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1,436 records · Page 80Linked to original sources
PubMed1996

Risk factors for xerophthalmia in the Republic of Kiribati.

OBJECTIVES: To identify risk factors for xerophthalmia in the Republic of Kiribati. DESIGN: Case-control study. SETTING: The Republic of Kiribati. SUBJECTS: 666 xerophthalmic preschool children (cases) and 816 children without xerophthalmia (controls) from a population-based sample of 4619 children who participated in a xerophthalmia prevalence survey. MAIN OUTCOME MEASURES: Clinical signs of xerophthalmia (night blindness, Bitot's spots, corneal xerophthalmia and keratomalacia). RESULTS: Multivariable logistic regression models showed older age [1.35(1.24, 1.47)] [odds ratio (95% confidence interval)]; male sex [1.32(1.05, 1.67)]; recent diarrhea [1.45(1.10, 1.89)]; severe [3.82(2.73, 5.35)], moderate [3.55(2.04, 6.18)], and mild [3.07(2.33, 4.04)] protein-energy malnutrition; current breast-feeding [0.30(0.19, 0.46)]; higher frequency of consumption of carotenoid-containing fruits and vegetables [0.93(0.80, 0.96)]; and the presence of a Foundation for the Peoples of the South Pacific garden project [0.70(0.52, 0.93)] were each independently associated with xerophthalmia. A recent history of measles was associated with corneal xerophthalmia [7.73(1.78, 33.65)]. CONCLUSIONS: These data provide further evidence of the relationship between xerophthalmia and factors that may be amenable to intervention, and suggest that greater availability and consumption of provitamin A carotenoids is associated with decreased risk of xerophthalmia among preschool children.

Breast Feeding↗
PubMed1996

A comparison between colorectal surgical admissions in Maori and nonMaori.

AIMS: To compare Maori with nonMaori colorectal surgical admissions to a specialised colorectal unit in a teaching hospital. METHODS: All patients admitted to the colorectal service of the university department of surgery, Wellington, New Zealand between April 1975 and March 1990 have been entered into a computerised data base. Patients claiming to be Maori or of Maori descent were compared, in relation to colorectal diagnosis, type of admission and surgery and surgical complications, with those designated European or other. RESULTS: There were 90 Maori admissions (47 male, 43 female) and 1842 nonMaori admissions (1007 male, 835 female). The urgency of admission was similar in both groups. There were no significant differences in admission rates for obstruction, perforation, bleeding, diverticular disease, or anorectal abscess but more Maori seemed to have problems with haemorrhoids and perineal condylomata acuminata. More nonMaori were admitted with colorectal cancer. The frequencies of most major operations were similar in the two groups studied, although haemorrhoidectomy was more common in the Maori. A higher proportion of nonMaori patients had a consultant surgeon as the primary operator. The overall complication rates, with the exception of urinary tract infections were similar in both groups. One Maori patient died and there were 31 nonMaori deaths. CONCLUSION: There was no evidence that Maori had either less access to the public hospital system or that surgical colorectal diseases were more neglected. In general hospital admission rates for colorectal diseases in Maori and nonMaori were remarkably similar.

Adult↗
PubMed1996

Community nursing issues in Maori mental health.

This paper derives from the first study of its kind to explore the issues and implications of a new role for mental health nurses at a time when the health care system in New Zealand was undergoing rapid changes and a new Mental Health (Compulsory Assessment and Treatment) Act 1992 had been implemented. This praxis research study utilized interviews and focus groups to address a range of issues in the practice of mental health nurses. This paper reports on the competing cultural perspectives in the nursing care provided to Maoris. This is an important issue for the community in bicultural New Zealand, and has clear relevance to mental health nursing in multicultural communities.

Community Health Nursing↗
PubMed1997

Comparison of Down's syndrome screening strategies in Asians combining serum free beta-hCG and alpha-fetoprotein with maternal age.

High free beta human chorionic gonadotropin (beta-hCG) and low alpha-fetoprotein (AFP) levels were found in 47 Asian Down's syndrome pregnancies (median values 2.79 and 0.77 MOM, respectively). At a 5 per cent false-positive rate, free beta-hCG alone would identify 46.8 per cent of Down's syndrome pregnancies, age alone detected 34.5 per cent of affected cases, whilst AFP alone detected 17 per cent and free beta-hCG/AFP MOM ratios detected 48.9 per cent of Down's syndrome cases. When combined with maternal age-specific risk, free beta-hCG could achieve a 59.6 per cent detection rate, with AFP achieving 42.6 per cent, free beta-hCG/AFP MOM ratios 61.7 per cent, and combined free beta-hCG and AFP a detection rate of 63.8 per cent for a 5 per cent false-positive rate. Down's syndrome screening at an early gestational age (before 18 weeks) could achieve a 68 per cent detection rate with a 5 per cent false-positive rate, compared with a 59.1 per cent detection rate for a 5.2 per cent false-positive rate when screening at a late gestational age. The use of free beta-hCG in Down's syndrome screening programmes can yield an improved efficacy in the detection of Down's syndrome in an Asian population.

