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PubMed2007

Ethnic variation in depressive symptoms in a community sample in Hawaii.

A modified CES-D was administered to a community sample of 176 European Americans (EA), 209 Native Hawaiians (NH), and 357 Japanese Americans (JA), yielding measures of depression, positive affect, depressed affect, somatic disturbance, and disturbed interpersonal relations. Positive affect was lower in JA relative to EA, consistent with findings among Native Japanese, a pattern attributed to cultural variation in emotion regulation. NH reported lower positive affect than EA, accompanied by elevated negative affect and somatic disturbance, suggesting generally higher levels of depressive symptoms. The three ethnic groups varied in mental health care usage with differing associations between depressive symptoms and experiences of stressful life events. Taken together, these results suggest ethnic variation in depressive symptoms may arise from differing cultural beliefs.

Adult↗
PubMed2000

Differences in State-Trait Anxiety Inventory scores for ethnically diverse adolescents in Hawaii.

This study examined the association between anxiety and 5 predictor variables: ethnicity (Caucasian, Native Hawaiian/part Hawaiian, Japanese, other), gender, grade level (9-12th), main wage earners' educational level, and State-Trait Anxiety Inventory (STAI; C. D. Spielberger, R. L. Gorsuch, & R. E. Lushene, 1970) factors for a diverse group of students. Hawaiian students were found to have significantly higher levels of anxiety than Japanese students; however, ethnicity was not a significant predictor when gender, grade level, and main wage earners' education were statistically held constant. An interaction between ethnicity and STAI factor scores indicated an atypical pattern for Caucasians. Female students scored significantly higher than male students, and main wage earners' education predicted amount of anxiety. In general, these 2 associations remained significant when ethnicity and grade level were held constant. An interaction between gender and STAI factor scores indicated that the difference between female and male students was relatively larger for positively (as opposed to negatively) worded State items and for negatively (as opposed to positively) worded Trait items. Overall, the findings suggested that apparent ethnic differences in anxiety levels may be due to causal variables related to other sociodemographic variables. Factor scores in the form of positively versus negatively worded items should be considered an important variable; using only a global STAI composite as a measure of anxiety will mask the differential effects of the STAI factor scores. Further research is needed to determine the generalizability of these findings to other groups and to provide knowledge on direct causal variables that may account for a greater percentage of variance.

Adolescent↗
PubMed2006

Urinary isoflavonoid excretion and soy consumption in three generations of Japanese women in Hawaii.

OBJECTIVE: To explore soy intake and urinary isoflavonoid excretion within several generations of American-Japanese women based on the hypothesis that earlier generations excrete higher levels of urinary isoflavonoids, in particular the metabolite equol, than later generations. SUBJECTS: A convenience sample of 43 women from 19 families aged 18-78 years, all of whom reported at least 50% Japanese ancestry. INTERVENTIONS: Each woman collected overnight urine samples at baseline and after consuming one serving of soymilk, both samples were analyzed for the isoflavonoids daidzein, genistein and equol using liquid chromatography-mass spectrometry. RESULTS: Median isoflavone intakes during the last year were 7.2 mg/day for the first generation, 7.3 mg/day for the second generation and 6.3 mg/day for the third generation (P=0.36). At baseline, the median isoflavonoid excretion for the first generation was nonsignificantly higher than for later generations (190, 86 and 42 nmol/h; P=0.20) but after intervention, the median urinary isoflavonoid excretion was very similar for the three groups: 2465, 1895 and 2775 nmol/h (P=0.70). Following intervention, a nonsignificantly higher proportion of older than younger women (53 vs 32 and 33%; P=0.41) excreted the metabolite equol. The respective median equol excretion rates by generation following intervention were 39.5, 4.2 and 3.5 nmol/h (P=0.04). CONCLUSIONS: This small investigation among three generations of Japanese-Americans detected a higher equol production among older women after a soy challenge, but no difference in the excretion of total isoflavonoids after a standardized dose of soymilk was observed.

