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Western and Asian features of multiple sclerosis in Mexican Mestizos.

OBJECTIVES: The objective of this study was to compare the clinical expression of MS in Mexican Mestizos with that of patients of European or Asian descent; as well as to compare the annual frequency of new cases with that observed in the previous decades. PATIENTS AND METHODS: All patients with diagnosis of definite MS seen at the National Institute of Neurology and Neurosurgery of Mexico from January 1993 to December 2003 were studied (n=312). Sociodemographic and clinical characteristics were compared with reports of patients from either Western or Asian origin; the long-term disability score was analyzed according to gender, age of onset of MS and the initial symptom. RESULTS: The clinical expression of MS in Mexican Mestizos shares some characteristics with both, Asian and Western forms of MS indicating that the genetic composition of Mexican Mestizos participates in the clinical expression of the disease. Also, at the prevalence date, the mean age of patients and the duration of the disease were lower in our patients than in MS patients from endemic countries suggesting a true increasing incidence in recent times, rather than only improved case ascertainment. CONCLUSIONS: Clinical expression of MS in Mexican Mestizos shows the coexistence of some features common in European and in Asian cases.

Adult↗

Upper blepharoplasty in the Asian eyelid.

Upper eyelid blepharoplasty is a major component of cosmetic surgery in the Asian face. The complicated and variable anatomy of the Asian upper eyelid is reviewed, stressing the major differences between Asian and Caucasian eyes. The authors' preferred surgery for the creation of a double eyelid is discussed, including the preoperative assessment, intraoperative maneuvers, and laser techniques. The article concludes with a discussion of the complications specifically related to Asian blepharoplasty and strategies to avoid them.

Asian People↗

Prevalence of menopausal symptoms in different ethnic groups of Asian women and responsiveness to therapy with three doses of conjugated estrogens/medroxyprogesterone acetate: the Pan-Asia Menopause (PAM) study.

OBJECTIVE: To survey the prevalence of 18 menopausal symptoms in nine ethnic groups of Asian women. To evaluate responsiveness of symptoms to three estrogen/progestin doses in Asian women. DESIGN: A prospective, randomized, double-blind multinational clinical trial in 1028 healthy postmenopausal women from 11 Asian countries/regions. Following 2 weeks of baseline observations, the women received one of three conjugated estrogens (CE)/medroxyprogesterone acetate (MPA) doses (in mg) daily for 24 weeks: 0.625/2.5; 0.45/1.5; or 0.3/1.5. At baseline and throughout the study period, the women were asked to record each symptom daily on diary cards translated into 10 languages. RESULTS: The number of women in the different ethnic groups ranged from 24 (Malay) to 248 (Chinese). The overall prevalence of symptoms differed among the groups, with Vietnamese women generally reporting the highest rates. Within each ethnic group, the prevalence of individual symptoms varied substantially. Only 5% of Indonesian women, for example, reported hot flushes but 93% complained of body or joint aches/pains. Overall, body or joint aches/pains was the most prevalent symptom, ranging from 76% in Korean women to 96% in Vietnamese women. Therapy resulted in a significant decline in all symptoms. The decline was observed with all three doses after 4 weeks of treatment and continued throughout the 6-month study period. CONCLUSION: The prevalence of individual menopausal symptoms differed among ethnic groups of Asian women. Within each ethnic group the percentage of women reporting each symptom varied substantially. Symptoms declined after 4 weeks of hormone therapy and thereafter throughout the study. The effect of the lowest dose of CE/MPA (0.3/1.5 mg/day) was comparable to that of the higher doses.

Adult↗

Knowledge, attitudes and behavior regarding secondhand smoke among Asian Americans.

