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PubMed1999

Diabetes mellitus among South Asian inhabitants of The Hague: high prevalence and an age-specific socioeconomic gradient.

BACKGROUND: The prevalence of diabetes mellitus is known to be high among South Asians. The Municipal Health Service in The Hague investigated the prevalence of self-reported diabetes among South Asian inhabitants of The Hague, and the relationship between diabetes prevalence and socioeconomic status in this population. METHODS: A total of 3,131 South Asians >30 years of age, randomly selected (stratified according to age and sex) from the municipal register, were included in a postal survey with subsequent telephone interviews with non-respondents. RESULTS: Self-reported diabetes prevalence varies from 6.4% in the 31-49 year age group to 37.1% in the over 60s age group. The relationship with age varies across the different socioeconomic strata. There are only a few people with diabetes in the 31-39 year age group in the highest stratum, whereas in the lowest stratum at the same age the prevalence of self-reported diabetes approximates 20%. In the over 60s age group the prevalence of diabetes does not significantly differ between the higher and lower socioeconomic strata. CONCLUSIONS: Diabetes is an extremely common disease among South Asian inhabitants of The Hague. In this population, the relationship between diabetes prevalence and socioeconomic status varies with age. Cohort and age effects may account for this variation.

Adult↗
PubMedDate not supplied

Genetic variability in East Asian dogs using microsatellite loci analysis.

An analysis of eight microsatellite loci in 213 animals was performed to define the genetic structure and variability of 11 East Asian native dog populations. Allele diversity, observed heterozygosities, expected heterozygosities, F-statistics, G(ST) estimates, number of migrants per generation (Nm), and Nei's DA distance were calculated. Expected mean heterozygosities of Asian native dogs varied within a range of 0.310-0.718 with a mean value of 0.580. In a sample of 11 Asian dogs, the highest genetic diversity was exhibited in the Korean native dogs and the lowest in the Shiba, the Japanese native dog. All populations except the Kishu and Akita showed statistically significant deviation from Hardy-Weinberg equilibrium at more than one locus. After corrections for multiple significance tests, deviations over all loci were statistically significant in 7 of 11 dog populations, meaning that Asian dogs are genetically subdivided (global F(ST) = 0.154). Despite the locus-specific deviations, statistically significant departures from the Hardy-Weinberg equilibrium reflect deviations in the direction of heterozygote deficit, the global F(IS) being 0.072. In the neighbor-joining and unweighted pair group method with arithmetic mean (UPGMA) dendrograms based on Nei's DA distance, the Korean native breeds (the Sapsaree and the Jindo) were grouped together, then with the Eskimo dog. The two Japanese native dogs (the Hokkaido and the Akita) also clustered together, with moderate bootstrap support. In spite of some deviation, the three-dimensional scattergram based on principal components supported the conclusions suggested by the dendrograms based on Nei's DA distance. From these two analyses, the Korean native dogs formed the closest groups and then showed a close relationship to the Eskimo dogs, reflecting the fact that the Korean native dogs might be originated from dogs in the northern part of Far East Asia.

Animals↗
PubMed2002

The emerging limbs and twigs of the East Asian mtDNA tree.

We determine the phylogenetic backbone of the East Asian mtDNA tree by using published complete mtDNA sequences and assessing both coding and control region variation in 69 Han individuals from southern China. This approach assists in the interpretation of published mtDNA data on East Asians based on either control region sequencing or restriction fragment length polymorphism (RFLP) typing. Our results confirm that the East Asian mtDNA pool is locally region-specific and completely covered by the two superhaplogroups M and N. The phylogenetic partitioning based on complete mtDNA sequences corroborates existing RFLP-based classification of Asian mtDNA types and supports the distinction between northern and southern populations. We describe new haplogroups M7, M8, M9, N9, and R9 and demonstrate by way of example that hierarchically subdividing the major branches of the mtDNA tree aids in recognizing the settlement processes of any particular region in appropriate time scale. This is illustrated by the characteristically southern distribution of haplogroup M7 in East Asia, whereas its daughter-groups, M7a and M7b2, specific for Japanese and Korean populations, testify to a presumably (pre-)Jomon contribution to the modern mtDNA pool of Japan.

