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PubMed2004

Personal cancer prevention and screening practices among Asian Indian physicians in the United States.

This study examines personal cancer prevention and screening practices of Asian Indian physicians. Asian Indians are the third largest group of Asian Pacific Islanders (APIs) residing in the United States. Using a cross-sectional study approach, we investigated cancer prevention and screening practices of 254 randomly selected Asian Indian physicians in the United States. Results showed that prevalence of conventional risk factors were low, e.g., smoking, alcohol consumption. Nutrition-related behaviors indicated 31-48% met the Food Guide Pyramid's recommendations for daily intake of fruits, vegetables, low fat/cholesterol diet, and grains. Certain cancer prevention and screening practices failed to meet age appropriate recommendations of leading health agencies. For men age 50 and over, only 27% ever had a flexible sigmoidoscopy and 25% ever had a fecal occult blood test (FOBT); 84% of women age 40 and over ever had a mammogram and 87% of women ever had a Papanicalou (Pap) smear. With respect to cancer screening behaviors, the respondents were less likely to engage in these preventive screenings (with the exception of mammography) than the general US population and the APIs (except Pap smears). Additionally, our respondents were less likely than other physicians to practice cancer screening behaviors. Results support the need to promote regular cancer prevention and screening among Asian Indian physicians.

Adult↗
PubMed2004

Estimation of internal radiation dose to the adult Asian population from the dietary intakes of two long-lived radionuclides.

Daily dietary intakes of two naturally occurring long-lived radionuclides, 232Th and 238U, were estimated for the adult population living in a number of Asian countries, using highly sensitive analytical methods such as instrumental and radiochemical neutron activation analysis (INAA and RNAA), and inductively coupled plasma mass spectrometry (ICP-MS). The Asian countries that participated in the study were Bangladesh (BGD), China (CPR), India (IND), Japan (JPN), Pakistan (PAK), Philippines (PHI), Republic of Korea (ROK) and Vietnam (VIE). Altogether, these countries represent more than 50% of the world population. The median daily intakes of 232Th ranged between 0.6 and 14.4 mBq, the lowest being for Philippines and the highest for Bangladesh, and daily intakes of 238U ranged between 6.7 and 62.5 mBq, lowest and the highest being for India and China, respectively. The Asian median intakes were obtained as 4.2 mBq for 232Th and 12.7 mBq for 238U. Although the Asian intakes were lower than intakes of 12.3 mBq (3.0 ug) 232Th and 23.6 mBq (1.9 ug) 238U proposed by the International Commission on Radiological Protection (ICRP) for the ICRP Reference Man, they were comparable to the global intake values of 4.6 mBq 232Th and 15.6 mBq 238U proposed by the United Nation Scientific Commission on Effects of Radiation (UNSCEAR). The annual committed effective doses to Asian population from the dietary intake of 232Th and 238U were calculated to be 0.34 and 0.20 microSv, respectively, which are three orders of magnitude lower than the global average annual radiation dose of 2400 microSv to man from the natural radiation sources as proposed by UNSCEAR.

Adult↗
PubMed2005

Development and validation of the Asian version of the oucher: a pain intensity scale for children.

UNLABELLED: The present study was designed to develop and test the validity of the Asian version of the Oucher pain intensity scale, with color photographs of Taiwanese children as the pain intensity cues. A series of 3 studies were conducted. The aim of the first study was to create male and female versions of the Asian Oucher poster. Each poster consisted of 6 color photographs of children's faces, ranging from "no hurt at all" (scored as 0) to the "biggest hurt you could ever have" (scored as 5). In the second study, 220 children aged 3 to 6 years were recruited to examine the content validity. Children who were able to complete a Piagetian seriation task were asked to choose the sequence of 6 photographs. Photo sequences were adjusted according to the study findings. The third study was conducted to examine the convergent, discriminate, and clinical validity for children who are at different levels of pain intensity. In total, 111 children aged 3 to 10 years old who were experiencing surgical pain were recruited. The construct validity of the Asian Oucher was supported. PERSPECTIVE: This study developed an Asian version of Oucher, with photographs of facial expressions of real Taiwanese children who were experiencing pain. The Asian Oucher can assess pain for children as young as 3 years old.

