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At least 19 recordsLinked to original sources

PubMed2005

Sexual health behaviours among Pacific Island youth in Vanuatu, Tonga and the Federated States of Micronesia.

ISSUES ADDRESSED: This study was conducted to describe the sexual risk behaviours of youth within the Pacific Island nations of Vanuatu, Tonga and the Federated States of Micronesia. METHODS: General health behaviour surveys were conducted with youth aged 15-19 years and not attending school in the three countries. A sample of 390 Ni-Vanuatu youth from the Shefa Province, 934 youth from three island provinces of Tonga and 92 youth from Pohnpei, the main island of the four island states of the Federated States of Micronesia, were interviewed in gender-specific groups. Questions were asked about sexual behaviours that may contribute to unintended pregnancy or sexually transmitted infections (STIs). RESULTS: Moderate to high percentages of youth were sexually active (had a least one sexual partner) in the Pacific island nations of Vanuatu (49.7%), Tonga (35.5%) and the Federated States of Micronesia (76.1%). Young men were more likely to engage in sexually risky behaviour than young women. They were more likely to be sexually active, have had multiple sexual partners and have had sex when drunk or high. Of those sexually active, more young men than women in Vanuatu (36.1% compared with 30.6%) and Micronesia (54.2% compared with 50%) never used protection against STIs. However, of the sexually active Tongan youth, the proportion of females (61.1%) who reported never using protection against STIs was nearly double the proportion reported by Tongan males (32.2%). CONCLUSION: A high percentage of young people not attending school in the Pacific island nations of Vanuatu, Tonga and the Federated States of Micronesia are at risk of unintended pregnancy and STIs, including HIV, because of patterns of sexual risk behaviour.

Adolescent↗

PubMed1998

Measles outbreaks in Micronesia, 1991 to 1994.

BACKGROUND: Several islands in Micronesia experienced large measles outbreaks, during 1991 through 1994. Except for Guam, none of the islands had reported measles outbreaks during the previous 20 years. METHODS: To characterize the outbreaks, measles surveillance data, hospital records and death certificates were reviewed. Preoutbreak vaccination coverage rates were assessed by reviewing public health vaccination records. Viral isolates were genetically sequenced to determine the source of transmission. Linear regression analysis was performed to assess the effectiveness of outbreak control measures. RESULTS: Between 1991 and 1994 more than 1300 measles cases and 16 measles-related deaths were reported in Micronesia. Preoutbreak vaccination coverage rates among 2-year-old children were 55 to 94%. Genetic sequencing of the viral isolates and epidemiologic investigations suggested transmission between islands and new importations from outside of Micronesia. The highest attack rates were among children ages < 5 years (20/1000) and 10 to 19 years (38/1000). Compared with attack rates among children ages < 1 and 10 to 19 years, attack rates were lower among those ages 5 to 9 years, in whom 2-dose vaccination coverage rates were highest (P < 0.001). Early and rapid implementation of mass vaccination campaigns was significantly associated with shorter duration of outbreaks (P = 0.049). CONCLUSION: The measles outbreaks in Micronesia show that island populations may be highly susceptible to measles. High two-dose vaccination coverage levels must be maintained to prevent such outbreaks. Early and rapidly implemented mass measles vaccination campaigns were effective in control of island outbreaks. Strengthening public health infrastructure and surveillance is necessary for early identification of outbreaks and rapid implementation of mass campaigns.

Adolescent↗

PubMed1983

A networking approach to rehabilitation service delivery in the developing nation/states of Micronesia.

The people of Micronesia , those inhabitants of a collection of over 2,000 islands and atolls encompassing three million square miles of Western Pacific Ocean, have developed by the establishment of three political entities, compacts of Free Association with the United States (United Nations Administrators of the area under the designation of the U.S. Trust Territory of the Pacific Islands). These emerging nations aim for self-sufficiency in all areas of national endeavor within specified periods of time. The University of Guam's Vocational Rehabilitation Training Program has addressed itself to the issue confronting not only these newly emerging nation/states of Micronesia , but indeed, those developing nations which currently struggle with the social, cultural and economic issues of providing for its citizenry , appropriate rehabilitation programming which meets criteria of high quality services to the largest number of people within an attainable cost structure. Initial findings suggest this Third World Rehabilitation community refrain from adopting a polarity of thinking approach in the design and delivery of Rehabilitation services. The logical extension of such either/or planning attempts seems only to limit current and future Rehabilitation programming effort. Rather, a comparative cost analysis of selected rehabilitation services and accompanying travel expenses related to providers from both sides and throughout the Pacific, demonstrates that an admixture approach, which includes all available sources of services, warrants further investigation as a viable programming model for the nation/states of Micronesia to utilize as they develop locally based Vocational Rehabilitation Service programs of their own.

