitor iron status in children not weaned from the baby bottle by age 2 years. Changes in education practices and policies are needed to prevent iron deficiency from the overintake of cow's milk that results from prolonged bottle feedings in this ethnic group.

Asia, Southeastern↗

Periodontal health in adopted children of Asian origin living in Sweden.

In the present study the periodontal condition of a group of adopted 6-17 year-old children of Asian origin living in Sweden was compared with that of age- and sex matched Sweden children. Thirty-one Asian children and 31 Swedish children participated. Data on general health for all the children and on age at arrival for the Asian children was collected by interview. A clinical examination included recording of presence of plaque, supragingival calculus, bleeding on probing, probing depth, and caries. Radiographs were used to determine marginal bone loss (distance between the cemento-enamel junction and the marginal bone level > 2 mm), proximal calculus, and proximal caries. In addition, previously taken and filed radiographs of the primary dentition of the older children and current radiographs of the younger children with primary teeth were analysed to determine the prevalence of bone loss and calculus. The children of Asian origin showed a significantly higher number of surfaces with plaque and bleeding on probing. No significant differences were noted in the number of individuals with probing depths > or = 4 mm, supragingival calculus, or radiographic calculus. Three of the Asian and none of the Swedish children displayed radiographic bone loss. The retrospective analysis of all available radiographs from the primary dentition showed that 9 of 29 (31%) Asian children and 2 of 29 (7%) Swedish children had experienced bone loss in primary teeth.

Adolescent↗

The experiences and health care needs of Asian coronary patients and their partners. Methodological issues and preliminary findings.

The incidence of heart disease in the Asian population in the UK is high and mortality from coronary heart disease for both Asian men and women is also higher than for non-Asians. The need to provide more information on cardiac rehabilitation programmes is highlighted. Cultural factors influence how Asian people perceive the heart, health and health care practices. A number of methodological issues are pertinent to conducting research involving ethnic groups, namely inter vs intra group differences, victim blaming, sampling, measurement, language issues and researcher effect. The aim of the study is to design, refine and validate a number of tools for use with Asian people in relation to cardiac rehabilitation. Preliminary and tentative conclusions suggest that cardiac rehabilitation services need a higher profile within the Asian community and that established approaches to data collection may need to be challenged if accurate and relevant feedback is to be achieved.

Aged↗

Breast cancer and oral contraceptive use in Asian-American women.

Breast cancer incidence has historically been 4-7 times higher in the United States than in Asia. A previous study by the authors in Asian-American women demonstrated a substantial increase in breast cancer risk in women who migrated from Asia to the United States, with the risk almost doubling during the first decade after migration. Increased use of oral contraceptives soon after migration to the United States could possibly explain this rapid rise in risk. In a population-based case-control study of Chinese, Filipino, and Japanese-American women, aged 20-55 years, who lived in San Francisco-Oakland, California; Los Angeles, California; and Oahu, Hawaii during 1983-1987, 597 cases (70% of those eligible) and 966 controls (75%) were interviewed. Controls were matched to cases on age, ethnicity, and area of residence. Oral contraceptive (OC) use increased with time since migration; 15.0% of Asian-born women who had been in the West <8 years, 33.4% of Asian-born women who had been in the West > or =8 years, and 49.6% of Asian women born in the West had ever used OCs. However, duration of OC use (adjusted for age, ethnicity, study area, years since migration, education, family history of breast cancer and age at first full-term birth) was not associated with increased risk of breast cancer. Moreover, neither OC use before age 25 years nor before first full-term birth was associated with increased risk. Results were unchanged when restricted to women under age 45 years or under age 40 years. After adjustment for duration of OC use, women who had been in the United States > or =8 years were still at almost twice the risk of breast cancer compared with women who had been in the United States 2-7 years. This study suggests that OC use cannot explain the elevated risk observed in Asian women who migrated to the United States > or =7 years ago.

Adult↗