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Individualism-collectivism, self-efficacy, and other factors associated with risk taking among gay Asian and Caucasian men.

A theoretical framework, which included perspectives of individualism-collectivism and self-efficacy, was used to investigate factors associated with sexual risk practice among gay Asian and Caucasian men. "Risk" was defined as unprotected anal intercourse with any casual partner or with a regular partner whose HIV status was not concordant with the participant's. Altogether, 201 Caucasian and 199 Asian gay men, largely recruited from gay social venues in inner Sydney, completed an anonymous questionnaire. Most participants were gay self-identified and gay community attached, and more than half of the Asian men had been living in Sydney for at least 3 years. Overall, the Asian men were more collectivist oriented and the Caucasian men more individualist oriented. Data analyses revealed that higher self-efficacy in avoiding casual risk encounters and smaller proportion of gay friends were associated with less risk. The inclusion of individualism-collectivism and social cognitive variables in the examination of sexual risk practices among gay men from different cultural backgrounds holds promise.

Adult↗

Risk behaviors among Asian women who work at massage parlors in San Francisco: perspectives from masseuses and owners/managers.

This study investigates cognitive, cultural, and contextual factors that influence HIV-related risk behaviors among Asian women who engage in sex work at massage parlors in San Francisco. Focus groups and qualitative interviews were conducted for Vietnamese and Thai masseuses and massage parlor owners/managers. Economic pressure as well as subjective evaluation of customers for the risk of HIV/STD infection increase unprotected sexual behaviors among Asian masseuses. Massage parlor owners/managers do not establish a clear policy for condom use at their parlors. Consequently, male customers often manipulate their intention not to use a condom while negotiating with masseuses. HIV/STD prevention intervention programs should address specific risks and needs for Asian masseuses, owners/managers, and male customers in order to promote health and well being among Asian masseuses who have been neglected by public health and social services.

Asian↗

Chinese and South Asian religious institutions and HIV prevention in New York City.

Religious institutions in Asian immigrant communities are in a unique position to confront the challenges of the HIV epidemic for the populations they serve. However, there has been little research on whether these institutions are willing or able to take a role in HIV prevention. This article reports on findings from a qualitative study of three Asian immigrant religious institutions in New York City (a Buddhist temple, a Hindu temple, an Islamic center/mosque) that are part of a larger study of Asian immigrant community institutions and their response to the HIV epidemic. Several prominent themes arose that formed the basis of a preliminary theoretical framework describing the way Asian immigrant religious institutions may evaluate their role in HIV prevention. The interview data indicate that the institutions take a stance of "conservative innovation," weighing their role as keepers of morality and religious tradition against the changing needs of their communities and then adjusting their practices or positions incrementally (to varying degrees) to stay responsive and relevant.

Adult↗

Cortisol responses following placebo and alcohol in Asians with different ALDH2 genotypes.

Alcohol-induced flushing occurs in Asians who possess ALDH2*2 alleles. This study genotyped 30 Asian American men for ALDH2 and evaluated them on two separate occasions where they received in random order placebo and 0.75 ml/kg alcohol. Blood samples were drawn at baseline and 15, 30, 60, 90, 120 and 150 minutes after beverage administration for subsequent estimation of blood alcohol and plasma cortisol levels. Subjects with ALDH2*2 alleles demonstrated significantly higher cortisol levels after alcohol consumption than subjects with ALDH2*1/2*1 genotype, despite equivalent blood alcohol concentrations. One subject who was homozygous for ALDH2*2 had extraordinarily high cortisol levels at 90, 120 and 150 minutes after alcohol. These data are consistent with the hypothesis that Asians with ALDH2*2 alleles, who flush after drinking, experience more intense reactions to alcohol than nonflushing Asians with ALDH2*1/2*1 genotype.

Adult↗

Aortic aneurysm morphology in Asians: features affecting stent-graft application and design.