Delivery of Health Care↗

PubMed2004

Cancer in Micronesia.

Between November 1998 and December 1999, trained medical record abstractors visited the Micronesian jurisdictions of Chuuk, Kosrae, Pohnpei, and Yap (the four states of the Federated States of Micronesia), as well as the Republic of Palau (Belau), the Republic of Kiribati, the Republic of the Marshall Islands (RMI), and the Republic of Nauru to review all available medical records in order to describe the epidemiology of cancer in Micronesia. Annualized age-adjusted, site-specific cancer period prevalence rates for individual jurisdictions were calculated. Site-specific cancer occurrence in Micronesia follows a pattern characteristic of developing nations. At the same time, cancers associated with developed countries are also impacting these populations. Recommended are jurisdiction-specific plans that outline the steps and resources needed to establish or improve local cancer registries; expand cancer awareness and screening activities; and improve diagnostic and treatment capacity.

Developing Countries↗

PubMed2004

Cancer, reproductive abnormalities, and diabetes in Micronesia: the effect of nuclear testing.

Many suggest that cancer and other diseases in Micronesia have been caused by nuclear testing in the Pacific. The 50-year commemoration of the March 1, 1954 Bravo thermonuclear test has rekindled interest in this area. This paper explores the documentation for, and the plausibility of, claims for disease causation by nuclear testing. Given the sheer volume of testing that the US conducted in the Pacific, it appears plausible that excess cancer would have occurred in areas of Micronesia other than the Marshall Islands. An excess of birth abnormalities in the Marshall Islands has been documented. While diabetes is not a radiogenic disease, and other cancers are generally less radiogenic than leukemia or thyroid cancer, the social and cultural effects of nuclear testing specifically, and the strategic uses to which Micronesia has been put generally, have had roles in the social production of disease. Integration into a globalized, cosmopolitan economy-with attendant phenomena such as the importation of tobacco, alcohol, foods of poor nutritional value, and new cultural morés-are also factors.

Abnormalities, Radiation-Induced↗

PubMed2005

Areca (betel) nut chewing habit among high-school children in the Commonwealth of the Northern Mariana Islands (Micronesia).

OBJECTIVE: To investigate the prevalence of its use by high-school children in Saipan in Micronesia. Usage of the areca nut is indigenous to south Asia and the western and south Pacific. Some serious health effects of areca nut chewing are recognized and the International Agency for Research on Cancer has recently classified regular use of areca nut as being carcinogenic to humans. Information on usage by young people, however, is scarce. METHODS: Data on consumption of areca nut were obtained by a self-administered questionnaire. Following an oral mucosal examination using WHO criteria any detectable oral mucosal diseases were recorded. FINDINGS: Of 309 schoolchildren surveyed (mean age 16.3 +/- 1.5 years), 63.4% claimed regular use, the highest level recorded in any school population survey. Significant oral diseases detected were oral leukoplakia in 13% and oral submucous fibrosis in 8.8% of children. CONCLUSION: These findings from Saipan suggest that areca nut chewing starts at a young age in Micronesia. As many users develop dependency this raises important concerns regarding its consequences for oral health.

Adolescent↗

PubMed1999

Schizophrenia in Kosrae, Micronesia: prevalence, gender ratios, and clinical symptomatology.

The utility of genetic isolates for research is in part based on the assumption that the illness of interest is similar across cultures. In this report, we review the data on schizophrenia in Micronesia, a collection of small islands in the western Pacific Ocean. Significant variations in prevalence between the islands have been reported, as have male to female ratios which are strikingly high. We focus on the patients in Kosrae, one of the islands in the Federated States of Micronesia. Twenty-two schizophrenics are identified. We found a prevalence rate of 6.8 per 1000 and a male to female ratio of 6.3:1. Although, in many ways, the patients resemble their Western counterparts, 19 of the patients were episodically mute, especially when untreated or undermedicated. Possible explanations for this unusual symptom are discussed.

