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PubMed2006

Prevalence of overweight and obesity and their association with hypertension and diabetes mellitus in an Indo-Asian population.

BACKGROUND: The associations of body mass index (BMI) and chronic disease may differ between Indo-Asian and Western populations. We used Indo-Asian-specific definitions of overweight and obesity to determine the prevalence of these problems in Pakistan and studied the sensitivity and specificity of BMI cutoff values for an association with hypertension and diabetes mellitus. METHODS: We analyzed data for 8972 people aged 15 years or more from the National Health Survey of Pakistan (1990-1994). People considered overweight or obese were those with a BMI of 23 kg/m2 or greater, and those considered obese as having a BMI of 27 kg/m2 or greater. We built multivariable models and performed logistic regression analysis. RESULTS: The prevalence of overweight and obesity, weighted to the general Pakistani population, was 25.0% (95% confidence interval [CI] 21.8%-28.2%). The prevalence of obesity was 10.3% (95% CI 7.0%-13.2%). The factors independently and significantly associated with overweight and obesity included greater age, being female, urban residence, being literate, and having a high (v. low) economic status and a high (v. low) intake of meat. With receiver operating characteristic curves, we found that the use of even lower BMI cutoff values (21.2 and 22.1 kg/m2 for men and 21.2 and 22.9 kg/m2 for women) than those recommended for an Indo-Asian population yielded the optimal areas under the curve for an association with hypertension and diabetes, respectively. INTERPRETATION: A quarter of the population of Pakistan would be classified as overweight or obese with the use of Indo-Asian-specific BMI cutoff values. Optimal identification of those at risk of hypertension and diabetes and healthy targets may require the use of even lower BMI cutoff values than those already proposed for an Indo-Asian population.

Adolescent↗
PubMed2000

Non-Asian hepatocellular carcinoma: correlation between histologic features and echogenicity.

Studies of hepatocellular carcinoma in Asia have revealed a correlation between lesion hyperechogenicity and five histologic features: nonliquefied necrosis, sinusoidal dilatation, hemorrhage, fatty metamorphosis, and fibrosis. However, this correlation has not been investigated for non-Asian hepatocellular carcinoma, despite substantial differences between the Asian and non-Asian forms of this carcinoma. We retrospectively reviewed records of 29 patients seen at one United States institution who had hepatocellular carcinoma lesions that were either completely hyperechoic or completely hypoechoic. Tissue specimens obtained surgically (n = 7) or percutaneously (n = 22) were evaluated microscopically for the presence of nonliquefied necrosis, sinusoidal dilatation, hemorrhage, fatty metamorphosis, and fibrosis. A statistically significant correlation was identified between the number of histologic features identified and lesion diameter (P = 0.04) but not between the number of histologic features identified and the likelihood of hyperechogenicity (P = 0.11). Two lesions (50%) with three histologic features, four lesions (40%) with two histologic features, and six lesions (55%) with one histologic feature were hypoechoic. The echogenicity of non-Asian hepatocellular carcinoma lesions cannot be attributed to the histologic features that are believed to underlie echogenicity of the Asian type of hepatocellular carcinoma.

Adult↗
PubMed2000

Defining mental illness and accessing mental health services: perspectives of Asian Canadians.

Asian Canadians consistently underutilize mainstream mental health services. This study investigates how the definition and meaning of mental illness relates to barriers Asian Canadians find in accessing mental health services. Personal interviews were conducted with 60 Asian Canadians in a northern community in the province of British Columbia. Content analyses revealed six themes that defined a mental health problem: (a) feeling a lack of purpose in life, (b) feeling lonely, (c) difficulties understanding and dealing with a new environment, (d) high anxiety levels, (e) descriptions of mental health problems as somatic illnesses, and (f) perceptions of mental illness as serious and potentially not treatable. It was also found that poor English language ability and a lack of understanding of mainstream culture were major barriers to accessing mental health facilities. Findings of this study provided valuable insights concerning Asian immigrants' hesitancy accessing and utilizing mainstream mental health facilities. The many poignant personal anecdotes illustrate that the migration and adaptation processes can be painful and full of anguish. Unless their experiences are better understood and accepted, many Asian Canadians will likely remain outside of the available mainstream mental health facilities.