PURPOSE: To determine the morphological features of abdominal aortic aneurysms (AAA) in an Asian cohort in order to identify unique features relevant to stent-graft planning and application. METHODS: Spiral computed tomography (CT) and angiographic assessment of AAA morphology was performed on 65 ethnic Chinese (58 men; mean age 74 years, range 50-87) who underwent endovascular AAA repair. Morphological parameters were compared with published data from American and European patients. The eligibility and potential concerns referable to 4 current stent-graft designs were addressed. RESULTS: Both common iliac arteries (CIA) measured significantly shorter in Asians, particularly on the right side. The mean RCIA and LCIA lengths were 29.9 mm and 34.2 mm, respectively (25.7 and 34.1 mm for CIAs <20 mm in diameter), compared to >50-mm in Caucasians (p<0.001). The distance between the lowest renal artery and the CIA bifurcation averaged 20 mm shorter in Asians: 148 mm on the right side and 153 mm for the left. The CIAs were also wider, averaging 20.2 mm for the right and 17.9 mm for the left. Other linear measurements did not show a population difference. The AAAs in this series were slightly larger (p<0.001), with a shorter neck (mean 23 mm, p<0.001). No correlation was found between the morphological parameters and body build. Internal iliac artery coverage with or without embolization was necessary in 51% of endovascular repairs due to short or aneurysmal CIAs. CONCLUSIONS: These differences in AAA morphology pose unique challenges for endovascular repair in Asians. Preoperative angiography is more often necessary. The need for an accurate landing in a short CIA and insufficient length for maneuvering placed constraints on 2-piece graft designs with long main body lengths. A 3-piece endograft with wider aortic and iliac diameters is currently the most attractive option.

Aged↗

Infant mortality and related risk factors among Asian Americans.

To examine differences in perinatal health among nine Asian ethnic subgroups, a descriptive epidemiological study was conducted using linked birth/infant death certificates for 1982 to 1987. When compared with Whites, Asians had a lower proportion of young mothers, unmarried mothers, and women who received first trimester prenatal care; a higher proportion of foreign-born mothers; and a different birthweight distribution. A great deal of heterogeneity was found in risk factors and infant mortality rates among the various Asian ethnic subgroups. Paradoxically, although Asian ethnic subgroups had a higher perinatal risk profile, they had more favorable birth outcomes than did Whites.

Adolescent↗

Age- and sex-specific prevalence of diabetes and impaired glucose regulation in 11 Asian cohorts.

OBJECTIVE: To report the age- and sex-specific prevalence of diabetes and impaired glucose regulation (IGR) according to revised World Health Organization criteria for diabetes in Asian populations. RESEARCH DESIGN AND METHODS: We performed 11 studies of 4 countries, comprising 24,335 subjects (10,851 men and 13,484 women) aged 30-89 years who attended the 2-h oral glucose tolerance test and met the inclusion criteria for data analysis. RESULTS: The prevalence of diabetes increased with age and reached the peak at 70-89 years of age in Chinese and Japanese subjects but peaked at 60-69 years of age followed by a decline at the 70 years of age in Indian subjects. At 30-79 years of age, the 10-year age-specific prevalence of diabetes was higher in Indian than in Chinese and Japanese subjects. Indian subjects also had a higher prevalence of IGR in the younger age-groups (30-49 years) compared with that for Chinese and Japanese subjects. Impaired glucose tolerance was more prevalent than impaired fasting glycemia in all Asian populations studied for all age-groups. CONCLUSIONS: Indians had the highest prevalence of diabetes among Asian countries. The age at which the peak prevalence of diabetes was reached was approximately 10 years younger in Indian compared with Chinese and Japanese subjects. Diabetes and IGR will be underestimated in Asians based on the fasting glucose testing alone.

Adult↗

Asian-American men's acculturation and gender-role conflict.

There is limited research on Asian-Americans' acculturation and conflicts with contemporary gender roles. This research assessed three samples of Asian-American men's acculturation and gender-role conflict. Differences between Chinese-American, Japanese-American, and Korean-American men's acculturation and the four patterns of gender-role conflict were analyzed. The relationship of demographic and acculturation variables to gender-role conflict was also calculated. Subjects (N = 125) were administered a demographic questionnaire, the Suinn-Lew Asian Self-identity Acculturation Scale, and the Gender-role Conflict Scale. Multivariate analysis of variance showed no differences between the Asian-American groups on acculturation and the four patterns of gender-role conflict. A canonical correlation analysis indicated one significant variate connecting acculturation with two patterns of issues of gender-role conflict: success, power, and competition and restrictive emotionality. Methodological limitations and research are mentioned.