Adolescent↗

PubMed1989

Environmental health education in Micronesia.

Water supply and sanitation programmes in Micronesia require substantial capital investments. In the past, many of these projects have failed to achieve their maximum impact on preventing water-related diseases. Cases of cholera and the continuation of frequently occurring gastro-intestinal diseases undermine the expectations that new and planned water and sanitation systems will result in disease prevention. This report indicates that knowledge of water-related diseases and the understanding of the benefits of safe water supply and sanitation are limited as programmes in Micronesia that would educate the different sectors of the community have never been institutionalised. We have developed the first comprehensive system for teaching about water supply, sanitation and health in a Micronesian environment. The educational materials will be used as curricula in public education and as information resources for appropriate individuals in these remote and scattered communities of the Pacific.

Environmental Health↗

PubMed1992

Transcultural nursing considerations of child abuse/maltreatment in American Samoa and the Federated States of Micronesia.

A conceptual analysis focuses on defining child maltreatment from the perspective of two Island nations in the Pacific Basin, American Samoa and the Federated States of Micronesia. Based on a review of the literature on child maltreatment laws and cultural factors in each region, a range definition is proposed. The range definition is comprised of defining features and borderline features for child maltreatment as it exists across these cultures in the Pacific Basin. Defining features were derived from evaluation of child abuse and neglect laws in each specified population. Borderline features were derived from cultural factors in American Samoa and the Federated States of Micronesia. While these Island nations already have child abuse and neglect laws, they are adapted from the United States. The degree at which unreasonable harm becomes abuse is culturally dictated, hence, these territories of the Pacific Basin are seeking culturally specific terminology when defining child maltreatment. The findings of this analysis indicate the significance of transcultural knowledge in nursing practice and the legal accountability nurses hold on the issue of child maltreatment.

Child↗

PubMed2007

Molecular cloning of functional genes for high growth-temperature and salt tolerance of the basidiomycete Fomitopsis pinicola isolated in a mangrove forest in Micronesia.

Several functional genes encoding putative proteins, heat shock protein 70, sphingosine phosphate lyase, and Na+/H+ antiporter, were cloned from the basidiomycete Fomitopsis pinicola, a wood-rotting fungus isolated in the tropical mangrove forest of Pohnpei Island of the Federated States of Micronesia. The deduced amino acid sequences of the obtained genes involved in heat shock resistance, lipid synthesis, and salt tolerance showed diverse similarities to other homologous proteins. Molecular phylogenetic trees of these proteins suggested that encoded proteins of the cloned genes of F. pinicola differed remarkably from other homologs in various organisms, even fungal proteins. Putative candidates for other genes related to several cellular metabolisms were also amplified, implying the possible existence of those genes in F. pinicola. This is the first report of possibly functional genes derived from a basidiomycetous mushroom growing in tropical islands such as Micronesia. The genes found in this study might play important roles in the cellular survival of the basidiomycete F. pinicola under severe environmental conditions.

Amino Acid Sequence↗

PubMed2006

Overweight in the Pacific: links between foreign dependence, global food trade, and obesity in the Federated States of Micronesia.

The Federated States of Micronesia (FSM) has received considerable attention for their alarming rates of overweight and obesity. On Kosrae, one of the four districts in the FSM, 88% of adults aged 20 or older are overweight (BMI > 25), 59% are obese (BMI > 30), and 24% are extremely obese (BMI > 35). Recent genetic studies in Kosrae have shown that obesity is a highly heritable trait, and more work is underway to identify obesity genes in humans. However, less attention has been given to potential social and developmental causes of obesity in the FSM. This paper outlines the long history of foreign rule and social change over the last 100 years, and suggests that a combination of dietary change influenced by foreigners, dependence on foreign aid, and the ease of global food trade contributed to poor diet and increased rates of obesity in Micronesia. The last section of the paper highlights the Pacific tuna trade as an example of how foreign dependence and global food trade exacerbates their obesity epidemic.

