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The polymorphism of the alpha 2-HS-glycoprotein (A2HS) was analysed in Rarotonga and Mangaia, the Cook Islands. The A2HS*2 frequency was found to be the highest value among all populations studied up to now. There was a significant difference in A2HS*2 gene frequencies between the two populations, Rarotonga (0.62) and Mangaia (0.76).
Human ageing is most usefully conceptualised as an interaction between intrinsic and extrinsic processes. Comparison of age-associated trends in populations living under different environmental conditions provides a method of recognising the effects of extrinsic influences. This paper compares the age-associated trend in mean frontal plane QRS axis in the male adult population of Pukapuka with the trend observed in an age-matched sample from a British population. The Pukapukans show no rise in mean blood pressure with age and have other features placing them at low risk of coronary heart disease. Although the British population showed the shift to the left in mean QRS axis characteristic of economically advanced populations there was no change in mean QRS axis with age among the Pukapukans. The conclusion is drawn that the shift with age in QRS axis observed in advanced populations is extrinsic in origin but is not necessarily a manifestation of coronary heart disease.
Polynesian (Maori and Pacific Island) children account for approximately one quarter of the children in New Zealand, but good data for lung function in this group are not available. In this review, we report lung volume measurements in 571 healthy children 5 to 13 yr of age: 270 Polynesians (139 boys and 131 girls) and 301 Europeans (177 boys and 124 girls). All measurements were made in a body plethysmograph. Polynesian boys had significantly larger VC, FVC, FRC, TLC, and expiratory reserve volume than did Polynesian girls. Polynesian and European children generally showed different slope and intercept relationships for the prediction of lung volume from height. Racial differences are not adequately explained by differences in body proportions or social factors including parental smoking. Possible explanations include racial differences in lung growth and maturation.
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Bronchial or nasal ciliated epithelium from 13 patients with bronchiectasis (12 Polynesians and 1 European) was examined by electron microscopy. All cilia examined lacked dynein arams. In 2 patients, this was the only abnormality observed, but in the others, various ciliary abnormalities were present, including cilia with missing tubules, extra tubules, and misplaced tubules, as well as compound cilia, intracytoplasmic cilia, vesiculated cilia, and cilia with long winglike folds. In all of these patients pulmonary mucociliary transport rates were either absent or markedly reduced. It is suggested that these abnormalities were due to a mutation or group of mutations, which was the underlying cause of the bronchiectasis.
The author hypothesizes that the underreporting of mental illness in Tutuila, American Samoa, is a direct result of the social system, which provides a means of "curing" emotional disorder by family group process and shamanistic ritual, by making the disorder less disruptive, and by absolving the affected individual of personal guilt.
Transcultural psychiatry is generally thought to be an appropriate concern only in distant or unusual environments. But because many immigrant groups in the U.S. maintain their original customs and traditions, a transcultural approach may be necessary in many clinical situations, as illustrated by the case histories of three immigrant patients on a university hospital's psychiatric service. All had manifestations of severe psychiatric disturbance, but their clinical evaluation and management were complicated by difficulties in communication and by culturally linked behavior patterns and family responses at variance with American norms. Careful attention to transcultural factors is necessary for the optimal management of such cases.
We examined the skeletal remains of 1338 early Hawaiians (preserved in the Bishop Museum, Honolulu) to determine total caries and root surface caries prevalence. Specimens from seven islands were represented in the collection. Estimation of age at death was made by a combination of dental developmental staging for younger individuals and occlusal attrition and/or alveolar bone loss in adults. Museum records were also consulted for age estimation of adults which was primarily based on osteological criteria. The material was divided into six age groups. Predentate infants and edentulous adults were not included. A total of 19,425 teeth was examined. Caries lesions were observed in 462 individuals (34.5%) and 1895 teeth (9.8%). Coronal caries lesions in children and adolescents tended to be small and not particularly destructive of tooth structure. Root surface lesions in young adults were also small but increased progressively in size in the older groups, resulting in pulp exposure and coronal amputation. Although coronal caries was apparently not a significant dental health problem in children and young adults (compared with contemporary Hawaiians), root surface caries was an increasingly important source of tooth morbidity and tooth mortality in the older population groups. This age-related caries pattern was similar for all of the islands.
PURPOSE: This study examined the perception of diabetes among a sample of Pacific Islanders in Honolulu, Hawaii. All 23 participants were diagnosed with type 2 diabetes, ranged in age from 21 to 70 years, and had glycosylated hemoglobin levels of 5.8% to 13.9%. METHODS: Four focus groups were held in English and audiotaped. Outreach workers served as translators and comoderators. The content of transcripts was analyzed with Ethnograph software by investigators. The priority issues were confirmed by the comoderators and participants. RESULTS: Participants perceived diabetes as full of complications, emotions, symptoms, and behavior changes. Responses to hyperglycemia were fear, frustration, and uncertainty. Barriers to staying on the prescribed diet were habit, cultural ritual, ideal body image, and limited budget. CONCLUSIONS: Participants suggested that helpful activities would include walking/support group, cooking class, community healthy food store, translated material, and family participation. A community-based diabetes program has been developing as a result of the focus group findings.