Acculturation↗

Job satisfaction of Asian Americans.

Since Asian Americans have demographic and labor force characteristics more similar to Euro-Americans than African Americans, one might predict that their job satisfaction would be more like the former than the latter. And, because Asian Americans originating from different countries are heterogeneous in language, culture, and recency of immigration, one might predict that they may report obtaining different amounts of satisfaction from their jobs. However, data from 21 nationally representative opinion surveys from 1972 through 1996 suggest the opposite. Asian Americans (n = 199) reported job satisfaction more like African Americans (n = 1,231) than Euro-Americans (n = 10,709), and Asian Americans from China (n = 53), Japan (n = 44), India (n = 55), and the Philippines (n = 47) reported similar job satisfaction. These differences persisted when age, education, occupation, and personal income were held constant.

Adult↗

Validation of a genome-wide polygenic score for body mass index in South Asians.

Obesity is a complex disorder, manifested by the interaction of inherited and environmental factors and modulated by a person's lifestyle habits. India has witnessed more than a two-fold increase in the number of overweight adults in the last 30 years. The polygenic risk score (PRS) quantitatively measures an individual's risk for common diseases. The PRS for obesity have been validated in the Caucasian population but not in the South Asian (SAS) population. In this study, we benchmarked and validated the existing genome-wide PRS model of obesity with 2.1 million variants in the SAS population. We analyzed a total of 14,263 individuals from three different South Asian cohorts. We compared the risk score with the body mass index (BMI) categories (underweight, normal weight, overweight, and obese) in all three cohorts. High PRS was associated with increased BMI in all the three cohorts. This study also compared validation results from another population-specific PRS model for the BMI. We conclude that high PRS is associated with high BMI in South Asians. Our study suggests that the PRS score can perhaps be an early predictor of overweight and obesity in the South Asian population.

South Asian↗

Health insurance coverage for vulnerable populations: contrasting Asian Americans and Latinos in the United States.

This paper examines the role that population vulnerabilities play in insurance coverage for a representative sample of Latinos and Asians in the United States. Using data from the National Latino and Asian American Study (NLAAS), these analyses compare coverage differences among and within ethnic subgroups, across states and regions, among types of occupations, and among those with or without English language proficiency. Extensive differences exist in coverage between Latinos and Asians, with Latinos more likely to be uninsured. Potential explanations include the type of occupations available to Latinos and Asians, reforms in immigration laws, length of time in the United States, and regional differences in safety-net coverage. Policy implications are discussed.

Adolescent↗

Smoking among Asian American and Hawaiian/Pacific Islander youth: data from the 2000 National Youth Tobacco Survey.

OBJECTIVES: One of the first steps to reducing the disproportionate burden of tobacco on racial and ethnic minorities is to understand how tobacco differentially affects these populations. This paper, based on a nationally representative sample of Asian American youth and a smaller sample of Hawaiian/Pacific Islander youth, provides the tobacco control community with important information about the smoking behavior of these youth. METHODS: The National Youth Tobacco Survey conducted during the Spring of 2000 (NYTS 2000) provides recent national estimates of smoking behavior among Asian American youth. The data also permit a limited exploration of possible differences between self-described Asians and Hawaiian/Pacific Islander youth, two groups that have been combined into a single racial/ethnic category in earlier national studies. FINDINGS: This report provides estimates and 95 percent confidence intervals for current smoking, age of smoking initiation, use of menthol cigarettes and tobacco brand preferences. CONCLUSIONS: NYTS 2000 data indicate that during the last year of high school, one third of Asian American youth are smokers. Of these youth, 60% report that their usual brand of cigarettes is a menthol brand. Among female Hawaiian/Pacific Islander youth in middle school, more than 25% report having smoked during the past month.

Adolescent↗

Why are thyroid cancer rates so high in southeast asian women living in the United States? The bay area thyroid cancer study.