Base Sequence↗
PubMed1994

Can the uptake of breast screening by Asian women be increased? A randomized controlled trial of a linkworker intervention.

This study investigates the effectiveness of a linkworker intervention, giving encouragement and explanations about breast screening, on the subsequent attendance for screening by 'Asian' women. The control group received no visits. The study population comprised all women with Asian names, from a batch of general practices where high proportions of patients were Asian, who were invited for screening. It was found that 59 per cent of the intervention group could be contacted by linkworkers. No difference in attendance was found between the intervention and control groups (49 per cent and 47 per cent). Twenty-five per cent of women were permanently or temporarily not resident at the invitation address. Attendance for screening was related to length of stay in the United Kingdom. This type of intervention was not a successful strategy for promoting uptake by Asian women, and indicates that it is essential to evaluate rigorously projects with such objectives.

Aged↗
PubMed2001

Development and validation of a computerized South Asian Names and Group Recognition Algorithm (SANGRA) for use in British health-related studies.

BACKGROUND: Studies on ethnic variations in health have played an important role in aetiological and health services research. Most routine datasets, however, do not include information on ethnicity. South Asians, one of the largest minority ethnic groups in Britain, have distinctive names that also allow differentiation of the main sub-groups with their important differences in health-related exposures and disease risks. METHODS: A computerized name recognition algorithm (SANGRA) was developed incorporating directories of South Asian first names and surnames together with their religious and linguistic origin. SANGRA was validated using health-related data with self-ascribed information on ethnicity. RESULTS: SANGRA was successful in recognizing South Asian origin in reference datasets, with sensitivity of 89-96 per cent, specificity of 94-98 per cent, positive predictive value (PPV) of 80-89 per cent and negative predictive value (NPV) of 98-99 per cent. Religious origin was correctly assigned in the majority of cases: sensitivity, specificity and PPV were 94 per cent, 91 per cent and 90 per cent for Hindus; 90 per cent, 99 per cent and 98 per cent for Muslims; and 76 per cent, 99 per cent and 94 per cent for Sikhs. SANGRA correctly identified 76 per cent Gujerati and 70 per cent Punjabi names, although only 62 per cent of Gujerati names were sufficiently distinct to be allocated to the Gujerati-only category and only 53 per cent Punjabi names were allocated to the Punjabi-only category. However, specificity and PPV were high for both languages (respectively 97 per cent and 93 per cent for Gujerati, and 99 per cent and 97 per cent for Punjabi). CONCLUSIONS: SANGRA provides a practical and valid method of ascertaining South Asian origin by name and, to a lesser degree of accuracy, of differentiating between the main religious and linguistic subgroups living in Britain. This algorithm will be useful in health-related studies where information on self-ascribed ethnicity is not available or is of a limited nature.

Algorithms↗
PubMed2000

Fetal and maternal outcomes in Indo-Asian compared to caucasian women with diabetes in pregnancy.

Maternal and fetal complications are increased when pregnancy is complicated by diabetes, and this may be further influenced by racial and cultural differences. We examined fetal and maternal outcomes in Indo-Asian and Caucasian women attending the same antenatal diabetes service to see if there were any differences. Women with diabetes mellitus (type 1, type 2 and gestationally-acquired disease) complicating pregnancy, registered at the combined diabetes/antenatal clinic of this University teaching hospital over the period 1990-1998 were included. Fetal outcomes examined were miscarriage <24 weeks, stillbirths, neonatal deaths up to 28 days of life, perinatal mortality, congenital malformations and size for gestational age. Maternal outcomes examined were rates of caesarean section and vaginal deliveries, and number of pre-term deliveries <37 completed weeks of gestation. Outcomes for Indo-Asian and Caucasian women were similar, with a take-home baby rate of 96% and 92%, respectively. There was no perinatal mortality in Indo-Asian women, who were more likely to have a vaginal delivery and less likely to have a baby large for gestational age. Pregnancies complicated by type 2 diabetes in both groups pose the greatest threat to a successful pregnancy outcome. Indo-Asian and Caucasian women attending the same antenatal diabetes service have comparable outcomes. Attendance for pre-pregnancy care needs to be encouraged to combat the high early pregnancy loss and congenital malformation rate identified, particularly in those with type 2 disease, irrespective of ethnicity.