Journal Article↗

PubMed1995

Changing migration patterns in the Federated States of Micronesia.

"This article traces the changing role of migration in the Federated States of Micronesia during the twentieth century. We begin with a brief geographical, historical, and cultural overview of each state in the country, summarizing demographic change over the past 70 years and providing a foundation for understanding much of the area's past and present human mobility. Attention then turns to migration within the Federated States, focusing on data from censuses conducted in 1930, 1973, and 1980 and using supplemental information when possible. Emigration to destinations outside the country is examined briefly. Finally, we discuss potential causes and impacts of mobility in this emerging island nation."

Demography↗

PubMed1993

Changing regional demography in the Federated States of Micronesia: contrasting planning challenges in an emerging Pacific nation.

"Island nations consisting of small landmasses separated by large expanses of ocean face particularly severe challenges in their quest for economic and social development. In this paper, planning concerns in one such nation, the Federated States of Micronesia (FSM), are examined. The study opens with a description of each of the four separate states in the FSM.... Regional aspects of FSM development are then examined by a statistical analysis of the geographical distribution of population in the individual states.... The study concludes with an assessment of the regional challenge of developing the FSM into an economically and culturally sustainable nation."

Demography↗

PubMed1999

Genetic epidemiological study of schizophrenia in Palau, Micronesia: prevalence and familiality.

We are studying the genetic etiology of schizophrenia in the Republic of Palau, a remote island nation in Micronesia that has been geographically and ethnically isolated for approximately 2,000 years. The first epidemiological phase sought to estimate the lifetime prevalence of schizophrenia and evaluate the familiality of the illness based on complete ascertainment of cases and families segregating schizophrenia. A total of 160 strictly defined cases of schizophrenia were ascertained in a population of 13,750 adults who were 15 years of age and older. The lifetime prevalence of strictly defined schizophrenia in Palau was 1.99% overall and 2.77% in males vs. 1.24% in females. This greater than 2:1 male-to-female risk ratio for schizophrenia was accompanied by an earlier mean age of onset for males (23.3 years) than for females (27.5 years). These 160 cases of strict schizophrenia represent 59 separate families each identified by a single common founder. Eleven of these families have 5 to 14 cases and represent nearly half of the strict schizophrenia cases in Palau. Although schizophrenia is clearly aggregating in these 11 families, cases are distributed sparsely throughout the large sibships. In the entire sample of 160 cases of strict schizophrenia, there were only 11 sib-pairs and 2 sib-trios. When a family was defined to include third-degree relatives, only 11 cases (6.9%) were nonfamilial. The majority of the ascertained cases can be linked together into extended pedigrees with complex multilineal inheritance patterns. These intricately interconnected families may pose challenges for traditional linkage techniques. However, these Palauan families represent a valuable resource for studying the genetic etiology of schizophrenia because there may be fewer susceptibility genes for schizophrenia in this genetic isolate than in the heterogeneous populations that are common throughout the world today.

Adolescent↗

PubMed2004

Coral skeletal tin and copper concentrations at Pohnpei, Micronesia: possible index for marine pollution by toxic anti-biofouling paints.

We present 40 year-long skeletal chronologies of tin (Sn) and copper (Cu) from an annually-banded coral (Porites sp.) collected from Pohnpei Island, Micronesia (western equatorial Pacific). Both the elements are present in antifouling marine paints and are released inadvertently into ambient seawater. Especially, Sn has often been used in the form of tributyltin (TBT). Based on a stepwise pretreatment examination, Sn and Cu both inside and outside the aragonite lattice of the coral skeleton show a potential for providing marine pollution indicators. High values of extra-skeletal Cu/Ca and Sn/Ca atomic ratios were found between late 1960s and late 1980s during a period of active use of TBT-based antifouling paints worldwide. However, a significant decrease in both the ratios in the beginning of 1990s can be attributed to regulation of the use of TBT on cargo ships by countries such as the USA, Japan and Australia.

Animals↗

PubMed2005

Blood lead levels and risk factors for lead poisoning in children and caregivers in Chuuk State, Micronesia.

