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Case identification of mood disorders in Asian American and Caucasian American college students.

Past studies have sometimes found that Asian American participants score higher on checklists that measure psychological distress compared to Caucasian American participants. However, studies using diagnostic interviews have not found corresponding elevated rates of mood disorders in Asian American participants. In the present study, Asian American (n = 238) and Caucasian American students (n = 556) completed checklist measures of distress (the Beck Depression Inventory, BDI and the Mood and Behavior Questionnaire, MBQ) and a subsample of students (n = 118) received a diagnostic interview. Asian American students had higher BDI scores, but the groups did not differ on either the MBQ, a measure closely tied to DSM criteria for major depression, or on rates of current mood disorders. Elevated BDI scores overestimate rates of mood disorders, particularly in Asian American students.

Adolescent↗

Predictors of nonattendance of intake appointments among five Asian American client groups.

The authors examined the relationship of demographic, clinical, and service program factors with preintake attrition rates, or the nonattendance of intake appointments, among 5 Asian American groups at an ethnic-specific program. The results show that younger age, earlier appointment, Asian language match with the prescreening interviewer, and assignment of the prescreening interviewer as the intake therapist increased; however, gender match with prescreening interviewer decreased-the likelihood of intake attendance. As hypothesized, Southeast Asians (Cambodian, Iu Mien, and Vietnamese Americans to a lesser degree) reported higher intake attendance rates than more established East Asian groups (Chinese and Korean Americans). Specific implications of these results to program evaluation and to development and improvements in service delivery to Asian American groups are discussed.

Adult↗

Frequency and intensity of social anxiety in Asian Americans and European Americans.

Asian American students have typically reported greater levels of social anxiety than European American students on self-report measures (e.g., Okazaki, 1997; Norasakkunkit & Kalick, 2002). This study employed an event-contingent experience sampling methodology to examine whether Asian American university students experienced social anxiety more often and more intensely than European Americans in their daily lives. Forty-five Asian American and 38 European American students participated in a two-week diary study. The results showed that on average, Asian Americans and European Americans reported a similar number of events that evoked anxiety in social situations, but Asian Americans reported more negative emotions on average in social situations than did European Americans.

Adolescent↗

The role of acculturation in the career adjustment of Asian American workers: a test of Leong and Chou's (1994) formulations.

F.T.L. Leong and E.L. Chou (1994) provided a theoretical model for understanding the acculturation process among Asian Americans and applied that model to predicting the potential career adjustment problems encountered by Asians in the United States. Several of the hypotheses proposed by Leong and Chou were empirically tested in 2 separate studies. In Study 1, acculturation (R.M. Suinn, K. Rickard-Figueroa, S. Lew, & P. Vigil, 1987) was found to be positively related to job satisfaction (A.H. Brayfield & H.F. Rothe, 1951) and negatively related to occupational stress and strain (S. H. Osipow & A.R. Spokane, 1981) in a sample of 39 Asian American employees from 2 major companies who attended career development workshops. In Study 2, acculturation was found to be positively related to supervisors' performance ratings in a different sample of 27 Asian American employees. These preliminary data suggest that acculturation plays an important role in the career development of Asian Americans. The theoretical, research, and counseling implications of the findings are discussed.

Acculturation↗

Does place of birth influence endogenous hormone levels in Asian-American women?

In 1983-87, we conducted a population-based case-control study of breast cancer in Asian women living in California and Hawaii, in which migration history (a composite of the subject's place of birth, usual residence in Asia (urban/rural), length of time living in the West, and grandparents' place of birth) was associated with a six-fold risk gradient that paralleled the historical differences in incidence rates between the US and Asian countries. This provided the opportunity to determine whether endogenous hormones vary with migration history in Asian-American women. Plasma obtained from 316 premenopausal and 177 naturally premenopausal study controls was measured for levels of estrone (E1), estradiol (E2), estrone sulphate (E1S), androstenedione (A), testosterone (T), dehydroepiandrosterone (DHEA), dehydroepiandrosterone sulphate (DHEAS), progesterone (PROG) and sex hormone-binding globulin (SHBG). Levels of the oestrogens and sex hormone-binding globulin did not differ significantly between Asian- and Western-born women, although among premenopausal women, those least westernised had the lowest levels of E1, E2, and E1S. Androgen levels, particularly DHEA, were lower in women born in the West. Among premenopausal women, age-adjusted geometric mean levels of DHEA were 16.5 and 13.8 nmol l(-1) in Asian- and Western-born women respectively; in postmenopausal women these values were 11.8 and 9.2 nmol l(-1), (P<0.001) respectively. Among postmenopausal women, androgens tended to be highest among the least westernised women and declined as the degree of westernisation increased. Our findings suggest that aspects of hormone metabolism play a role in population differences in breast cancer incidence.