The atoll community of Fenuafala was surveyed during July-August, 1987. A disproportionate demographic structure was found: There was a large, young population with an uneven sex distribution in the adolescent cohorts. Adoption of relatives was frequent. Employment varied according to sex, with women restricted from horticulture, fisheries, and hard labour. The use of alcohol and tobacco was common. Causes of mortality included cancer, heart failure, meningitis, alcoholism, and accidents. Bacterial and fungal skin infections were prevalent. There were several cases of congenital disorders. Malaria, leprosy, and most other tropical diseases were absent. However, there was a single case of filariasis. Musculoskeletal disorders were numerous and more common among women. Falls from trees have resulted in serious sequelae including epilepsy and death. Hypertension, diabetes, and gout appear to be on the increase, but angina and myocardial infarction were not reported. There were also cases of epilepsy and Parkinson's disease.
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Morinda citrifolia L (noni) is one of the most important traditional Polynesian medicinal plants. Remedies from isolated Polynesian cultures, such as that of Rotuma, illustrate traditional indications that focus upon leaves, roots, bark, and green fruit, primarily for topical ailments. Anecdotally collected Hawaiian remedies that employ noni fruit illustrate changing usage patterns with shifts in recent times to preparation of juice made of ripe or decaying fruit. Ralph M. Heinicke promoted a wide range of claims about noni, and these seem to have fueled much of the current commercial interest in the plant. Recent studies of the proliferation of commercial products have shown that noni product manufacturers are promoting a range of therapeutic claims. These claims are based upon traditional Polynesian uses, Heinicke's ideas, and fragments of recent scientific studies including the activity of noni in the treatment of cancer. A review is provided of recent studies of potential anticancer activity of noni fruit. While noni's anticancer potential is still being explored, it continues to be widely used by Polynesians and non-Polynesians alike for both traditional and newly hypothesized indications.
In 2000, a major dengue epidemic, caused by the type-1 virus (DENV-1), began in the Pacific and Asia, with cases still being reported in 2006. The phylogenetic analysis of full-length sequences of the envelope-protein gene of DENV-1 isolates recovered during outbreaks in Hawaii and Tahiti in 2001-2002 indicated that most Hawaiian isolates were Tahitian in origin. All the Hawaiian and Tahitian isolates were identified as the Pacific subtype (i.e. subtype IV) of DENV-1. A Hawaiian isolate, collected from a resident who had travelled to Samoa, differed significantly at the nucleotide level, however, from all the other Hawaiian strains, clustering, in the phylogenetic analysis, with a virus previously isolated from another visitor to Samoa. These results not only indicate that two distinct strains of DENV-1 were introduced into Hawaii in 2001 but also illustrate the ease with which dengue can be carried across distances of many thousands of miles.
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Blacks are known to have a higher bone mass than whites and have recently been found to have significantly different levels of calcitropic hormones and other biochemical indices of calcium metabolism. To assess the possible significance of these biochemical differences to interracial differences in bone mass, we have undertaken an assessment of indices of calcium metabolism in Polynesian subjects, since they also have a higher bone mass than whites. Serum concentrations of 25-hydroxyvitamin D were slightly lower in Polynesians than in whites (65 +/- 5 vs. 95 +/- 10 nmol/L; P less than 0.02), but there were no differences between the groups in serum levels of calcium (total and ionized), phosphate, magnesium, 1,25-dihydroxyvitamin D, PTH, calcitonin, alkaline phosphatase activity, and bone gla-protein. Furthermore, urinary excretion of hydroxyproline, calcium, phosphate, magnesium, sodium, and potassium and the tubular maximum for the reabsorption of phosphate were not different between whites and Polynesians. Intestinal strontium absorption was similar in the two groups. In contrast, distal forearm bone mineral content was higher in Polynesians (P less than 0.01) and midupper arm muscle area was also increased in this group (P less than 0.005). It is concluded that the higher bone mass of Polynesians cannot be attributed to alterations in the basal levels of calcitropic hormones, but may be related to their greater muscle mass. It is probable that the previously observed black-white differences in the vitamin D endocrine system are secondary to the effects of skin color on vitamin D synthesis and are not contributory to the lower bone mass of whites.
In an effort to determine whether life in industrialized societies can have an effect on hearing, 90 natives from Easter Island over 45 years old were evaluated. They underwent complete clinical and audiological assessment and were divided into groups according to those having lived only on the island or those having lived in modern civilization. With all factors being equal, except exposure to modern civilization, our results showed that living in civilized societies has a significant negative effect on hearing; the severity is directly proportional to the years of exposure. The median hearing thresholds of natives always living on the island (men and women combined) was found to be similar to those of female citizens of the United States; there was no significant difference in hearing thresholds between men and women among these natives. These results suggest that there are no significant inherent racial differences nor significant inherent differences between males and females in the sensitivity of hearing. A relationship between aging and hearing was noted and interpreted as true or intrinsic presbycusis. There were no cases of otosclerosis, Meniere's disease, or exostoses of the external ear canal among natives who had always lived on the island. Pure natives were found not to be prone to otitis media in spite of having an extremely high incidence of severe upper respiratory tract allergies.
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