BACKGROUND: This study seeks to measure exposure to secondhand smoke and to evaluate potential differences in knowledge, attitudes, and tolerance of secondhand smoke among subgroups of Asian Americans in the Delaware Valley region of Pennsylvania and New Jersey. METHODS: A cross-sectional study was conducted among 1374 Asian Americans, which included Chinese, Koreans, Vietnamese, and Cambodians. The sample was selected by using a stratified-cluster proportional sampling technique. Study measures included demographic variables, smoking status, exposure to secondhand smoke, and knowledge, attitudes, and behavior regarding secondhand smoke. Data were analyzed using SPSS. RESULTS: Involuntary exposure to secondhand smoke remains a common public health hazard among Asian Americans, with 38.3% reporting exposure at home and 40.3% at the worksite. Knowledge and tolerance differed significantly by ethnic groups, gender, education, and smoking status. Knowledge level had a significant effect on tolerance behavior. CONCLUSIONS: Findings indicate an urgent need for a smoke-free policy at home, in the work place, and in public areas. Tobacco prevention/intervention and cessation programs for Asian Americans should emphasize the adverse health effects of secondhand smoke and promote a smoke-free environment. Further studies are needed to explore the unexplained differences in tolerance levels regarding secondhand smoke across ethnic groups.

Adult↗

Resting energy expenditures in Asian women measured by indirect calorimetry are lower than expenditures calculated from prediction equations.

OBJECTIVE: Measured resting energy expenditure (REE) and REEs calculated using the Harris-Benedict equation, Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU) equations (FAO equations), and the Liu equation were compared in Asian women. DESIGN: REEs were measured using indirect calorimetry in the morning after an overnight fast and compared with REEs calculated using the Harris-Benedict equation, the FAO equations, and the Liu equation. Height, weight, and 3-day diet records were also obtained. SUBJECTS: Thirty-six healthy, free-living Asian women aged 19 to 52 years and living in the United States were recruited from Washington State University, Pullman, and completed the study. STATISTICAL ANALYSES: Paired t tests, stepwise regression, one-way analysis of variance, and Pearson correlation coefficients were used for the statistical analyses. Significance was set at P < or = .05. RESULTS: A significant correlation was found between measured REE and REE derived from the Harris-Benedict equation (R = 0.67, P < .0001), the FAO equations (R = 0.70, P < .0001), and the Liu equation (R = 0.70, P < .0001). However, measured REE was significantly lower than REE calculated using the Harris-Benedict and FAO equations by 8.5% (P < .001) and 5.4% (P < .01), respectively. No significant difference was noted between measured REE and REE derived from the Liu equation. APPLICATIONS: Caution must be taken when predicting REE of Asian women using the Harris-Benedict equation or the FAO equation. Indirect calorimetry or an equation specific to Asians, such as the Liu equation, is recommended when an accurate estimate is necessary.

Adult↗

Asian students change their eating patterns after living in the United States.

OBJECTIVE: To collect information on changes in dietary patterns among Asian students before and after immigration to the United States. DESIGN: A questionnaire designed to collect information about background, changes in food habits, and frequency of food consumption from a 72-item food list was mailed to subjects. SUBJECTS/SETTING: Potential participants were students of local universities and junior colleges who were born in China, Taiwan, Hong Kong, Japan, or Korea and were aged 18 years or older. All subjects were required to have been residing in the United States for at least 3 months before the start of the study. Questionnaires were mailed to 120 potential participants. STATISTICAL ANALYSIS: Paired t tests were used to determine differences in eating patterns and frequency of food consumption of subjects before and after immigrating to the United States. RESULTS: Seventy-one questionnaires were returned. Because of missing information on 8 of these questionnaires, only 63 were used in the analysis, which gave a response rate of 53%. The number of students consuming only 2 meals per day increased significantly; 29 (46%) respondents skipped breakfast because of their school schedules. Despite no significant change in the frequency of snack consumption, a majority (n = 46; 73%) of the respondents were consuming more salty and sweet snack items. Subjects were eating out less often, but they were selecting more American-style fast foods when they did eat out. Significant increases were noted in consumption of fats/sweets, diary products, and fruits, and significant decreases were noted in the consumption of meat/meat alternatives and vegetables after immigration to the United States. APPLICATIONS/CONCLUSIONS: Results of this study could be useful to dietetics practitioners as they observe changes in dietary patterns of Asian immigrants. These health professionals can use this information to plan nutrition education programs for Asian groups so that they can make informed decisions in adapting to new eating patterns and make wise food choices in their new environment. It is important to help Asian immigrants retain healthful food habits from their original country and to encourage them to choose eating patterns of the new culture that are nutritionally sound.