Adolescent↗
PubMed1989

Current comment. (xix). Why don't general practitioners refer their disabled Asian patients to district nurses?

Research into the needs of disabled people in Central Birmingham and their use of community health and social services has shown that Asian people are 'underusers' of these services, particularly district nursing. We have found that in this district, general practitioners (GPs) refer the majority of district nurses' disabled patients, but they are not referring Asians. Possible explanations--that elderly Asians have low contact rates with GPs, lack knowledge about the district nursing services, or refuse to use the service--are not supported by the research data. More likely explanations are offered--that GPs hold stereotyped views about Asians and their needs, have a misunderstanding of the role and function of the district nurse and inflexible assumptions about the 'typical' patient seen by the district nurse. Attention is drawn to the urgent need for GPs to address these issues and for further research as the numbers of older Asians are set to rise sharply.

Aged↗
PubMedDate not supplied

The nutritional status of Asian end stage renal failure patients: a cross sectional study.

Nutritional status was assessed in 303 dialysis patients and the results of Asian and non Asian patients was compared. Mid Arm Muscle Circumference (MAMC) was found to be lower [22.7 +/- 2.7 v 24.2 +/- 2.9 (p = 0.008)] and TSF higher [15.9 +/- 7.2 v 13.6 +/- 7.4 (p = 0.078)] in Asians as compared to non Asians. Body Mass Index (BMI), Mid Arm Circumference (MAC) and Serum Albumin were not significantly different in the two groups. Difficulties in assessing and interpreting nutritional status in the Asian dialysis population are discussed and areas for further work are identified.

Body Mass Index↗
PubMed1999

Knowledge, attitudes and beliefs of adult South Asians living in London regarding risk factors and signs for oral cancer.

BACKGROUND: South Asian communities in the UK are thought to be a high-risk group for oral cancer, primarily because of betel-quid (pan) chewing habits. However there has been little research on the communities' perception of oral cancer. AIM: This investigation was undertaken to assess the knowledge, attitudes and beliefs of South Asian adults (n = 367) regarding the risk factors and signs for oral cancer. DESIGN AND SETTING: The information was obtained by means of a self-administered questionnaire and structured interviews at six Asian community centres and three general medical practices in north west London. PARTICIPANTS: Subjects ranged in age from 16 to 80 years and came from diverse socio-economic and cultural backgrounds. RESULTS: Tobacco use was the only risk factor correctly identified by most adults (82%). A significant difference (P < 0.001) was seen in betel-quid chewing habit among the age groups with 42.2% of adults in the 50-80 year age group practising this habit as compared to only 5.3% in the 16-29 year age group. Another finding was that the traditional method of betel-quid chewing is being replaced with readily available processed areca nut and tobacco products. CONCLUSIONS: There is extensive misinformation and a general lack of awareness about the risk factors and signs of oral cancer among the South Asian communities irrespective of age, gender, South Asian subgroup and social class. It is clear that betel-quid chewing is a common habit among the population and especially in the elderly population. It is recommended that health promotion advice be targeted to this population and their carers.

Adolescent↗
PubMed1999

Somatisation among Asian refugees and immigrants as a culturally-shaped illness behaviour.

Epidemiological studies indicate a high prevalence of major depression and anxiety disorder (including post-traumatic stress disorder) among Asian refugees and immigrants living in North America. Yet there exists an alarming underutilization of mental health services and underdiagnosis of psychiatric illness in this rapidly growing minority group. In order to investigate a culturally-derived basis for these observations, a critical review was conducted on descriptive epidemiologic, sociologic, and anthropologic studies of psychiatric illness among Asians and Asian refugees and immigrants reported in the general psychiatric and trans-cultural psychiatric literature of the past forty years. Studies examining the mode of illness presentation among Asian refugees seeking medical care suggest a marked tendency to articulate somatic rather than affective complaints when serious underlying psychiatric conditions exist. In this context, somatisation among Asian refugees and immigrants may reflect culturally-shaped beliefs regarding notions of disease aetiology and treatment as well as what is deemed culturally-appropriate help-seeking behaviour during illness. Misdiagnosis and underdiagnosis of psychiatric illness in this and other minority populations can be minimised by establishing pluralistic norms and multidimensional criteria which take into account the ethnically diverse manifestations of illness behaviour encountered increasingly in Western primary care and psychiatry clinics.