Adolescent↗
PubMed2000

Prostate cancer in Honolulu, Hawaii: pathological and clinical characteristics.

We reviewed trends in prostate cancer at our institution to determine if there are changing characteristics that need to be considered in conducting comparative studies with patients from other institutions. Assessed between 1993 and 1998 were trends in PSA status, race, tumour grade, clinical stage and treatment. The incidence dropped between 1993 and 1994, but has remained stable since, except in Philipinos. Changes in clinical tumour stage and PSA positive rate were not noted; Gleason score distribution changed with marked decline of low grade tumours. This reflects the tendency pathologists had of undergrading prostatic adenocarcinoma in biopsy specimens during the early 1990s. Use of hormonal treatment increased from 21% to 57%. Patients receiving radiation therapy also increased slightly. Comparative studies between institutions would require review of the biopsy material for accurate Gleason scores. Outcome studies would need to control for the changing pattern of prostate cancer therapy.

Adenocarcinoma↗
PubMedDate not supplied

Supports and obstacles to cancer survival for Hawaii's native people.

PURPOSE: Investigators have suggested that high cancer mortality rates among Native Hawaiians are due to fatalistic attitudes toward the disease, poor access to care, and lack of consideration of Native Hawaiian cultural values in Western approaches to healthcare. This study used qualitative methods to examine these factors in Native Hawaiian cancer survivors. METHODS: Eight focus groups were held on five islands, attracting 45 Native Hawaiian cancer survivors from both rural and urban locales. The focus groups explored survivors' experiences with cancer diagnosis, treatment, and recovery. Participatory research methods were used, with researchers gaining community input on study design, incorporating appropriate Native Hawaiian cultural protocols into the focus groups, and engaging participants in the interpretation of the data. RESULTS: Similar to cancer survivors of other ethnicities, these individuals demonstrated the following: success in accessing healthcare information, professionals, facilities, and insurance; the ability to overcome the barriers confronted; and proactive health behaviors regarding screening, diagnosis, and treatment. They also demonstrated ways in which they were sustained through the cancer experience by Native Hawaiian traditions, such as helping others, gaining strength from Hawaiian spiritual beliefs, and relying on family for personal support. Participants did not respond passively to their cancer diagnoses, and they expressed few fatalistic attitudes. Participants did give numerous examples of other Native Hawaiians who did not seek screening or treatment for cancer because they lacked insurance, had poor access to care, or felt alienated by Western healthcare. CLINICAL IMPLICATIONS: The findings suggest that improving access to care and incorporating cultural values in health education and services can enhance survivorship and quality of life for Native Hawaiians with cancer. These themes may have applications for other minority groups.

Attitude↗
PubMed1987

Radiocarbon dates on bones of extinct birds from Hawaii.

Bones from a stratified sedimentary deposit in the Puu Naio Cave site on Maui, Hawaiian Islands, reveal the late Holocene extinction of 19 species of birds. The age of the sediment and associated fauna was determined by direct radiocarbon dating (tandem particle accelerator-mass spectrometer; TAMS) of amino acids extracted from bones weighing as little as 450 mg. The 14C dates indicate that sediment has been accumulating in the lava tube for at least the last 7750 years, a suitable time frame for testing the hypothesis that Holocene extinction on islands began after human colonization. Despite growing evidence that a worldwide wave of extinctions coincided with human colonization of oceanic islands, little radiometric data have been available to date the extinction of most small fossil vertebrates on islands. The TAMS technique of dating purified collagen from the bones of small vertebrates could lead to vastly improved chronologies of extinction for oceanic islands where catastrophic mid- to late-Holocene extinction is expected or known to have occurred. Chronologies derived from nonarcheological sites that show continuous sedimentation, such as the Puu Naio Cave deposit, may also yield key evidence on the timing of earliest human settlement of Oceania.

Animals↗