Adult↗

The anatomical evaluation of internal mammary vessels using sonography and 2-dimensional computed tomography in Asians.

The aim of this study is to get anatomical information on internal mammary vessels in Asians. Cadaver study is very limited in our country due to sociocultural backgrounds. We used two dimensional reconstructive computed tomography (2DCT) and Doppler ultrasound for anatomic study. The branching patterns, level of bifurcation, size of vessels and distance from the sternal edge to the internal mammary vein (IMv) were measured. This study was performed in 60 breast cancer patients from May 1999 to May 2001. Patient's age ranged from 30 to 63 years (average 46). One artery and one vein on both sides were the most common types that were observed in 44 of 60 patients. The diameter of the internal mammary artery (average 2.1 mm) was constant but that of the IMv had a wide variation (ranged 0.8-4.8 mm). The distance from sternum to internal mammary artery gradually decreased as it passed caudally. Compared to Caucasians, in Asians, the cases of IMv bifurcation were fewer. The level of IMv bifurcation was higher than that of Caucasian. The level of choice for anastomosis was 3rd intercostal space in Asians due to their shorter chest. The combination of 2DCT and Doppler ultrasound provided us with a useful preoperative information as well as general anatomical data in Asians.

Adult↗

Mammographic parenchymal patterns in Asian and Caucasian women attending for screening.

The breast parenchymal patterns were assessed and compared on the screening mammograms of 200 Asian and 400 Caucasian women, matched for age and between 50 and 64 years of age. The breast patterns were allocated according to Wolfe's classification. The results show a significant excess of Asians in the P1 and N1 groups and a deficit in the P2 group. Taking N1 and P1 as a low risk group and P2 and DY as a high risk group, there is a highly significant excess of Asians in the low risk group. These findings are considered in relation to the low incidence of breast cancer in Asian women and their poor acceptance of breast screening.

Asia↗

Beliefs related to breast health practices: the perceptions of South Asian women living in Canada.

Breast cancer is becoming a major concern for many South Asian women. Clinical observations of women from a South Asian community living in Canada revealed an under use of early detection strategies. The purpose of this qualitative ethnoscience study was to examine breast health practices from the perspective of South Asian women to provide a foundation for the development of culturally suitable breast health services for this group. Open-ended interviews were conducted with a convenience sample of 50 South Asian women over the age of 30 who had not been diagnosed with breast cancer. Adequate representation of the main religious groups (i.e. Sikh, Hindu, Muslim and Christian) was ensured through sampling techniques. Analysis of translated interviews involved identification of themes and the development of a taxonomy to represent relationships among emerging cultural themes and domains. Four central domains of beliefs related to breast health practices were identified: beliefs about a woman's calling, beliefs about cancer, beliefs about taking care of your breasts and beliefs about accessing services. These beliefs hold important implications for how health promotion strategies should be structured and offered, In particular, attention must be paid to the language that is used to talk about breast cancer, the importance of the role of the family in women's health decisions and traditions related to using narratives to share information and advice.

Adult↗

Magnetic resonance imaging of Asians with multiple sclerosis was similar to that of the West.