Asia↗
PubMed1993

MEDLINE Search Strategies for Literature on Asian Americans/Pacific Islanders.

PURPOSE OF THE REVIEW: The purpose of this study is to examine the professional health literature on Asian American/Pacific Islanders in MEDLINE, review the guiding indexing principles used in MEDLINE, and present suggestions on how to most effectively search for material in the database. SEARCH METHODS USED: The authors conducted database searches in MEDLINE and examined the National Library of Medicine indexing principles related to Asian Americans/Pacific Islanders to develop database search strategies. SUMMARY OF IMPORTANT FINDINGS: Two factors which contribute to the difficulty in identifying health literature on Asian Americans/Pacific Islanders are the small amount of material published when compared to other ethnic groups and the complex nature of indexing in MEDLINE that may create problems for less experienced database searchers. MAJOR CONCLUSIONS: Additional journal publications concerning Asian Americans/Pacific Islanders, a more thorough understanding of how the literature on this group is best retrieved from MEDLINE, and the development of more user&shy;friendly approaches to the National Library of Medicine databases will aid researchers interested in this ethnic group. KEY WORDS: Asian Americans, MEDLINE, periodicals, databases, bibliographic

Journal Article↗
PubMed1993

Public Mental Health Services to Asian American Ethnic Groups in Two California Counties.

PURPOSE OF THE STUDY: The purpose of this article is to examine the use of public mental health services among Chinese, Filipino, Southeast Asians, Japanese, and other Asian Americans. SEARCH METHODS USED: This article used two data sources from San Francisco City and County and Santa Clara County. By combining data from these two counties, the study had access to information on 3,095 adult Asian users of services. SUMMARY OF IMPORTANT FINDINGS: The study found differences among various Asian ethnic groups in their likelihood of using individual service modalities, but fewer statistically significant differences in the amount of use once services started. MAJOR CONCLUSIONS: Differences in the use of public mental health services were related to differences in the two counties' implementing services. KEY WORDS: Asian Americans, Public Mental Health Services, Utilization, Ethnic Differences

Journal Article↗
PubMed2002

Intimate partner violence against South Asian women in greater Boston.

OBJECTIVES: to identify the prevalence of male-perpetrated intimate partner violence (IPV) against South Asian women (Indian, Pakistani, Bangladeshi, Sri Lankan, Bhutanese, Nepalese, Maldive Islanders) residing in Greater Boston; to identify forms of abuse, abuse-related injuries, and help-seeking behaviors of South Asian women reporting IPV; and to assess the relationship between current IPV victimization and history of nonpartner abuse, acculturation, and victim-blaming attitudes. METHODS: A community-based volunteer sample of South Asian women (n=160) in relationships with male partners participated in a cross-sectional study of women's health. Participants were recruited via community outreach (eg, fliers, snowball sampling, referrals) and were interviewed in person by trained South Asian women. RESULTS: Participants were 18 to 62 years old (mean age=31.6) and predominantly immigrant (87.5%); 74.4% were married, 51.6% had children, and 71.9% had family incomes of more than $2100 per month. Forty percent of the sample reported physical IPV, sexual IPV, or injury/need for medical services due to IPV from current male partners; few women (9.4%) who reported ever experiencing IPV from current male partners reported no abuse in the past year. Twice as many participants reported needing to see a doctor for abuse-related injuries, but not seeing one (6.3%), as actually seeing a doctor (3.1%). Only 11.3% of women reporting IPV reported having received any counseling related to the abuse. Other variables assessed were not related to abuse in current relationships. CONCLUSION: Domestic violence is a serious and highly prevalent concern among this group of South Asian women. Their knowledge of available services is limited, and victim-blaming attitudes are not uncommon. Culturally tailored domestic violence services and IPV education are needed for this underserved population.