Bangladesh↗
PubMed2002

No-scar Asian epicanthoplasty: a subcutaneous approach.

PURPOSE: The epicanthal fold is a normal finding in the medial portion of the upper eyelid in many Asians. We describe a simple technique of removing the excess muscle and softening or eliminating the epicanthal fold without making incisions in the medial canthal region, thus avoiding complications such as scarring or web formation METHODS: Interventional case series. The subcutaneous epicanthoplasty was performed on all Asian patients undergoing concurrent upper eyelid blepharoplasty or aponeurotic ptosis repair. RESULTS: Thirty-eight Asian patients underwent epicanthal fold correction between January 1996 and December 2000. All patients had softening of the epicanthal fold; however, some cases of mild undercorrection were noted. CONCLUSIONS: Softening or elimination of the Asian epicanthal fold can be accomplished without making skin incisions in the medial canthal region. Our technique is a simple, graded procedure that can be performed in conjunction with upper blepharoplasty or ptosis repair.

Asia↗
PubMed1995

Interpretation of symptom presentation and distress. A Southeast Asian refugee example.

Symptom expression or the manifestation of distress is greatly influenced by one's cultural background. This exploratory study investigated symptom presentation of distress among a community sample of Vietnamese, Chinese-Vietnamese, Cambodian, and Lao refugees. The study examined whether or not the Western-designed distress measure used in the study was culturally sensitive enough to accurately capture culturally framed expressions of distress. The results of the factor analyses showed that the four Southeast Asian refugee groups did not express distress in three separate factors as devised in the original measure. Instead, a single robust factor emerged. The single factor comprised items from the depression, anxiety, somatic, and psychosocial dysfunction subscales. The items that made up the single factor strongly resemble the construct for the diagnosis of neurasthenia. Researchers have found neurasthenia to be a culturally sanctioned Asian cultural idiom of distress. The findings strongly suggested that this Southeast Asian refugee population expressed distress in a pattern of symptoms more consistent with Asian nosology. The clinical and research implications of the results of this exploratory study are also discussed.

Acculturation↗
PubMedDate not supplied

The postpartum experience for southeast Asian women in the United States.

PURPOSE: To examine the meaning of postpartum experiences for Southeast Asian women living in the United States. STUDY DESIGN AND METHODS: Phenomenology. Open-ended interviews were conducted with 19 women; audio-taped interviews were transcribed and analyzed for recurrent themes. RESULTS: Women identified culturally specific treatments they needed to use following the birth of an infant. These treatments are meant to delay aging and to prevent chronic ailments, and include stringent dietary measures and prolonged rest periods. Because childbirth signifies a paramount event in the life of a woman belonging to the Cambodian, Vietnamese, or Hmong cultures, she is accorded a great deal of assistance from female relatives. Three themes were discovered through this research: Prolonged Rest, Regaining Balance in the Body, and the Affiliation of Women. The themes give meaning to childbirth experiences and future well-being in the community. CLINICAL IMPLICATIONS: The childbirth experience in Southeast Asian cultures is saturated with great status, particularly in the family and community. In addition, postpartum cultural traditions of Southeast Asian women comprise deep meaning for healthy aging. Through this study, nurses can gain a more in-depth appreciation of the underlying meanings of postpartum practices for Southeast Asian women.

Adult↗
PubMed2000

Deep vein thrombosis after major spinal surgery: incidence in an East Asian population.