Adult↗

Prediction of fat-free mass by bioimpedance analysis in migrant Asian Indian men and women: a cross validation study.

BACKGROUND: Bioimpedance analysis (BIA) is a fast and convenient field technique for estimation of total body fat-free mass (FFM). However, bioimpedance-based prediction equations have been developed in predominantly white populations and little information is available on their usefulness in Asian Indian populations. OBJECTIVE: To develop a prediction equation for FFM based on BIA measurements applicable to a migrant population of Asian Indians and to investigate the predictive accuracy of published BIA-based equations in this ethnic group. DESIGN: FFM was measured by dual-energy X-ray absorptiometry in 211 healthy adults (110 men, 101 women; age ranges 19-74 year) of Asian Indian ethnicity and used as the reference measure to develop prediction equations based on single-frequency BIA measurements of resistance and reactance. A cross-validation technique was applied. Predictive accuracy of published BIA-based equations was assessed in this sample. RESULTS: Sex-specific equations developed in the entire group included height2/resistance and body weight as predictors (R2=0.84 and 0.70 and standard errors of estimate of 2.8 and 2.0 kg for males and females, respectively; CV: 6%). Of published equations examined, one predicted FFM satisfactorily in men with nonsignificant bias and may be applicable to Asian Indian populations. None of the published equations tested performed satisfactorily in women. CONCLUSIONS: Bioimpedance-based equations for predicting FFM developed specifically in Asian Indians are recommended for field studies designed to measure body composition of this ethnic group.

Absorptiometry, Photon↗

Laser-assisted hair removal in Asian skin: efficacy, complications, and the effect of single versus multiple treatments.

BACKGROUND: Alexandrite laser hair removal can be quite successful in lighter skin types. Effective hair removal in Asians can be difficult, and multiple treatments are usually required for effective treatment. OBJECTIVE: To evaluate the safety and efficacy of alexandrite laser hair removal in Asian skin, to determine the benefit of multiple treatments, and to evaluate the value of test patches before laser treatment. METHODS: One hundred forty-four Asian subjects with Fitzpatrick skin types III to V were treated with a cooled 40-ms alexandrite laser with fluences of 16 to 24 J/cm2. Initially, all treated subjects underwent test patch application. After test patch application, 35 subjects with 66 anatomic sites received three treatments. Thirty-five subjects with 66 anatomic sites received two treatments, and 74 subjects with 124 anatomic received a single treatment. All subjects were followed for 9 months after their final treatment. RESULTS: In subjects that were treated three times, a 55% hair reduction was noted at 9 months after the third treatment. In subjects treated two times, a 44% hair reduction was noted at 9 months after the second treatment. In subjects treated only one time, a 32% hair reduction was noted at 9 months after the single treatment. No subjects had scarring or long-term pigmentary changes. There appeared to be no correlation between test patch acute complications and those seen after actual treatments. CONCLUSION: Although Asian skin can be effectively treated with a cooled, long-pulsed alexandrite laser, complications do occur. Laser hair removal efficacy was increased with multiple treatments. There does not appear to be an exact correlation in Asian skin between complications occurring after test patch treatment and those seen with subsequent treatments.

Adolescent↗

Physico-chemical properties of low density lipoproteins in normolipidemic Asian Indian men.

The present study investigated whether a predisposition to high frequency of small, dense low density lipoproteins (LDL) could be an additional coronary risk factor in migrant Asian Indians. Ninety-three normolipidemic (fasting plasma cholesterol levels < or = 240 mg/dl and triglyceride levels < or = 250 mg/dl) adult Asian Indian men residing in the U.S. were compared to a group of 59 Caucasian men for the prevalence of LDL electrophoretic patterns A and B (size of major LDL peak > or = 255 A for LDL pattern A and < 255 A for LDL pattern B). Compared to the Caucasians, the Asian Indians had larger LDL size (mean +/- SD; 260.1 +/- 12.8 A vs 267.7 +/- 11.4 A, respectively; p = 0.0002), an increased frequency of LDL pattern A (59% vs 85%, respectively) and a lower frequency of LDL pattern B (41% vs 15%, respectively) (p = 0.0005). The difference in LDL size in the two study groups persisted after adjusting for the various confounding variables, such as age, plasma triglycerides, high-density lipoprotein cholesterol and dietary habits. We conclude that compared to Caucasians, Asian Indian men have larger LDL particles and a lower prevalence of LDL phenotype B in the presence of normolipidemia. Therefore, we exclude a genetic predisposition to atherogenic LDL phenotype as a factor contributing to the high incidence of coronary heart disease in migrant Asian Indians.