Adolescent↗
PubMed2006

[Chinese men's attitudes to life events and sexuality: prevalence of erectile dysfunction and related health concerns among Chinese men in Asian MALES study].

OBJECTIVE: The aims of Asian Men's Attitudes to Life Events and Sexuality (Asian MALES)-China study were to identify the prevalence of erectile dysfunction (ED) and related health concerns in the general male population in China, and to examine the attitudes and behaviors of men in relation to these health issues. METHODS: A total of 2055 men aged 20-75 years were included in Phase-I MALES study using a standardized questionnaire, and another 225 recruited from the sub-sample of Phase-I MALES participants with reported ED and some ED patients from other sources were involved in Phase-II Asian MALES- China study, with the prevalence of ED and men's associated attitudes as the main measure. RESULTS: The overall rate of ED in the Asian MALES-China sample was 5.9%. The rate of self-reported ED rose with age increase. A higher rate of ED was reported in men with co-morbid medical conditions and risk factors, including cardiovascular disease, hypertension, dyslipidemia, and depression, and so were the rates of these co-morbid conditions in ED patients. Data from Phase-II Asian MALES-China indicated that among men with reported ED, only 17% would seek treatment. CONCLUSION: The rate of ED is high in Chinese men and it is associated with co-morbid conditions. For Chinese men, it is necessary to know more about ED and to seek safe and effective treatment of its symptoms.

Adult↗
PubMed1991

Asian Taenia saginata: species or strain?

Asian Taenia has a special epidemiological pattern. Many people eat raw and/or undercooked pork and pig viscera more often than that of cattle and acquire a T. saginata-like tapeworm infection. The pig has been found to be the most favorable laboratory intermediate host for four geographical strains of Asian Taenia. Numerous pinpoint cysticerci have been found in naturally infected livers of one wild boar and six domestic pigs in Taiwan. It is likely that pigs are the natural intermediate host of Asian Taenia in endemic areas other than Taiwan. Moreover, the cysticerci of Asian Taenia are only found in the livers of the infected animals and have similar morphological characteristics, which are distinguishable from the cysticerci of T. saginata and T. solium. These cysticerci are small in size and armed with two rows of rudimentary hooklets and can develop to maturity in as short a period as 4 weeks. It is possible that Asian Taenia is a different species or at least a different strain.

Animals↗
PubMed1990

Asian osteomalacia is determined by dietary factors when exposure to ultraviolet radiation is restricted: a risk factor model.

Twenty-seven previously osteomalacic and 77 normal Asian women participated in a seven-day survey of dietary intake and daylight outdoor exposure. Individual levels of daylight outdoor exposure discriminated poorly between normal and osteomalacic women. The presence of osteomalacia was strongly related to varying degrees of vegetarianism. Lactovegetarianism (no meat, fish or egg consumption) was associated with significantly greater osteomalacic risk than ovolactovegetarianism (no meat or fish consumption). Unlike Asian rickets, high-extraction wheat cereal as chapatti was not a significant risk factor for osteomalacia in Asian women and dietary fibre was a less important risk factor than absent dietary meat, fish or egg. When exposure to ultraviolet radiation is limited, Asian osteomalacia (and Asian rickets) are determined by dietary factors.

Adolescent↗
PubMed1990

Dental knowledge, beliefs, attitudes and behaviour of the Asian community in Glasgow.

Epidemiological studies suggest that Asians living in Britain, particularly children, have poor oral health. This study of the dental health knowledge, beliefs, attitudes and behaviour of a random sample of sixty-nine Asian adults in Glasgow aimed to identify some possible underlying factors. The dental health knowledge of Asians living in Glasgow appeared to be limited, specifically with regard to methods of reducing the incidence of caries. Thirty per cent could not name any foods which were known to be detrimental to dental health and only 30% felt that children under the age of five required access to dental services. The aesthetic value of a healthy mouth was highly appreciated by the majority of respondents and poor oral health was considered to be socially unacceptable. The Asian population examined would seem to be an appropriate target group for dental health education, since low knowledge levels rather than negative attitudes appear to cause Asians to be at high risk from caries.