STUDY DESIGN: A prospective study of 313 patients who underwent major spinal surgery. OBJECTIVES: To determine the incidence of deep vein thrombosis after major spinal surgery in an east Asian population without antithrombotic prophylaxis. SUMMARY OF BACKGROUND DATA: Spinal surgery has been associated with few thrombotic complications (2-14%) compared with other reconstructive surgeries (20-70%). It has also been well documented that the incidence of deep vein thrombosis in east Asians (10%) is lower than in westerners (20-70%) in total joint replacements. There has been no previous report on the incidence of deep vein thrombosis after reconstructive spinal surgery in east Asians. METHODS: Three hundred thirteen patients who underwent major spinal surgery were evaluated prospectively. All patients were examined with duplex ultrasonography assessments of both lower extremities. No specific antithrombotic prophylaxis were used in any patients before or after surgery. RESULTS: There were four patients with positive findings of deep vein thrombosis on duplex ultrasonography, and there was only one with clinically symptomatic deep vein thrombosis. The overall incidence of thrombotic complications was 1.3%, and the incidence of symptomatic deep vein thrombosis was 0.3%. CONCLUSION: Considering the low rate of deep vein thrombosis, routine screening and prophylaxis for deep vein thrombosis appears unwarranted in east Asians before or after major spinal surgery.

Adolescent↗
PubMedDate not supplied

A Pap test screening clinic in a South Asian community of Vancouver, British Columbia: challenges to maintaining utilization.

The purpose of this article is to describe experiences and challenges in establishing a South Asian Pap Test Clinic. The specialized Pap test clinic for immigrant South Asian women was a community-initiated response to high rates of cervical cancer within this population. Efforts were made to ensure that the clinic provided health services in a sensitive and culturally appropriate manner. Although women were generally positive about their experiences at the South Asian Pap Test Clinic and often encouraged other women to attend the clinic for Pap testing, attendance patterns have not been maintained. The three most significant challenges to the clinic's ongoing success were: (1) maintaining the continued involvement of stakeholders in developing long-term strategies to enhance community awareness about cervical cancer; (2) creating mechanisms to strengthen support from physicians in the community; and (3) meeting the needs of the underserved within a specialized health service for South Asian immigrant women. These challenges provide important lessons for others to increase the participation of immigrant women in screening practices. Nurses can play a key role in mobilizing and maintaining collaborations that are essential to the continuing success of community-based programs.

Adult↗
PubMed1988

The molecular basis of thalassaemia major and thalassaemia intermedia in Asian Indians: application to prenatal diagnosis.

A study of the molecular pathology of beta thalassaemia in the Asian Indian immigrant population in the U.K. included 37 patients with thalassaemia major and 14 with thalassaemia intermedia. Using a combination of oligonucleotide probe hybridization and restriction endonuclease analysis the mutations in 100/102 (98%) of the beta thalassaemia genes were characterized. Nine different types were found, of which six are associated with beta zero, one with severe beta+ and two with mild beta+ thalassaemia. Comparison of the beta-globin gene cluster haplotypes, alpha globin genotypes and beta gene mutations of the thalassaemia major group with the thalassaemia intermedia group suggests that the co-inheritance of a high Hb F determinant associated with the - + - + + 5' beta haplotype and the inheritance of a mild beta-thalassaemia mutation are the major ameliorating factors of disease severity in Asian Indians. In comparison with other population groups. beta thalassaemia in Asian Indians is not associated with one or two predominant mutations. Despite this, prenatal diagnosis by direct detection is possible in the majority of families by restriction analysis and a limited number of oligonucleotide probes since the majority of severely affected individuals are homozygous for a single mutation. The characterization of these mutations should be useful for the planning of prenatal diagnosis programmes for beta thalassaemia in other Asian Indian communities.

Female↗
PubMed2004

Insulin resistance and endothelial dysfunction in the brothers of Indian subcontinent Asian women with polycystic ovaries.