Adult↗

Heavy metal hazards of Asian traditional remedies.

In recent years there has been an increase in the use of traditional Asian medicines. It is estimated that 30% of the US population is currently using some form of homeopathic or alternative therapy at a total cost of over $13 billion annually. Herbal medications are claimed and widely believed to be beneficial; however, there have been reports of acute and chronic intoxications resulting from their use. This study characterizes a random sampling of Asian medicines as to the content of arsenic, mercury, and lead. Traditional herbal remedies were purchased in the USA, Vietnam, and China. The Asian remedies evaluated contained levels of arsenic, lead, and mercury that ranged from toxic (49%) to those exceeding public health guidelines for prevention of illness (74%) when consumed according to the directions given in or on the package. Heavy metals contained in Asian remedies may cause illness of unknown origin and result in the consumption of health care resources that are attributable to other causes. The public health hazards of traditional herbal Asian remedies should be identified and disclosed.

Arsenic↗

Asians have lower body mass index (BMI) but higher percent body fat than do whites: comparisons of anthropometric measurements.

We studied the correlations between body mass index (BMI) and percent body fat (fat%) measured by dual-photon absorptiometry (DPA) in 445 white and 242 Asian adults aged 18-94 y. In addition, comparisons in six circumferences and eight skinfold-thickness measurements between whites and Asians were made to explain the discrepancies. Although Asians had lower BMI, they were fatter than whites of both sexes. The correlations between fat% and BMI varied by BMI and sex and race. Comparisons in anthropometry show that Asians had more subcutaneous fat than did whites and had different fat distributions from whites. Asians had more upper-body subcutaneous fat than did whites. The magnitude of differences between the two races was greater in females than in males. Prediction equations developed for each sex and race, based on BMI alone, gave SEEs ranging from 4.4% to 5.7%. All were significantly improved to the range of 3.5-4.4% when age and several skinfold-thickness measurements were added.

Adipose Tissue↗

Frequency of deletional alpha-thalassemia genotypes in a predominantly Asian-American population.

alpha-Thalassemia is prevalent among Asian-Americans. Most cases involve deletions of one or more alpha-globin genes. Parents with two-gene cis deletions can have offspring with hemoglobin Bart's hydrops fetalis or hemoglobin H disease. The diversity of deletions poses special challenges to laboratories that offer DNA-based testing for alpha-thalassemia. The purpose of this study was to determine both the frequency of alpha-thalassemia genotypes in a predominantly Asian-American population (n = 78) and the mutation detection rate of a comprehensive Southern blot method. The ethnic composition of the study population was similar to the major Asian-American groups that reside in the United States as a whole. Three mutations (the Southeast Asian type, --SEA; -alpha3.7; and the Filipino type, --FIL) accounted for all mutant alleles present in the Asian-American patients tested for reproductive reasons. The relative frequencies of these three mutations were 62%, 27%, and 11%, respectively. The mutation detection rate was 100%. Laboratories that perform DNA-based alpha-thalassemia testing in populations similar to the one residing in Washington State should use a testing system that allows for the unequivocal identification of the haplotypes detected in the study population, namely --SEA, -alpha3.7, and --FIL.

Anemia↗

Idiopathic pulmonary fibrosis risk loci in East Asian populations mirror those of European populations.

RATIONALE: Common and rare variants that are associated with the risk of developing idiopathic pulmonary fibrosis (IPF) have been identified predominantly in European ancestry populations. OBJECTIVES: To better understand the genetic variants that contribute to IPF in individuals with Asian ancestry, we conducted a genome-wide association study of IPF in East Asian populations. METHODS: We included 1026 patients with IPF and compared them to 1723 unaffected controls of Japanese and Korean ancestry. Genome-wide association analysis was conducted in the Japanese and Korean ancestry cohorts separately and combined using meta-analysis. Restricted maximum likelihood was used to estimate the SNP-based heritability and local ancestry of chromosome 11 was inferred for each subject. MEASUREMENTS AND MAIN RESULTS: We identified loci on chromosomes 4 (FAM13A; rs7690839), 5 (TERT; rs7734992), 6 (DSP; rs2076295), and 11 (MUC5B; rs35705950) that were significantly associated with risk of IPF. Importantly, the sentinel variants in each of these loci are the same as, or in strong linkage disequilibrium with, the risk variants that have been observed in studies of European ancestry populations. In aggregate, common variants (not including the MUC5B promoter variant) account for approximately 25% of the risk of developing IPF in these East Asian ancestry cohorts. Moreover, local ancestry analysis indicates that the presence of MUC5B promoter variant in the East Asian population is not a result of admixture with European ancestry populations. CONCLUSIONS: We conclude that the IPF risk loci in East Asian populations are shared with those of European ancestry populations, although their risk allele frequencies and effect sizes differ. These findings indicate shared genetic risk factors of IPF across ancestries.