The purpose of this study is to understand why thyroid cancer incidence rates are higher among Southeast Asian (SA) women living in the United States than among other United States women. A multiethnic population-based, case-control study of thyroid cancer among women ages 20-74 was conducted in the San Francisco Bay Area. Cases diagnosed between 1992 and 1998 were identified through the area's population-based cancer registry. Controls were identified using random digit dialing and matched to cases on age and ethnicity. Asian women were classified as SA (n = 214) or Northern Asian (n = 196) based on self-reported ethnicity. Relative attributable risks, by age group (<50 and 50+), were calculated to assess what proportion of the difference in incidence rates between these populations could be attributed to the prevalence of specific thyroid cancer risk factors, assuming common relative risks across ethnic groups. Among younger women, a history of goiter or thyroid nodules and lower consumption of isoflavones from soy-based foods account for 66% of the difference in incidence between SA and Northern Asian women. Among older women, these factors, along with recent migration, accounted for 95% of the difference between these groups. When comparing SA with Caucasian women, goiter/nodules and lower consumption of carotenoids explained 67% of the difference in incidence in younger women, whereas goiter/nodules and socioeconomic variables explained 81% of the difference in incidence in older women. A greater prevalence of goiter and thyroid nodules accounts for a substantial portion of the higher thyroid cancer incidence rates among SA women. Dietary patterns also contribute to the rate differences.

Adult↗

Cigarette smoking among Southeast Asian immigrants--Washington state, 1989.

Since 1975, approximately one million Southeast Asians have immigrated to the United States. In general, the efforts of local public health agencies to meet the needs of these immigrants have focused on identifying and treating acute and chronic diseases rather than identifying and modifying health-risk behaviors (e.g., smoking) among these immigrants. However, efforts to determine the prevalence of smoking suggest that smoking rates are high, especially among men of Southeast Asian origin. During 1989, to characterize cigarette smoking among Southeast Asian immigrants, the Seattle-King County (Washington) Health Department surveyed newly arriving Southeast Asian immigrants who intended to reside in the county regarding their health problems and health-risk behaviors. This report summarizes survey findings regarding their smoking habits.

Adolescent↗

Renal disease disparities in Asian and Pacific-based populations in Hawai'i.

The prevalence of end-stage renal disease (ESRD) in the United States is expected to double over the next 10 years. The identification of ethnic differences in the prevalence, treatment, morbidity, and mortality related to chronic kidney disease (CKD) is of great concern. Asian Americans comprise a rapidly expanding sector of the U.S. population and are reported to have ESRD growth rates that are approximately 50% higher than caucasians. Hawai'i has a large, well-established Asian and Pacific-based population that facilitates the examination of disparities in renal disease among the state's diverse ethnic groups. The prevalence of ESRD in Hawai'i has continued to rise due, in part, to high rates of diabetes, glomerulonephritis, and hypertension reported in Asian Americans and Pacific-based populations. ESRD patients in Hawai'i have a two-fold higher prevalence of glomerulonephritis, compared with the general ESRD population in the United States. Other potential sources of renal disparities-such as cultural factors, language barriers, and health access factors-among Hawaii's major ethnic groups are assessed. However, few studies have examined the relative contribution of these potential factors. Consequently, efforts to reduce and eventually eliminate renal disease disparities will require a better understanding of the major sources of health disparities, such as timely medical care, a diverse health workforce, and cultural/social barriers, that affect optimal health care practices in Asian and Pacific-based populations.

Asian↗

Genetic polymorphism of cytochrome P450 enzymes in Asian populations: focus on CYP2D6.

Published studies demonstrate that significant ethnic differences can exist in the metabolism of some drugs. These differences are caused by cytochrome P450 polymorphisms and result in the potential for wide interpatient and interethnic variability in adverse events. One of the most common of these cytochrome P450 polymorphisms is related to the CYP2D6 isozyme. Many classes of commonly used drugs are metabolized by CYP2D6, creating the potential for significant adverse events. Due to the variety of genetic polymorphisms among Asian populations, this article focuses on this group rather than on other ethnic populations and discusses the clinical importance of genetic polymorphisms with regard to potential drug interactions. Polymorphism of CYP2D6 can either increase the rate of drug elimination (ultrametabolizers, leading to faster metabolic clearance potentially resulting in reduced effectiveness and need for higher doses) or decrease drug metabolism (poor metabolizers, which may increase the potential for drug interactions and adverse events). Although the CYP2D6 poor metabolizer phenotype is less frequent in Asian than in Western populations (e.g. about 1% in Thai, Chinese and Japanese populations and up to 4.8% in Indians versus 5-10% in Caucasians), the increased prevalence of the CYP2D6*10 allele in Asians does have an impact on drugs metabolized by CYP2D6. Enzyme activity is reduced, potentially increasing circulating drug doses and increasing the risk for drug interactions. Thus, in Asian populations it may be important to optimize pharmacotherapy either by assessing patients' CYP2D6 genotype, or by prescribing medications that are not metabolized by this isozyme.