Lead poisoning is a preventable environmental disease. Children and developing fetuses are especially vulnerable; even low blood lead levels (BLLs) are linked with learning and behavioral problems. We assessed children's and their caregivers' BLLs and risk factors for lead exposure in Chuuk State, Federated States of Micronesia. Children aged 2-6 years were randomly selected within 20 randomly selected villages. Children and caregivers provided venous blood, and caregivers offered information about possible risk factors for lead exposure. Mean BLLs were 39 microg/l for children and 16 microg/l for caregivers. Children with BLLs of > or = 100 microg/l (elevated) were 22.9 (95% CI: 4.5-116.0) times more likely to have a caregiver with an elevated BLL, 6.2 (95% CI: 1.4-27.3) times more likely to live on an outer island, and 3.4 (95% CI: 1.7-6.9) times more likely to have a family member who made lead fishing weights than did other children even after controlling for age and sex. For children, 61% of elevated BLLs could be attributed to making fishing weights. Caregivers with elevated BLLs were 5.9 (95% CI: 1.5-23.7) times more likely to live in a household that melted batteries than other caregivers even after controlling for age and education. For caregivers, 37% of the elevated BLLs could be attributed to melting batteries. The association of elevated BLLs in children and their caregiver suggests a common environmental exposure. Melting batteries to make fishing sinkers is a preventable source of lead exposure for children and their caregivers in Chuuk. Published by Elsevier GmbH.

Adult↗

PubMedDate not supplied

Medical support for emergency relief workers after typhoon Sudal in Yap, Micronesia.

INTRODUCTION: On 09 April 2004, Typhoon Sudal struck the Island of Yap in the Federated States of Micronesia (FSM). Over 90% of homes, public utilities, and public property were damaged or destroyed. Nearly 10% of the population was displaced to shelters, and the majority of the population was without drinking water or power. United States disaster workers were deployed to Yap for three months to assist in the recovery and relief efforts. OBJECTIVE: The objective of this study was to evaluate the acute healthcare needs of the US disaster relief population serving in a remote setting with limited medical resources. METHODS: A retrospective chart review of all disaster relief workers presenting to an emergency clinic in Yap during the disaster relief effort from April 2004-July 2004 was performed. Investigators extracted demographic data, chief complaints, medical histories, medical management, disposition, and outcome data from the clinic charts. RESULTS: Together, the 60 disaster workers present on Yap during the relief effort made 163 patient contacts in the disaster emergency clinic. A total of 92% of patient contacts were for minor medical complaints or minor trauma, 13% were for upper-respiratory infections, 9% were for gastrointestinal illness, and 9% were for dermatological problems. Eight percent of visits were for serious medical problems or trauma. Life-threatening illnesses or injuries did not occur. CONCLUSIONS: Disaster relief workers on Yap frequently utilized the disaster relief clinic. In general, disaster workers remained healthy during the relief effort in Yap, and most injuries and illnesses were minor. On-site medical providers resulted in rapid care and stabilization, and after treatment, disaster workers were able to return to duty.

Disasters↗

PubMed2003

Insights on food and nutrition in the Federated States of Micronesia: a review of the literature.

BACKGROUND: Nutrition-related disorders, including vitamin A deficiency (VAD) and chronic diseases, are serious problems in the Federated States of Micronesia (FSM). Many suggest that these disorders are new problems related to dietary and lifestyle changes. In the past four decades, imported foods, such as white rice, flour, sugar, refined foods and fatty meats, have increasingly replaced local foods in the diet. AIM: A literature review was conducted to understand underlying issues related to dietary change and obtain insights for nutrition research and interventions. METHOD: Published and unpublished papers from different disciplines were reviewed and collated for information on food and nutrition in FSM. Topics covered were historical background, local foods, infant and child feeding, dietary assessment, and nutritional status. Particular focus was on information and data relating to VAD, the primary topic that led to the review of the literature. CONCLUSIONS: FSM, a tropical country of abundant agricultural resources, has suffered a great loss in production and consumption of local foods. Inconsistent external and internal government policies and food aid programmes have contributed to the problem. Further research on the nutrient content of local foods and factors affecting production, acquisition and consumption is needed, as well as a broad, well-planned, intersectoral intervention aimed at dietary improvement for all age groups in the population.

Adult↗