Age Factors↗
PubMed2004

Evaluation of post-thaw Asian elephant (Elephas maximus) spermatozoa using flow cytometry: the effects of extender and cryoprotectant.

Although the development of semen cryopreservation in the African elephants (Loxodonta africana) has been accomplished, effective procedures for cryopreservation of Asian elephant (Elephas maximus) spermatozoa have not been established. In the present study, we investigate the freezing methods for conservation of Asian elephant spermatozoa under field conditions and identify the most suitable freezing protocols which provide acceptable post-thaw semen quality. Semen was collected from two Asian elephant bulls (EM1 and EM2, 10 ejaculates from each bull) by manual manipulation and were assessed for volume, pH, sperm cell concentration, and progressive motility. Eight out of 20 ejaculates were of acceptable quality (progressive motility >/= 60%), and were used for cryopreservation studies. Semen were frozen in TEST + glycerol, TEST + DMSO, HEPT + glycerol, or HEPT + DMSO. The post-thaw progressive sperm motilities were assessed, and sperm cells were stained with PI and FITC-PNA for membrane and acrosomal integrity assessment using flow cytometry. Post-thaw progressive motility of spermatozoa (EM1: 42.0 +/- 4.3%; EM2: 26.0 +/- 17.3%) and the percentage of membrane and acrosome intact spermatozoa (EM1: 55.5 +/- 8.1%; EM2: 46.3 +/- 6.4%) cryopreserved in TEST + glycerol were significantly higher than (P < 0.05) those frozen in the other medium investigated choices for cryopreservation of Asian elephant spermatozoa. The data support the use of TEST + glycerol as an acceptable cryopreservation media of Asian elephant semen for the establishment of sperm banks.

Acrosome↗
PubMed2006

Assistance provided abroad to insured travellers from Australia following the 2004 Asian tsunami.

BACKGROUND: On 26 December 2004, the Asian tsunami hit countries around the Indian Ocean rim, particularly around its earthquake-associated epicentre off Indonesia. A number of popular tourist destinations for Australian travellers are located in this region. This study was designed to investigate travel insurance claims reported by travellers from Australia following the Asian tsunami and to examine the role of travel insurance and emergency assistance companies. METHODS: In December 2005, all claims reported, following the Asian tsunami on 26 December 2004, to a major Australian travel insurance company were examined for those claims associated with the Asian tsunami. RESULTS: Twenty-two tsunami-related claims were submitted of which nine travellers (40.9%) used the travel insurance company's emergency assistance service. Four travellers (18.2%) cancelled their trip to Asia, mainly to Thailand. Five travellers (27.3%), who were already abroad, also curtailed their trip as a result of the tsunami. Half of travellers (50.0%) were claiming loss of personal belongings. Of those using the emergency assistance service, five travellers (22.7%) sought policy and claiming advice, two (9.1%) sought assistance with flight rearrangements, and one (4.5%) sought situation advice. There was also assistance provided following the death of one insured traveller as a direct consequence of the tsunami, which included a lump sum payment to the deceased estate. The mean refund, where a travel insurance claim was paid, was Australian dollars (AUD)2234 (SD=AUD5755). CONCLUSIONS: This study highlights the importance of travellers taking out appropriate travel insurance, which provides for emergency assistance. Travel insurance agencies do play some role after emergencies, such as the Asian tsunami. This assistance predominantly involves dealing with cancellation of travellers' intended visits to the affected area, but does also involve some assistance to travellers affected by the crisis. Travellers should be advised to seek travel health advice well before departure overseas and to ensure that they are aware of travel advisories for their destination.

Adult↗
PubMed2003

Development and evaluation of cultural food frequency questionnaires for South Asians, Chinese, and Europeans in North America.

