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Health practices, problems, and needs in a population of Micronesian adolescents.

Saipan, one of many islands of the Pacific Trust Territory, depends on the United States for its medical care. The limited resources on the island have resulted in little medical attention for adolescents. This study surveyed 519 Saipan adolescents to determine their health practices, problems, and needs. Although these teenagers rarely saw physicians, they commonly reported health problems such as headaches, abdominal pain, and dental cavities. In the psychosocial arena, their problems involved parents, girlfriends/boyfriends, school, and suicidal thoughts. The health topics found to be of most interest included sex education, jobs, suicide prevention, drugs, and birth control. The most popular methods for learning about these subjects were books, movies, films, and school classes. There were high reported incidences of drug and alcohol problems among boys, and thoughts about suicide in all respondents.

Adolescent↗

Genetic variability, molecular evolution, and geographic diversity of HLA-B27.

HLA-B27 represents a family of 23 closely related alleles (B*2701-23) that differ at 24 amino acid positions. The pattern of polymorphisms of B27 was studied, with special reference to synonymous (Ks) and nonsynonymous (Ka) divergence among alleles. B27 alleles are characterized by the enhanced rate of nonsynonymous nucleotide substitution in the peptide-binding region (PBR). The percentage of substitutions between each of the B27 pairs ranges from 0.2%-3% in exons 2-3 to 1.8%-20.1% in the PBR. A phylogenetic analysis of all B27 alleles is described in order to identify subtypes with a common evolutionary history. These results, together with the phylogenetic trees obtained from the comparison between exons 2-3 and PBR indicate that polymorphism of B27 is selectively maintained. Most of the differences are clustered in the C/F pocket affecting the specific binding of antigenic peptides. Gene conversion and point mutation are the most important mechanisms responsible for B27 diversification. The interaction of selection, genetic drift, and recombination events is important for generating polymorphism at B27 alleles. We analyzed a large extended B27 positive population from different parts of the world. Our results indicate that B27 subtypes differ in their ethnic distribution, which may be the result of different genetic and geographical origins. Different factors such as genetic drift, bottleneck effect, and admixture among populations could contribute to the genetic constitution of B27. The striking correlation between the structural features of B27 and the ethnic distribution of these subtypes suggests a model of strong directional evolution, in which the subtypes could have arisen from B*2705.

Africa↗

Articular surfaces of the pectoral girdle: sex assessment of prehistoric New Zealand Polynesian skeletal remains.

Prehistoric Polynesian skeletal remains are frequently being recovered in New Zealand due to the increasing pace of urbanisation. Since such material must often be reinterred quickly, it is important that the sex of individuals be determined from the remains in a relatively short time. For this purpose, discriminant function analysis was utilised for sex determination of prehistoric adult New Zealand Polynesian clavicles (31 male and 31 female) and scapulae (33 male and 38 female). Diameters of the acromial and sternal ends of the clavicle and the height and breadth of the scapular glenoid cavity were measured and subjected to Statistical Package for the Social Sciences (SPSS) direct discriminant function analysis. For the single discriminant function derived, accuracy of sex determination was 97.7% and reduction in error over random assignment by sex was 95%. This discriminant function will be a useful tool in the assessment of human remains in the forensic and archaeological context because it incorporates measurements which can be taken on incomplete bones.

Clavicle↗

The talus: sex assessment of prehistoric New Zealand Polynesian skeletal remains.

Prehistoric Polynesian skeletal remains are frequently being recovered in New Zealand due to the increasing pace of urbanisation. Since such material must often be reinterred quickly, it is important that the sex of individuals be determined from the remains in a relatively short time. For this purpose, discriminant function analysis was utilised for sex determination of prehistoric adult New Zealand Polynesian tali (24 males and 27 females). Five measurements were taken and subjected to Statistical Package for the Social Sciences (SPSS) discriminant function analysis. For the discriminant functions derived, accuracy of sex determination ranged from 85.1 to 93.3%. Reduction in error over random assignment by sex ranged from 70 to 87%.

Female↗

Incidence of facial fractures resulting in hospitalisation in New Zealand from 1979 to 1988.