Aged↗

Impact of Asian ethnicity and national origin on infant birth weight.

To investigate the relation between Asian ethnicity/national origin and low birth weight (< 2,500 g), the authors analyzed singleton live births among 50,044 Asian and 221,866 white women who delivered in California during 1992. Ethnic and subgroup differences in prenatal characteristics and birth weight outcomes were found between Asian and white women and between Asian subgroups. In unadjusted comparisons, very low birth weight (500-1,499 g) was more likely among Filipino women and less likely among Chinese women, relative to whites. Moderately low birth weight (1,500-2,499 g) was more likely among Cambodian, Filipino, Indian, Japanese, Laotian, and Thai women and was less likely among Koreans, relative to whites. In multivariate analyses, Filipino women remained at increased risk of both very low and moderately low birth weight, while Cambodian, Indian, and Laotian women had elevated odds of moderately low birth weight. Chinese women were less likely to have very low birth weight infants than were whites. Utilization of prenatal care was also associated with low birth weight. Perinatal outcomes among Asians vary by national origin, and accepted risk factors that were studied only partially explain this variation.

Adolescent↗

Laser blepharoplasty in Asians.

Traditional blepharoplasty removes periorbital wrinkles by cutting and stretching the skin. However, this method has a substantial risk of producing ectropion or scleral show. In addition, fine periocular wrinkles may persist because this method does not change skin texture. The pulsed CO2 laser has recently become a primary surgical tool in treating aging eyelids. Periorbital wrinkles vary in depth not only from person to person, but also among different races. Compared with whites, most Asians have a thicker dermis, so more laser passes and a higher power may be required to remove periorbital wrinkles, but concerns about hyperpigmentation and prolonged erythema have limited its use on Asian skin. In this study, 346 patients underwent laser blepharoplasty at the Korea University Medical Center and at Dr Choi's Aesthetic Clinic. They were followed for 12 months on average from September 1995 to September 1999. The CO2 laser was used in resurfacing periorbital wrinkles, transcutaneous skin excision, and transconjunctival blepharoplasty, including fat removal. The authors assessed the benefit of using the UltraPulse CO2 laser in Asian blepharoplasty. They found that 291 patients (84%) had good to excellent results. The incidence of side effects was very low. Prolonged erythema occurred in 19 patients (5%) and hyperpigmentation occurred in 35 patients (10%), but the erythema disappeared spontaneously within 2 months and the hyperpigmentation could be managed readily by the topical use of retinoids and hydroquinone cream. Therefore, the authors conclude that postoperative hyperpigmentation is no longer a problem limiting laser resurfacing in Asian blepharoplasty. The UltraPulse CO2 laser is a safe and effective rejuvenation method for treating aging eyelids in Asians.

Adult↗

Longitudinal comparison of the academic performances of Asian-American and white medical students.

PURPOSE: To compare the academic performances of Asian-American medical students--before, during, and after medical school--with those of white students. METHOD: The 140 Asian-American graduates and 2,269 white graduates from the classes of 1981-1992 at Jefferson Medical College were studied prospectively: data on academic performance, indebtedness, and delayed graduation were analyzed and compared for all the graduates. F-tests, chi-square tests, and regression models were used. RESULTS: The Asian-Americans had statistically significantly higher scores on the SAT (Scholastic Aptitude Test) quantitative subtest and on the MCAT (Medical College Admission Test) chemistry, physics, and science problems subtests; the whites had significantly higher scores on the MCAT reading subtest; third-year grade-point averages for required clerkships; and scores on National Board of Medical Examiners Part I, II, and III examinations (NBME I, II, and III). No significant difference was found in the other performance measures, including ratings in the first year of residency. Regression analysis showed that the MCAT reading score was the major predictor of Asian-Americans' performances on the NBME I and II. CONCLUSION: Because the MCAT reading score is the major predictor of later performance for Asian-American students, schools should consider employing different criteria in predicting and monitoring these students' performances.

Achievement↗

The frequency and distribution of thiopurine methyltransferase alleles in Caucasian and Asian populations.