BACKGROUND: Ultrasonographic appearances of polycystic ovaries (PCO) are found in 50% of South London Indian subcontinent Asians, a population at high risk of coronary disease and type 2 diabetes (DM). PCO is a familial condition but the genetics remain to be clarified. At present, the only characteristic documented in male family members is premature male pattern balding before the age of 30 years. Our aim was to quantify insulin resistance and endothelial cell function in the brothers of Indian subcontinent Asian women with PCO and/or a family history of type 2 DM. METHODS: Indian subcontinent Asian women (n = 40, age 16-40 years) with a brother available for study were recruited from the local population. They were stratified into four groups according to the ultrasound appearances of PCO and/or a family history of type 2 DM. Control subjects had no PCO and no family history of DM. Insulin sensitivity (KITT) was measured using a short insulin tolerance test and endothelial function using brachial artery ultrasound to measure flow-mediated dilatation (FMD). FINDINGS: Groups were well matched for age, body mass index (BMI) and waist-hip circumference ratios. Asian women with PCO demonstrated insulin resistance independent of BMI or family history of diabetes. Women with PCO and a family history of DM have reduced FMD, though PCO alone was not a marker. The brothers of women with PCO also have insulin resistance, comparable to that associated with a family history of type 2 DM. This was associated with elevations of blood pressure, abnormalities in serum lipid concentrations and impaired endothelial cell function. Endothelial cell function was particularly impaired in those subjects with both a sister with PCO and a family history of DM. INTERPRETATION: In an ethnic minority population at higher risk of coronary heart disease, brothers of women with PCO have evidence of insulin resistance and endothelial cell dysfunction in early adult life. Further study is required to establish whether these findings are associated with an increased incidence of cardiovascular events in this population.

Adolescent↗
PubMed2006

Assessment of need for psychosocial interventions in an Asian population of carers of patients with schizophrenia.

AIM: This paper reports on a study to establish the profile of need for psychosocial family interventions and to examine the concurrent validity of the Relatives' Cardinal Needs Schedule with an Asian population of carers in England, UK. BACKGROUND: Although psychosocial interventions for schizophrenia have a strong evidence base, little is known of the needs of Asian families. A cardinal need is indicative of the existence of a problem causing the carer a strain for which the carer is willing to co-operate if help is offered and for which systematic help has not been provided in the last 12 months. METHODS: The Relatives' Cardinal Needs Schedule was used to assess needs in a small randomly selected sample of Asian carers in one English locality and to compare the results with independent measures of patient symptoms and carer distress. RESULTS: Feedback from carers indicated that the Relatives' Cardinal Needs Schedule was culturally acceptable and appropriate to their needs. There was evidence for the validity of the assessment in that there were large and statistically significant associations between the number of needs detected by the Relatives' Cardinal Needs Schedule and independent measures of both carer distress (as measured by the 28 item General Health Questionnaire) and patient symptom severity (as reliably assessed from case notes). CONCLUSION: The Relatives' Cardinal Needs Schedule may prove useful for nurses and service managers in establishing the need for psychosocial family interventions amongst Asian families in the United Kingdom.

Adaptation, Psychological↗
PubMed2004

Changing epidemiology of gastroesophageal reflux disease in the Asian-Pacific region: an overview.

Gastroesophageal reflux disease (GERD) is a common disease in the West, which now appears to be also increasing in prevalence in the Asian Pacific region. The reasons for this changing epidemiology are two-fold: an increased awareness among doctors and patients, and/or a true increase in the prevalence of the disease. Prevalence rates of reflux esophagitis (RE) of up to 16% and prevalence of GERD symptoms of up to 9% have been reported in the Asian population. However, the frequency of strictures and Barrett's esophagus remain very low. Non-erosive reflux disease (NERD) appears to be the most common form of GERD among Asian patients accounting for 50-70% of cases with GERD. Among Asian patients differences can also be discerned among different ethnic groups. For example, in Malaysia where a multiracial society exists, RE is significantly more common among Indians compared to Chinese and Malays whereas NERD is more frequently seen in the Indian and Malays compared to the Chinese. The reasons for these differences are not known but may indicate both genetic factors and environmental factors peculiar to the particular racial group. GERD has also been increasing in the region demonstrating a time-lag phenomenon compared to the West. Differing predisposition to GERD among different ethnic groups would mean that such an increase would be more prominent among certain racial groups.