We developed three ethnic food frequency questionnaires (FFQs) to characterize the diets of South Asian, Chinese, and European immigrants. FFQs were developed from foods reported in the diet records and recalls of 29 South Asians, 25 Chinese, and 20 Europeans participating in a pilot study from 1995-1996 in Hamilton, Ontario, Canada. The FFQ and a seven-day diet record were then administered to 342 South Asians, 317 Chinese, and 346 Europeans participating in the Study of Health Assessment and Risk in Ethnic groups (SHARE) in three Canadian centers from 1996-1998. For FFQ validation, a subset of these participants completed a second seven-day diet record and second FFQ 8 to 10 months later. The FFQ generally underestimated macronutrient and overestimated micronutrient intake compared with the records. Consumption of most macronutrients was lower among South Asians. Energy-adjusted deattenuated correlation coefficients between the records and second FFQ ranged from 0.32 to 0.73 (South Asians), 0.17 to 0.84 (Chinese), and 0.30 to 0.83 (Europeans). The FFQs generally performed well and will be used to investigate diet-disease relations in SHARE. Lower correlations for dietary fats among Chinese persons (0.17 to 0.31) may be improved with more direct questions on the FFQ regarding brand, type, and amount of oil consumed in stirfry servings.

Asia↗
PubMed1989

A comparison of smoking and drinking among Asian and white schoolchildren in Glasgow.

A self-completion questionnaire survey of 385 Asian and white schoolchildren, aged 13 to 16 years, was conducted at three Glasgow schools, and a number of health and social issues were studied. The aims of this study included not only the provision of baseline data on smoking and drinking, and general health and social issues among schoolchildren, but was also to examine the implications for health education and health services. The response rate was 362/385 (94%) and important differences were observed between the two groups. In particular, Asians were less likely to smoke or drink, and their attitudes towards these drugs were, broadly, negative. However, it is emphasised that the Asian community in Britain is heterogeneous and the data from Glasgow cannot be mechanistically extrapolated to other Asian communities in Britain. The results of the study provided information on the beliefs, attitudes and behaviour of Glasgow schoolchildren and gave new data on their drinking and smoking habits, especially of Asians. Health education needs to take into account ethnic differences among schoolchildren as part of a broad, materialist approach rather than an individual-based behaviouralist approach to health education.

Adolescent↗
PubMed1998

The impending kidney transplant crisis for the Asian population in the UK.

Kidney transplantation offers the opportunity of an improved quality of life for those patients suffering from renal failure. Unfortunately, this treatment is not available to all people as this is influenced by the increasing demand for a limited supply of suitable organs. This situation is particularly alarming for the UK's Asian population with their higher susceptibility to end-stage renal failure which has resulted in a greater demand for transplants. Consequently, the proportion of Asians on transplant waiting lists is growing rapidly. Coupled with this are problems of cross-racial tissue type matching which has led to longer waiting times for a transplant. The situation is clear, there is an urgent need to address the number of Asians requiring a kidney transplant otherwise the human and economic costs will be very severe. In the short term there needs to be a greater number of donors coming forward from the Asian communities to increase the pool of suitable organs. In the long term, there needs to be greater attention on preventive strategies to reduce the number of Asians requiring renal replacement therapy.

Asia↗
PubMed1981

Reduced prevalence of rickets in Asian children in Glasgow.

As judged by admissions to a children's hospital, the prevalence of Asian rickets in Glasgow increased from 1960 to 1973 and then decreased gradually. 400 children born of Indian or Pakistani parents (200 in 1974 and 200 in 1979), from two schools, were examined for clinical, biochemical, and radiological evidence of vitamin-D deficiency. In 1974 there were 10 children with florid rickets and 15 with subclinical rickets, whereas in 1979 no child had florid rickets and only 9 had subclinical rickets. Most Asian children now receive vitamin-D supplements. In the short term, general practitioners, physicians, and obstetricians in the United Kingdom must try to ensure vitamin D supplementation not only by children but also by young adults (aged 13-18 years) of Asian origin. A particular target should be pregnant Asian women, to prevent osteomalacia, fetal hypovitaminosis, and congenital rickets. The long-term answer to Asian probably lies in health education and a change towards the Western diet and life-style.