Alleles↗

Iris melanocyte numbers in Asian, African American, and Caucasian irides.

PURPOSE: The anatomical basis for iris color has long been a controversial issue in ophthalmology. Recent studies demonstrated that in Caucasians, blue-eyed, gray-eyed, and hazel-eyed individuals have comparable numbers of iris melanocytes. The present investigation was carried out to compare melanocyte numbers in the irides of Asian, African American, and Caucasian brown-eyed individuals. METHODS: Paraffin-embedded sections from 71 brown-colored irides were incubated with rabbit anti-cow antibody against S100a, linked with an FITC conjugate antibody, and counterstained with Evans blue. Cells were counted under a fluorescence microscope and scored as melanocytes or other cells. Cell number, density, and iris area were calculated for each specimen. RESULTS: Caucasian and African American irides had comparable mean total melanocyte numbers. Asian irides had fewer total melanocytes than African American (P = .042) and Caucasian (P = .001) irides and smaller total number of cells (ie, melanocytes plus other cells) than African American (P = .054) or Caucasian (P = .009) irides. CONCLUSIONS: There is a statistically significant smaller mean total melanocyte number and mean total cellularity in Asian irides as compared to Caucasian and African American irides. This difference appears to be due to the combination of smaller iris area and lower melanocyte density in the Asian irides. The possibility exists that this may be a factor in ethnic variations in certain ocular diseases.

Black or African American↗

Leisure time physical activity and metabolic syndrome in Asian Indian immigrants residing in northern California.

OBJECTIVE: Immigrant Asian Indians possess major lipid and non-lipid risk factors that constitute features characteristic of metabolic syndrome. First-line therapy recognized in risk management of this syndrome is weight reduction and increased physical activity. We investigated the relationship of intensity and duration of leisure time physical activity (LTPA) to physiological indices of metabolic syndrome in Asian Indian immigrants. METHODS: Fifty-six apparently healthy men (43.7 years +/- 7.1; body mass index [BMI] 21-34) and women (43.1 years +/- 6.9; BMI 21-36) were screened to participate in this cross-sectional study. Leisure time physical activity (LTPA) was determined by Minnesota LTPA questionnaire. Anthropometric measurements were recorded by using standard procedures. Blood samples taken after an overnight fast were analyzed for measures defined by the NCEP ATP III criteria for metabolic syndrome. RESULTS: Prevalence of metabolic syndrome was 33.9% (age 29-59 years; average BMI 26.1 +/- 3.7) suggesting development of syndrome at younger age. While participants reported little LTPA, men were more active than women (total activity metabolic index (AMI) per week: 533 vs 204, respectively). In men, moderate activity was associated with a lower prevalence of metabolic syndrome, lower fasting glucose (r=-0.44), 2-hour glucose tolerance (r=-0.40), and lower serum triglyceride (r=-0.63). Only heavy activity was inversely associated with waist girth for both men (r=-0.46) and women (r=-0.41). Leisure activity levels reported by women were not significantly associated with any other risk factors. Low levels of physical activity were associated with prevalence of low high-density lipoprotein cholesterol (HDL-C), but reported LTPA levels were not significantly associated with favorable changes in serum HDL-C or blood pressure in both sexes. CONCLUSION: We provide evidence that Asian Indians who are physically active have a more favorable metabolic syndrome risk factor profile. Results highlight need to encourage physical activity in Asian Indian immigrants, particularly women, to reduce prevalence of metabolic syndrome.

Adult↗