The incidence and aetiology of facial fractures resulting in admission to public hospitals in New Zealand in 1987 were investigated retrospectively from data collected by the Health Statistical Services. Data were analysed by the age group, ethnic origin and gender of those affected. During 1987 the overall incidence of facial fractures was 47.9/100,000 of the population. The highest incidence was for Maori males at 152/100,000. A comparison with data for the period 1979 to 1988 showed a decrease for the population as a whole but an increase for those who declared themselves to be Maori. Assault was the most common cause of facial fractures resulting in hospitalisation for both males and females. Sport was the second most common cause of facial fractures with rugby football contributing two-thirds of these. These results indicate where future preventive measures should be targeted.

Adolescent↗

Association of D2 dopamine receptor and alcohol dehydrogenase 2 genes with Polynesian alcoholics.

Alleles of the D2 dopamine receptor (DRD2) and the alcohol dehydrogenase 2 (ADH2) genes were determined in 69 French Polynesian alcoholic patients and 57 controls matched for racial origin. Three racial groups were studied: pure Polynesians (PP), Polynesians mixed with Caucasian (PCA) ancestry and Polynesians mixed with Chinese (PCH) ancestry. DRD2 A1 allele frequencies in the alcoholics compared to their controls in these groups were: PP,.26 vs.32 (P =. 69); PCA,.44 vs.35 (P =.46); PCH,.40 vs 0.39 (P =.88). ADH2 1 allele frequencies in alcoholics compared to their controls groups were: PP, .56 vs.62 (P =.66); PCA,.75 vs.56 (P =.09); PCH,.78 vs.32 (P =.009). In the PCA group, the combination of the DRD2 A1 genotypes and the ADH2 1 homozygotes was strongly associated with alcoholism (P =. 0027). This preliminary study shows the importance of ascertaining racial ancestry in molecular genetic association studies. Moreover, it suggests that a combination of genes are involved in susceptibility to the development of alcoholism.

Adult↗

Estimation of body fat in caucasian and Polynesian women from anthropometric measurements.

Girth measurements provide a simple method for estimation of total body fat that can be used over a wide range of percentage body fat (%BF). Well-established equations for determining %BF from girth measurements were applied to 42 Caucasian and 40 Polynesian women. %BF was determined from total body water measurement using oxygen-18 dilution. The relationship between the criterion measurement of %BF and that calculated from girth measurements differed significantly between the two ethnic groups. Assessment of body fat using girth measurements should use ethnicity-specific equations.

Adipose Tissue↗

Inflammatory pseudotumor of the liver: demographics, diagnosis, and the case for nonoperative management.

BACKGROUND: Inflammatory pseudotumor of the liver (IPL) is an unusual tumor-like condition that is becoming recognized as an important differential diagnosis in the patient presenting with liver masses. This report describes six cases of IPL. STUDY DESIGN: Clinical, diagnostic, pathologic, and followup data were collected prospectively on six patients presenting to a specialist hepatobiliary unit. RESULTS: Six patients with IPL presented over a 2-year period. Median age was 35 years (range 2 to 79 years) and five patients were men. Three patients were Polynesian (Tongan and Samoan) and one was New Zealand Maori. Five patients presented with nonspecific symptoms (fever, arthralgia, myalgia) and IPL was an incidental finding in one patient. At presentation, four patients had elevated white cell counts, and five patients had abnormal liver function tests with elevations in alkaline phosphotase and gamma-glutamyl transferase the most commonly seen. Carcinogenic embryonic antigen and alpha fetoprotein were normal in all patients, although one was a known hepatitis B carrier. In all cases of IPL, diagnosis was made on core biopsy of the liver lesions and all patients were managed nonoperatively with complete resolution of the tumors. Two patients had marked reduction in systemic symptoms (fever and pain) from a short course of oral steroids. CONCLUSIONS: IPL appears to be a relatively common problem in Maori and Polynesians. Recognition and differentiation of this condition from malignant liver lesions are important to avoid unnecessary surgery.

Adult↗

Severe sequelae after stonefish envenomation.

More tourists are visiting the idyllic waters of the South Pacific each year. They share the shallow waters with the native wildlife, including the venomous stonefish. Although the injection of its venom has been reported to have occasional fatal neuromuscular and cardiovascular sequelae, severe tissue necrosis at the injection site has not been described. We present a case of stonefish injury that describes serious localised sequelae of stonefish envenomation

Amputation, Surgical↗

Trends in body size, diet and food availability in the Cook Islands in the second half of the 20th century.