Adolescent↗
PubMed1994

Fatty acid composition of erythrocytes and plasma triglyceride and cardiovascular risk in Asian diabetic patients.

The excess of coronary heart disease in Indian Asians compared with Europeans is unexplained by conventional risk factors, although the high prevalence of diabetes may play a part. To explore the contribution of diet we compared the fatty acid composition of erythrocyte membrane phospholipid and plasma triglyceride in 36 Gujarati Asians and 24 Europeans with non-insulin-dependent diabetes. Erythrocytes from Asian subjects contained higher proportions of linoleic, dihomogammalinolenic, and arachidonic acids, and lower proportions of oleic and n-3 series fatty acids; triglycerides contained higher linoleic and lower oleic acid levels. For example, mean percentage (SE) of oleic acid (18:1n-9) in erythrocytes was 16.7 (0.2) in Asians and 20.5 (0.6) in Europeans (p = 0.0001), and total n-6:n-3 ratio was, respectively, 12.8 (0.7) and 6.7 (0.7) (p = 0.0001). A high dietary intake of linoleic acid may not be cardioprotective unless balanced by significant intakes of oleic and n-3 series fatty acids, at least in diabetic Indian Asians. By itself, the conventional recommendation to substitute polyunsaturated for saturated fat in the diet may be inadequate to reduce thrombogenesis, and the overall balance of fatty acids, including monounsaturates, should be considered.

Arachidonic Acids↗
PubMed1998

Glaucoma drainage implants in Asian eyes.

OBJECTIVE: Previous studies have suggested that there are racial differences in the outcome of conventional filtration surgery. This study aims to evaluate the outcome of glaucoma drainage implants in Asian eyes with complicated glaucoma and to determine whether there are racial differences in the results of such implant surgery compared to previous reports in non-Asian patients. DESIGN: The study design was a retrospective review of all patients with more than 6-months' follow-up after glaucoma implant surgery at the Singapore National Eye Centre between January 1993 and August 1996. PARTICIPANTS: A total of 83 Asian patients with uncontrolled complicated glaucoma participated. INTERVENTION: A total of 29 patients received Molteno implants and 54 received Baerveldt implants. MAIN OUTCOME MEASURES: The surgical outcome was assessed in terms of final intraocular pressure (IOP), visual acuity outcome, and incidence of complications. Success was defined as final IOP less than 22 mmHg with no medications and qualified success as an IOP less than 22 mmHg with medication. RESULTS: With mean follow-up of 13.41 months, success in IOP control was achieved in 73.5% of patients and qualified success in 12%. Visual acuity remained stable or improved in 85.5%. There were no patients who encountered intraoperative complications, and the incidence of serious postoperative complications was low. The most frequently observed short- and long-term postoperative complication was hyphema in 14 eyes (16.9%) and bullous keratopathy in 7 eyes (8.4%), respectively. CONCLUSIONS: Glaucoma drainage implants have good outcome and visual stabilization in Asian eyes with success rates for IOP control comparable to those reported in previous studies in non-Asian eyes.

Adolescent↗
PubMed2003

South Asian grandmothers' influence on breast feeding in Bristol.