Magnetic resonance imaging (MRI) of the brain is the most important paraclinical diagnostic test in multiple sclerosis (MS). The appearance of MRI in Asians with MS is not well defined. We retrospectively surveyed the first brain and spinal cord MRI in patients diagnosed to have MS, according to Poser's criteria in seven regions throughout Asia to define the MRI changes among Asians with MS. There were 101 patients with first brain, and 86 with first spinal cord MRI, 66 of whom had both. The brain MRI showed a mean of 17 lesions per patient in T2 weighted images, mostly asymptomatic. Almost all the lesions were in the white matter, particularly in the juxtacortical, deep and periventricular white matter. A third of the lesions were greater than 5 mm, 14% enhanced with gadolinium. There were more supratentorial than infratentorial lesions at a ratio of 7.5: 1. Ninety five percent of the spinal cord lesions were in cervical and thoracic regions, 34% enhanced with gadolinium. The lesions extended over a mean of 3.6 +/- 3.3 vertebral bodies in length. Fifty (50%) of the brain and 54 (63%) of the spinal MRI patients had the optic-spinal form of MS. The MRI of the optic-spinal and classical groups of patients were similar in appearance and distribution, except that the optic-spinal MS patients have fewer brain but longer and more severe spinal cord lesions. In conclusion, the brain and spinal cord MRI of Asian patients with MS was similar to that of the West, although, in this study, Asian MS patients had larger spinal cord lesions.

Adult↗

Awareness of cancer information among Asian Americans.

The present study aimed to find the awareness level of cancer information among Asian Americans in the Delaware Valley region (Pennsylvania and South Jersey). A cross-sectional self-report survey was conducted with a sample of 1374 Asian Americans including Chinese, Korean, Vietnamese and Cambodians. The sample was collected by using a stratified-cluster proportional sampling technique. This paper assessed self-reported smoking behaviors, knowledge of smoking cessation methods, availability of health professional's advice in quitting smoking in the past 12 months, awareness of the National Cancer Institute's Cancer Information Service, knowledge of, and interest in participation in cancer clinical trials for identified Asian smokers. Overall, the level of awareness of cancer information services among the four subgroups was low. Among current and former smokers, only 31% had been advised by a health care professional to quit smoking. Forty-three percent used at least one smoking cessation method to quit in the past. The results also reveal an increased awareness level among those who had health insurance, higher education and were less likely to speak their native language. Significant differences on cancer awareness existed among the four ethnic groups as well. This study suggests urgent needs to educate Asian Americans about important cancer control issues and services and highlights the differences in baseline knowledge and attitudes among the various ethnic groups.

Asian↗

Photoaging in Asians.

The aging process of the skin can be divided into intrinsic and photoaging. Clinically, naturally aged skin is smooth, pale and finely wrinkled. In contrast, photoaged skin is coarsely wrinkled and associated with dyspigmentation and telangiectasia. Although the population of Asia is more than half the population of the Earth, no well-designed study has been undertaken to investigate the characteristics of cutaneous photodamage in Asian skin. As Asian skin is more pigmented, the acute and chronic cutaneous responses to UV irradiation seen in brown skin differ from those in white skin. The clinical characteristics of photoaging in Asian skin, such as pigmentary changes and wrinkle patterns, differ from those of Caucasian skin. This review provides an outline of the characteristic features of photoaging on the brown skin of Asians.

Asian People↗

Asian-American educational achievements. A phenomenon in search of an explanation.

Considerable attention has been paid to the academic achievements of Asian Americans because there is convergent evidence that this population has attained high educational mobility. In trying to explain the achievement patterns, researchers have largely limited their investigations to one of two contrasting hypotheses involving (a) hereditary differences in intelligence between Asians and Whites and (b) Asian cultural values that promote educational endeavors. Research findings have cast serious doubt over the validity of the genetic hypothesis. Yet, there has been a failure to find strong empirical support for alternative hypothesis concerning cultural values. It is proposed, under the concept of relative functionalism, that Asian Americans perceive, and have experienced, restrictions in upward mobility in careers or jobs that are unrelated to education. Consequently, education assumes importance, above and beyond what can be predicted from cultural values. Research and policy implications of this view are noted.

Achievement↗

Prioritized assignment to intake appointments for Asian Americans at an ethnic-specific mental health program.

This study examined the relationship of demographic, clinical, and therapist factors to decisions about prioritized assignment to the earliest intake appointment for 983 Asian Americans who contacted an Asian-oriented, ethnic-specific mental health program. The logistic regression results showed that Asian language preference, ethnicity, suicidality, violent behavior, physical and sexual abuse, and psychotic symptoms increased the likelihood of a prioritized decision for the earliest intake appointment but that being female, being of an older age, and having somatic complaints decreased the likelihood. Given these findings, Asian American clinicians at an ethnic-specific program were found to consider clinical, demographic, and ethnically related factors in prioritized decisions about intake assignment, which could improve intake attendance.