Thiopurine methyltransferase metabolizes 6-mercaptopurine, thioguanine and azathioprine, thereby regulating cytotoxicity and clinical response to these thiopurine drugs. In healthy Caucasian populations, 89-94% of individuals have high thiopurine methyltransferase activity, 6-11% intermediate and 0.3% low, resulting from genetic polymorphism. Four variant thiopurine methyltransferase alleles were detected in over 80% of individuals with low or intermediate thiopurine methyltransferase activity. The wild-type allele is defined as TPMT*1 and the mutant alleles are TPMT*2 (G238C), TPMT*3A (G460A and A719G), TPMT*3B (G460A) and TPMT*3B (A719G). The frequency of these alleles in different ethnic groups is not well defined. In this study, DNA from 199 British Caucasian, 99 British South West Asian and 192 Chinese individuals was analysed for the presence of these variant alleles using polymerase chain reaction-restriction fragment length polymorphism and allele-specific polymerase chain reaction based assays. The frequency of individuals with a variant thiopurine methyltransferase genotype was: Caucasians 10.1% (20/199), South West Asians 2.0% (2/99) and Chinese 4.7% (9/192). Two TPMT*2 heterozygotes were identified in the Caucasian population, but this allele was not found in the two Asian populations. TPMT*3A was the only mutant allele found in the South West Asians (two heterozygotes). This was also the most common mutant allele in the Caucasians (16 heterozygotes and one homozygote) but was not found in the Chinese. All mutant alleles identified in the Chinese population were TPMT*3C (nine heterozygotes). This allele was found at a low frequency in the Caucasians (one heterozygote). This suggests that A719G is the oldest mutation, with G460A being acquired later to form the TPMT*3A allele in the Caucasian and South West Asian populations. TPMT*2 appears to be a more recent allele, which has only been detected in Caucasians to date. These ethnic differences may be important in the clinical use of thiopurine drugs.

Alleles↗

Startle modulation in Caucasian-Americans and Asian-Americans: a prelude to genetic/endophenotypic studies across the 'Pacific Rim'.

OBJECTIVES: Deficient prepulse inhibition (PPI) of startle in schizophrenia patients and unaffected family members may be a useful endophenotype in studies seeking to identify vulnerability genes for schizophrenia. Before expanding such studies to include Pacific Rim populations with distinct genetic origins compared with North American Caucasian populations, we examined PPI and related startle measures in normal North American Caucasian and Asian men. METHODS: One hundred and seventy-four consecutive carefully screened right-handed male 18-35 year olds completed tests of startle and PPI using bilateral electromyography measures of orbicularis oculi. Subjects identified their racial background. RESULTS: Startle in Caucasian subjects was of significantly larger magnitude and shorter latency compared with Asian subjects; the percent PPI was significantly greater in Asian versus Caucasian subjects at 60 and 120 ms prepulse intervals. Group differences in PPI but not reflex latency were eliminated when groups were matched for startle magnitude on pulse alone trials. Caucasian-American and Asian-American groups did not differ significantly in resting blink rate, resting electromyography activity, or startle reflex habituation. CONCLUSIONS: Robust phenotypic differences in acoustic startle magnitude and latency between Caucasian-American and Asian-American populations must be considered in studies using startle and PPI as endophenotypes across these populations.

Adolescent↗

Distribution of the FcgammaRIIIa 176 F/V polymorphism amongst healthy Chinese, Malays and Asian Indians in Singapore.

AIMS: To determine and compare the distribution of the FcgammaRIIIa 176 F/V polymorphism across three ethnically distinct populations (Chinese, Asian Indians and Malays) in Singapore. METHODS: The FcgammaRIIIa 176 F/V polymorphism was genotyped by direct sequencing from genomic DNA samples obtained from normal healthy Chinese, Asian Indians and Malays (n = 192 from each population). RESULTS: The allelic frequencies of the high binding affinity FcgammaRIIIa 176 V allele for Chinese, Asian Indians and Malays were 35%, 33% and 46%, respectively (F allele frequencies were 65%, 67% and 54%, respectively). Genotype distributions were found to conform to the Hardy-Weinberg law (P > 0.05) in each group. chi(2) comparisons revealed significant differences in the genotype distributions of the FcgammaRIIIa 176 V/F polymorphism of Malays from the other two populations (Chinese and Asian Indians). However, no significant difference in the genotype distributions of the FcgammaRIIIa 176 V/F polymorphism was observed between Chinese and Asian Indian populations. CONCLUSIONS: The genotype distributions of the FcgammaRIIIa 176 V/F polymorphism in healthy Malays are significantly different from both Chinese and Indians. These observations provide the fundamentals on which future disease associations may be built and also present important implications for the design of therapeutic regimens amongst various ethnic groups.

Adult↗