OBJECTIVES: To assess South Asian grandmothers' health beliefs and cultural practices around baby feeding, knowledge of breast feeding and their ability to support successful breast feeding. To design a suitable antenatal intervention for grandmothers to support their breast-feeding daughters/in-law in an area of low exclusive breast feeding and to assess the acceptability and feasibility of the initiative by means of structured interviews. DESIGN: Qualitative focus groups and interviews. Evaluation of an intervention. SETTING: Community health centre and family homes in Easton, Bristol, where 32% of women having babies are South Asian. PARTICIPANTS: 14 Pakistani, Bangladeshi or Indian grandmothers in focus groups or interviews. 16 South Asian families in the intervention. INTERVENTION: An intervention for grandmothers to support exclusive breast feeding was based around a leaflet, which covered the health benefits of breast feeding, good positioning and attachment, feed management, and how families can support breast feeding. The intervention was delivered to mother and grandmother pairs at around 36 weeks gestation, and was translated into three languages. FINDINGS AND CONCLUSIONS: South Asian women are not a homogeneous group and differences were seen in cultural and religious practices and in breast-feeding rates between the Pakistani, Bangladeshi and Indian communities. To ensure that the health education message of exclusive breast feeding, how to overcome problems and the importance of family support reaches all women, linkworkers with appropriate training should be available to speak the languages relevant to the ethnic groups in the area. An antenatal educational intervention for extended family members to promote good breast-feeding practice was appreciated by the South Asian families involved and seemed to be influencing behaviour, particularly in giving colostrum, water or artificial milk and the use of dummies/pacifiers. IMPLICATIONS FOR PRACTICE: Recording details of baby-feeding method at eight weeks systematically by ethnic group will enable local rates to be monitored, particular groups targeted with information and positive reinforcement provided. Linkworkers with appropriate training should be available to speak the languages relevant to the ethnic groups in the area. Involving influential local interpreters in an educational intervention will help to educate the wider population in practices to support exclusive breast feeding.

Adult↗
PubMed1990

Postnatal care: the attitudes and experiences of Asian women in east London.

Thirty-two Asian women living in East London were interviewed about their experiences of childbirth. A significant part of their accounts concerned their experiences in the postnatal wards. They reported fewer difficulties with infant feeding than their non-Asian counterparts in other studies, but there were indications of similar tensions between mothers and staff about how much responsibility mothers should take for their baby's care. Asian women raised several additional issues. Some centred on communication difficulties for Asian women who did not speak fluent English. Others point to their different ideologies around the care of the mother and baby and the nature of early mother-infant relations. Asian women viewed the opportunity to rest and recover postnatally as more central to their postnatal care than they considered hospitals did. Women had less to say and seemed less familiar with the discourse on bonding, and were less preoccupied with the establishment of close mother-infant relationship. The implications for ideas about 'normal' maternal behaviour and the quality of care are discussed.

Adolescent↗
PubMed1999

Depression and anxiety among Asian American elders: a review of the literature.

Depression and anxiety are often reported to be the most common psychological disorders among older adults in the United States. As the population of older Asian American adults steadily increases, mental health practitioners will need to be apprised of the etiological, diagnostic, and treatment issues in working with this population. This article reviews the existing literature on depression and anxiety among older Asian American adults. Little empirical research has been conducted, and more research on the mental health status and needs of older Asian American adults is needed. In addition, improved recruitment of Asian Americans into the health-care professions as well as improved clinical and research training in an increasingly diverse society are imperative to addressing the lack of attention to the mental health needs of older Asian American adults.

Aged↗
PubMed2002

Cultural stereotypes of women from South Asian communities: mental health care professionals' explanations for patterns of suicide and depression.

Low rates of treated depression and high rates of suicide in women from some South Asian communities are evident in epidemiological studies in the UK. It is argued here that explanations for these apparent differences are likely to be located in stereotypes of repressive South Asian cultures. This small scale study, utilising focus groups and individual interviews, sought to explore the construction of cultural stereotypes within mental health discourse with specific reference to stereotypes of women from South Asian communities. Mental health carers from a UK inner city area of relatively high social deprivation were targeted. Focus groups were conducted with a range of mental health care professionals who worked in both inpatient and outpatient mental health care services. In addition, individual interviews were conducted with consultant psychiatrists and General Practitioners. Extensive reference is made in this paper to the content of focus groups and interviews and how health carer's knowledge about and experience of South Asian cultures and caring for women from these communities was contextualised. Mental health care professionals constructed cultural difference in terms of fixed and immutable categories which operated to inferiorise Britain's South Asian communities. It is argued that their knowledge is constructed upon stereotypes of western culture as superior to a construction of eastern cultures as repressive, patriarchal and inferior to a western cultural ideal. Ultimately, it is argued that these stereotypes become incorporated as 'fact' and have the potential to misdirect diagnosis and therefore, also misdirect treatment pathways.

Adult↗
PubMed2003

Measuring culture: a critical review of acculturation and health in Asian immigrant populations.