Adolescent↗
PubMed1986

Investigation of vitamin A nutrition in pregnant British Asians and their infants.

Plasma retinol and retinol-binding protein (RBP) concentrations were lower in 23 South London Asian women of Indo-Pakistani origin than in 21 non-Asian controls during pregnancy (P less than 0.01 and P less than 0.05 respectively). Cord blood concentrations of retinol and RBP were the same in Asians and non-Asians. Plasma retinol concentration decreased with increasing gestation (P less than 0.01), but RBP concentration did not alter. Retinyl palmitate, 8000 i.u. daily from 30 weeks gestation to term, was given to a group of 14 Asian mothers with low plasma retinol concentrations. This caused a significant increase in maternal plasma retinol concentration at delivery compared with 15 controls, indicating possible deficiency, but did not affect cord blood concentrations. There was no difference in anthropometric measurements of the infants of control or supplemented mothers, nor was there a correlation between the anthropometric measurements and the plasma retinol or RBP concentrations.

Adult↗
PubMed1985

Attitudes of Asian patients in Birmingham to general practitioner services.

Attitudes of Asian patients to the delivery of primary health care in two Birmingham general practices were investigated by questionnaires administered by an Asian ethnic minorities worker who spoke dialects appropriate to the population under investigation. One practice was staffed by Asian doctors the other by British doctors. The responses to the questionnaires were analysed with reference to religion - Sikh, Hindu and Muslim and to the two practices. Choice of doctor appears to be determined more by the proximity of the patient's home to the practice premises than by ethnic considerations. Reported failures to meet the special needs of Asian patients were those inherent in the difficulties of British general practice and were not peculiar to Asian patients. The need for help from an interpreter did not seem to be important.

Adult↗
PubMed1969

Immunological interrelationships of Hong Kong, Asian and equi-2 influenza viruses in man.

Sera from an elderly population drawn prior to the 1968 Hong Kong influenza epidemic were found to have a high prevalence of Hong Kong antibody, indicating the circulation of a Hong Kong-like virus before 1900. This report compares an elderly (birth dates before 1892) and a young adult population with regard to serum antibody response to Hong Kong variant vaccine, avidity of Hong Kong antibody, and antibody absorption with Asian, A/Equi-2, and Hong Kong viruses.The demonstration of doubly-absorbable Hong Kong and A/Equi-2 antibodies in sera where both are present and of doubly-absorbable Hong Kong and Asian antibodies in young adult sera after Hong Kong variant vaccine lends new support to the view that there is an immunological relationship between these viruses.The difference in the response of the two age-groups to Hong Kong variant vaccine-specifically the anamnestic boosting of Hong Kong antibody together with the lack of Asian antibody rise in the elderly population in contrast to the striking Asian antibody response in the young adult population-leads to the conclusion that a Hong Kong-like virus may have been the original antigenic sin in the elderly population with initial Asian exposure in 1957. The excellent avidity of Hong Kong antibody in pre- and post-vaccine sera from the elderly suggests a close similarity if not identity of the haemagglutinins of the Hong Kong-like virus that circulated in human populations prior to 1900 and of the 1968 Hong Kong virus.

Adult↗
PubMed1983

Language and communication problems in an Asian community.

A survey of general practitioners working in an area of immigrant concentration was undertaken to find out about their contacts with the Asian community. An earlier study had shown that Pakistani women mostly spoke little or no English and that they had strict ideas of modesty, which suggested problems for the health services.Questionnaires were sent to 44 doctors and 39 (89 per cent) replied. To the question of language difficulty, 11 doctors answered that they could speak at least one Asian language, the remainder said they relied on patients' relatives to interpret. On frequency and length of consultations, more than half the doctors felt that Asians consulted more often and took up more time than English patients. Reluctance on the part of Asian women to be examined was reported by 30 doctors. However, the commonest comments volunteered by the general practitioners were not about language or modesty but about their Asian patients' tendency to complain of trivial ailments, while on the other hand they presented less often with psychosocial problems. A connection between the language barrier and apparently unnecessary complaining is postulated. It is also recommended that interpreting facilities and liaison workers should be made known to general practitioners.

Communication↗