The body size of adult Cook Islanders on Rarotonga for the years 1952, 1966 and 1996 has been increasing. The rate of increase in stature of women aged 20-39 years was 0.5cm per decade across the period 1952-1966, and 0.8cm per decade for the period 1966-1996. The rate of increase of weight in the 20-29 years age group was 0.6kg per decade in period 1, and 7.3kg per decade in period 2. In the age group 30-39 years, the rates were 3.2kg per decade and 5.1kg per decade respectively. Changing food availability for the period 1961-2000 is used to compare estimates of dietary energy availability with estimates of physiological energy requirements. There has been reduced availability of traditional staples, a likely reduction in consumption of fish, increased consumption of meat, and a decline in the availability of dietary fats and oils. Daily per capita energy intakes in 1952 and 1966 greatly exceed an hypothetical physiological maximum value for energy expenditure, suggesting a large positive energy balance in 1952 and an even greater one in 1966, both predisposing to weight gain. Although daily per capita energy availability in 1996 is similar to the hypothetical physiological maximum value for energy expenditure, it exceeds the measured level of energy expenditure at that time. It is speculated that excessive energy intake relative to requirement is more likely to predispose to positive energy balance and weight gain than decline in energy expenditure, although to a lower extent than in 1966 and 1952.

Adult↗

Variation in the vector competence of Aedes polynesiensis for Wuchereria bancrofti.

The vector competences of 6 geographic strains of Aedes polynesiensis for Wuchereria bancrofti were studied using two types of experimental infections. Experimental infection of laboratory-bred mosquitoes fed on the carriers' forearms with different levels of microfilaraemia showed that microfilariae (mf) uptake was directly proportional to the carrier's mf density and, as mf densities decreased, concentration capacity of Ae. polynesiensis increased. It was also shown that infection has an important effect on mosquito mortality, and that the mortality rate differed among mosquito strains. In infections using artificial feeders, the mf uptake was closely regulated, thus showing differences in the vectorial efficiency of Ae. polynesiensis related to the geographic origin of the mosquito strain. The mosquitoes from the Society archipelago were more efficient intermediate hosts than geographically distant strains when infected with W. bancrofti from an island within the archipelago (Tahiti). Mosquito strains from the Society archipelago developed the highest proportion of infective-stage larvae and exhibited the lowest mortality rate when infected with sympatric Tahitian W. bancrofti.

Adult↗

New species and new records of Ergasilus Nordmann (Copepoda: Ergasilidae) from the gills of grey mullet (Mugilidae).

Four new Ergasilus species are described from five host species of grey mullet, family Mugilidae, held in the fish collections of The Natural History Museum, London. Ergasilus extensus n. sp. was found on Myxus petardi (Castelnau) from Australia, E. sittangenesis n. sp. on Sicamugil hamiltoni (Day) from Burma, E. piriformis n. sp. on Sicamugil cascasia (Hamilton Buchanan) from India, and E. ecuadorensis n. sp. on Mugil curema Valenciennes and M. hospes Jordan & Culver from Ecuador. New records of E. cyanopictus Caravalho, E. magnicornis Yin, E. orientalis Yamaguti and E. rostralis Ho, Jayarajian & Radhakrishnan on grey mullet are also given.

Animals↗

A view from the other side: the place of spirits in the Tongan social field.

Spirits are part of everyday life in the Kingdom of Tonga. This study explores beliefs about the supernatural by analyzing discourse on spirits and death and by examining two examples of contemporary cultural practice related to spirits and death. The anthropological concepts of the body and its cultural construction and of thirdspace as a landscape of the Tongan islands that emerges out of the physical and the perceived provide the framework for this investigation. Research findings suggest that spirits participate in the natural order of Tongan society and thus serve to help maintain cultural identity in the face of uncertain social change and a popular but contested prodemocracy movement. Spirits also function as a system of representation, mirroring an image of an ideal self, something that is continually under negotiation. Encounters between spirits of ancestors and their living descendants suggest an uneasy acceptance of death and a sense of irony about its inevitability.

Culture↗

Race, combat, and PTSD in a community sample of New Zealand Vietnam War veterans.

The association between posttraumatic stress disorder (PTSD), combat exposure, and race was examined in a New Zealand community sample of 756 Vietnam War veterans. Maori veterans reported higher levels of PTSD than their non-Maori counterparts. However, the race effect was shown to be mediated by combat exposure level, rank, and combat role. These findings support differential experience explanations for the relationship between postwar adjustment and race, suggesting that higher levels of psychological symptoms reported by minority group veterans can be accounted for by their experience of higher levels of combat stressors.

Adaptation, Psychological↗