Adolescent↗
PubMed1997

Trends in leprosy case detection rates.

BACKGROUND: A systematic review of the trends in leprosy incidence is lacking. The question of whether leprosy transmission has declined remains, therefore, unanswered. This study investigates trends in new case detection rates (NCDRs) in selected leprosy-endemic areas from different continents. METHODS: A literature search using specific inclusion criteria was performed. Average annual rates of change in NCDRs were obtained by exponential curve fitting. The variation in trends within individual areas was investigated using direct and indirect information on leprosy control activities. RESULTS: This review covers 16 areas in the Pacific, Asia, Africa and Latin America. For 10 out of the 16 areas, the trend was seen to be declining consistently over the last 10 years or longer. Near stabilization or stabilization after decline was observed for two areas. For three areas, interpretation of recent NCDRs was difficult due to changes in control, but two of them showed a decline over the study period. A consistently increasing trend was observed over the last 20 years in the one remaining area. The observed downward trends could not be attributed to reduced control activities or changed diagnostic criteria. A general acceleration of downward trends in the NCDR after the introduction of multidrug therapy (MDT) has not so far occurred. CONCLUSION: Our main conclusion is that despite many differences between the studies and study areas, the review demonstrates a considerable tendency of downward NCDR trends. Lack of information and changing control conditions necessitate caution in interpreting NCDR trends in individual areas. A general impact of MDT on NCDR trends is so far not visible. The coming years will be crucial for MDT-based control to prove its ability to reduce leprosy incidence.

Adult↗
PubMed1997

Risk factors for coronary heart disease in a population with a high prevalence of obesity and diabetes: a case-control study of the Polynesian population of Western Samoa.

OBJECTIVE: To evaluate anthropometric, haemodynamic and biochemical risk markers for coronary heart disease (CHD) in the Polynesian population of Western Samoa in a case-control study of 43 cases of CHD compared with 90 age- (mean 53 years) and sex-matched controls. METHODS: Cases were identified on the basis of a 12-lead electrocardiogram and clinical history. RESULTS: More than 60% of the participants had a body mass index > or =30 kg/m2 and nearly 80% had central obesity. Both diabetes mellitus (17%) and impaired glucose tolerance (9%) were also common in this population. Nineteen per cent of the population were hypertensive and both antihypertensive therapy (21 versus 1%, P<0.001, risk 23.6) and hypertension (35 versus 11%, P<0.01, risk 4.3) were significantly more common among cases than they were among controls. In addition, the plasma high-density lipoprotein cholesterol level was lower (1.00+/-0.09 versus 1.24+/-0.05 mmol/l, P<0.05) and the plasma urate level was higher (0.42+/-0.02 versus 0.37+/-0.01 mmol/l, P<0.05) in the female cases than they were in their respective controls. Low-density lipoprotein (LDL) particle sizing did not reveal an excess of small LDL particles to be a feature of CHD cases, but more than 70% both of cases and of controls had multiple LDL species. The response of the triglyceride level to a fat-rich meal was the same for CHD cases and controls. CONCLUSION: The population studied had a high prevalence of several risk factors for CHD, including obesity and non-insulin-dependent diabetes mellitus; however, the most prominent factor relating to CHD within the community was the presence of hypertension.

Adult↗
PubMed1997

[Human races and hemato-sero-anthropology. Origin of Chilean natives and natives from Easter Island in the context of human races].

Geographical hematology of Bernard and Ruffie, or Hemato-sero-anthropology, intends to establish relationships between hereditary genetic characters of the blood and human races. Blood groups, haptoglobins, abnormal hemoglobin and other biological traits such as color vision are related to the origin of human races, their geographical distribution, history, settlements, drifts, invasions, customs, religious beliefs, cult to ancestors, dead modifications, culture, language, writing, sculpture, painting and pottery. Our investigations are aimed to locale Chilean natives and natives from Easter Island in the context of human races.

Blood↗
PubMedDate not supplied

Cultural safety and renal care.

The Maori are the indigenous people of New Zealand. They and other Polynesian peoples who have migrated here in more recent times are over represented in our health statistics in ways that are of concern to New Zealand health care providers. Maori and Polynesian have higher rates of infant mortality, lung cancer, mental illness and, pertinent to this discussion, higher rates of diabetes and End Stage Renal Failure. Some of the issues raised by these statistics are the subject of my presentation today.

Health Promotion↗