Adult↗

Asian American multidimensional acculturation scale: development, factor analysis, reliability, and validity.

This article describes the development and psychometric properties of the Asian American Multidimensional Acculturation Scale (AAMAS). The results of 3 separate studies provide strong evidence of the instrument's reliability and validity. The principles for the development of the AAMAS were orthogonality of cultural dimensions, inclusion of a pan-ethnic Asian American dimension, and ease of use across ethnic groups. Exploratory and confirmatory factor analyses indicate that within each cultural dimension (AAMAS-Culture of Origin, AAMAS-Asian American, and AAMAS-European American) there are 4 reliable acculturation domains of cultural identity, language, cultural knowledge, and food consumption. These features of the AAMAS allow for a more complex assessment of acculturation level of Asian Americans and its relationship to psychological functioning.

Acculturation↗

The Asian American values scale--multidimensional: development, reliability, and validity.

The development of the 42-item Asian American Values Scale-Multidimensional (AAVS-M) is presented. In Study 1, data from 163 Asian American respondents were subjected to a principal components analysis, which reduced the initial set of 180 items to 42 items divided into 5 components: collectivism, conformity to norms, emotional self-control, family recognition through achievement, and humility. The data also revealed initial evidence of the AAVS-M total and subscale scores' reliability and validity. In Study 2, data from 189 Asian American respondents were subjected to a confirmatory factor analysis, which supported a hierarchical factor structure underlying the AAVS-M. Additional reliability and validity evidence of AAVS-M total and subscale scores were found. In Study 3, data from 38 Asian American respondents yielded evidence of AAVS-M total and subscale scores' test-retest reliability.

Acculturation↗

Inter- and intra-group variability in perceptions of behavior among Asian Americans and European Americans.

Between-group and within-group differences in perceptions of behavior were examined among 74 Asian Americans and 111 European Americans. Participants rated videotaped interactions of Asian American mothers and daughters. Asian Americans, and a more homogeneous sample of Chinese Americans, perceived less maternal control and more reciprocity than did European Americans. Intra-cultural variations in perceptions were also evident, as within-group analyses revealed differences in perceptions based on the generational status of Asian Americans and the degree of multicultural experience of European Americans. Overall, findings suggest that perceptions of behavior are shaped as much by within-group differences in familiarity and experience with the target culture as by between-group differences in ethnicity. Implications for theories of child socialization, multicultural counseling, and observational research are discussed.

Adolescent↗

Renin-angiotensin system gene polymorphisms predict the progression to renal insufficiency among Asians with lupus nephritis.

The renin-angiotensin system (RAS) is a strong candidate as a mediator for the development and progression of lupus nephritis (LN). We performed an ethnically stratified analysis of 642 systemic lupus erythematosus (SLE) patients to determine whether various functional RAS gene polymorphisms are associated with SLE renal outcomes. Patients were genotyped for two angiotensin-converting enzyme (ACE) gene polymorphisms: Alu insertion/deletion (I/D) and 23 949 (CT)(2/3), and for two angiotensinogen (Atg) gene polymorphisms: M235T and C-532T. Multivariate analyses demonstrated associations between the ACE I/D, ACE (CT)(2/3) and Atg C-532T functional polymorphisms and LN among Asians. In stratified analyses among LN cases according to high vs low glomerular filtration rate (GFR), associations remained significant for the ACE D (odds ratio (OR) 5.9, P=0.001) and (CT)(2) (OR 6.2, P=0.001) alleles among Asian subjects with low GFR. Lastly, we found allelic dose-dependent associations between the ACE I/D (P=0.003), ACE (CT)(2/3) (P=0.005) and Atg M235T (P=0.04) polymorphisms, and GFR analyzed as a continuous variable among Asians. These findings suggest a significant role for ACE and Atg gene sequence variation and severity of LN among Asians with SLE.

Adult↗