Asia↗
PubMed2005

Lower urinary tract symptoms and male sexual dysfunction in Asia: a survey of ageing men from five Asian countries.

OBJECTIVE: To determine, using the Asian Survey of Aging Males (ASAM), the prevalence of lower urinary tract symptoms (LUTS) and sexual disorders in Asian men aged 50-80 years, and to investigate the relationship between LUTS and sexual dysfunction, as community-based studies have shown a relationship between LUTS and sexual dysfunction. SUBJECTS AND METHODS: The ASAM survey was conducted in selected cities in five Asian countries, using a combination of face-to-face and mail-survey methods. The survey evaluated demographics, urinary symptoms (using the International Prostate Symptom Score, IPSS, and bother score), functional problems (using the Danish Prostatic Symptoms Score, DAN-PSS-Sex, and International Index of Erectile Function, IIEF) and comorbidity factors. In all, 1155 men aged 50-80 years completed the survey. RESULTS: The prevalence of LUTS varied among the countries, ranging from 14% in Singapore to 59% in the Philippines. Moderate to severe LUTS were reported by 36% of men aged 50-59 years, 50% aged 60-69 years and 60% aged 70-79 years. About three-quarters of all respondents (72%) aged 50-80 years were sexually active. Erectile dysfunction was reported by 63% of men in the study, of whom 57% were bothered by their symptoms. Ejaculation disorders were present in 68% of respondents (52% reported bothersomeness) and pain on ejaculation was experienced by 19% of the men in the study (88% reported bothersomeness). Sexual disorders increased with age and increasing severity of their LUTS. Erectile and ejaculation problems were more common in subjects with diabetes or hypertension; these two groups showed the same relationship between LUTS severity and sexual disorders. CONCLUSION: These results confirmed that sexual activity is common in Asian men aged 50-80 years, even at an advanced age. They also confirmed the correlation between LUTS and sexual dysfunction.

Age Distribution↗
PubMedDate not supplied

Prevalence of insulin-dependent diabetes mellitus in Asian children.

A survey was conducted in 1984-85, within Leicester City boundaries, which contains 64,535 children below the age of 15 years (20,267 Asian and 44,268 White Caucasian) to ascertain the prevalence of insulin-dependent diabetes mellitus (IDDM) using a central register maintained for the changeover to U-100 insulin, diabetic health visitor index cards, hospital admissions of diabetic children, and individual registers maintained by us. Overall prevalence per thousand for children aged 0-15 years was 0.54 for Asian and 0.99 for White Caucasians; for ages 10-15 years they were 0.97 and 1.87, and for ages 0-9 years, 0.31 and 0.38, respectively. This was not statistically different at the 5% level. Ours is the first population based study of its kind in Asian children, and challenges the view that there is a large difference in the prevalence of IDDM between Asians and White Caucasians. A wider analysis of this observation incorporating a large population base is suggested.

Adolescent↗
PubMedDate not supplied

Increased incidence of end-stage renal failure secondary to diabetes mellitus in Asian ethnic groups in the United Kingdom.

Diabetic renal disease is more common in patients of Asian ethnic origin than White Caucasians in the United Kingdom. This study determines whether a disparity in the incidence of end-stage renal failure secondary to diabetes mellitus exists between these ethnic groups. The incidence of treated end-stage renal failure was estimated using the person-time at risk incidence rate for patients receiving renal replacement therapy secondary to diabetes mellitus in the county of Leicestershire from 1979 to 1988. The incidence rate of end-stage renal failure expressed for the estimated population of patients with diabetes mellitus in patients of Asian ethnic origin was 486.6 (95% CI, 185.1 to 788.1) cases per million person-years per year, compared to 35.6 (17 to 54.2) in White Caucasians. All patients of Asian ethnic origin developing end-stage renal failure had non-insulin-dependent diabetes. The high incidence of end-stage renal failure secondary to diabetes mellitus in patients of Asian ethnic origin in the UK imparts significant public health implications for resource planning and allocation, and the need to initiate strategies to ameliorate renal disease in this ethnic group.

Asia↗