The number of studies examining how acculturation affects the health of Asian immigrants has increased in recent years. The proliferation of studies reflects the growing size and heterogeneity of Asian immigrant populations in the United States, Canada, Australia, New Zealand, and the United Kingdom. This paper compares various approaches to acculturation within the health literature on Asian immigrants by reviewing the literature in three-health domains (1) mental health (2) physical health and (3) health services use. The review critically examines the conceptualizations and measures of acculturation in these three domains and presents major findings. We observe that measurement difficulties posed by the experiences of heterogeneous Asian groups compound theoretical and disciplinary disparities between acculturation instruments. The extent to which conceptual and methodological critiques of acculturation studies in Hispanic populations apply to studies of Asian populations is also discussed. The critical review thus provides insights into the diverse ways that the relationship between culture and health is measured in this complicated and growing literature.

Acculturation↗
PubMed1998

Chemical signals in the reproduction of Asian (Elephas maximus) and African (Loxodonta africana) elephants.

Asian (Elephas maximus) and African (Loxodonta africana) elephants exhibit polygynous mating that involves female choice of mates and male-male competition for access to females. Chemical signals mediate intersexual and intrasexual interactions associated with reproduction. The need for reliable and honest signals is accentuated by the markedly different social structure of adult males and females. Adult female elephants live in matriarchal herds consisting of a dominant female and several generations of offspring. Adult males are solitary or travel with other males except during breeding periods. Because females have a long 16-week oestrous cycle with a brief 1-week receptive period and a 4-5 year interval between births, a sexually active female is a limited resource. Asian elephant females advertise a forthcoming ovulation by releasing (Z)-7-dodecen-1-yl acetate in their urine during the preovulatory period. African elephants probably produce a sex pheromone as well. Females regularly contact the ano-genital region of other females and show heightened chemosensory responsiveness to urine during the follicular phase. The physiological impacts of this ability to detect reproductive condition (e.g. possible synchronizing or suppressing of oestrus) are uncertain. Males experience an annual period of heightened aggressiveness and highly elevated testosterone concentrations known as musth. Males secrete fluid copiously from their temporal gland and dribble strongly odoriferous urine during musth. Females appear to prefer musth males as mates, and captive Asian females exhibit greater chemosensory responses to urine from males in musth than not. Males in musth are competitively dominant to all other males, even those larger than themselves. Nonmusth males avoid males in musth, and captive Asian bulls show greater interest in musth than nonmusth urine. In captivity subordinate Asian females back away from musth secretions, and females with calves sometimes display protective behaviour. Clearly, chemical signals play an important role in communication by elephants between and within the sexes. Further work is needed to identify more of these chemical messengers and to understand their complete function in mediating reproductive interactions in the elephant social system.

Animals↗
PubMed1998

Origin and evolution of Asian hominoid primates. Paleontological data versus molecular data.

The origin and evolution of hominoid primates (apes and man) has long been studied exclusively on the basis of available fossil remains. Indeed, a migration of African primates towards Asia at about -16 to -17 Ma might have given the lineage of Miocene Asian hominoids. This hypothesis is supported by the oldest remains of Miocene Asian hominoids dated at about -16.1 Ma. But the recent discovery of anthropoid primates in the Eocene of Asia seems to indicate that Asia was a major evolutionary and differentiation centre for anthropoid primates as early as the Eocene. In addition, Asian primates probably continued to evolve in Asia from the Eocene onward and led at least to the extant Asian hominoids (orangutans and gibbons). African and Asian extant anthropoid primates might therefore have diverged at least 36 Ma ago, and this hypothesis is also supported by the most recent data in molecular biology. Moreover, an Asiatic origin of African Paleogene propliopithecine primates is suggested. In that context, evolutionary rates might not be constant, and molecular clocks should be necessarily characteristic for each studied group of mammals. Several examples that illustrate the conflict between paleontological and molecular data are discussed. The necessity to integrate more systematically paleontological data as chronological reference points in studies in molecular phylogeny is discussed.

Animals↗