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At least 19 recordsLinked to original sources

Addressing the cancer control needs of Pacific Islanders: experience of the Pacific Islander Cancer Control Network.

PURPOSE: This paper describes the accomplishments of the Pacific Islander Cancer Control Network (PICCN). PICCN's objectives fall under two broad categories: increasing cancer awareness and enhancing cancer control research among Samoans, Tongans, and Chamorros. METHODS: PICCN established an infrastructure for addressing the goals that include the University of California, Irvine; the UCI Chao Family Comprehensive Cancer Center; and community-based organizations (CBOs) in areas where large numbers of Pacific Islanders live. Activities that increase cancer awareness include assessing existing cancer education materials, developing new culturally-sensitive materials, and distributing the materials in a culturally-sensitive manner. Activities that enhance cancer control research include training Pacific Islander investigators and providing them with mentors to help with the development of research projects. RESULTS: During the four project years, PICCN has conducted more than 180 cancer awareness activities in its six study sites: Carson, CA; San Mateo, CA; San Diego, CA; Salt Lake City, UT; American Samoa; and Guam. PICCN members have also participated in conferences and lead discussions about the importance of clinical trials for Pacific Islanders. In addition, the Network has trained nine Pacific Islander investigators (three individuals from each ethnic group) in its cancer control academy. Finally, PICCN investigators are conducting pilot research projects that will answer important questions regarding the cancer control needs of these Pacific Islanders and set the stage for interventions aimed at addressing the needs. CONCLUSION: PICCN is advancing the national goal of eliminating cancer-related health disparities through its cancer awareness and research activities for Pacific Islanders.

American Samoa↗

Differential mortality of Asians and Pacific Islanders in the Pacific labour trade.

"Quantitative evidence is presented on the differential mortality suffered by Indian and Pacific Island labour migrants on Fiji's plantations between 1883 and 1919, and by Japanese, Chinese and Pacific Island labour migrants in the phosphate mines on Ocean Island and Nauru between 1913 and 1940. Pacific Island labour migrants suffered much higher death rates than Asian labour migrants, due, it is suggested, to their much greater vulnerability to newly introduced infectious diseases."

Communicable Diseases↗

Pacific island partnership: the Pacific Cancer Initiative.

BACKGROUND: Cancer is a leading cause of mortality in the US Associated Pacific Island Nations (USAPIN) due to few resources for prevention, screening, and treatment. METHODS: We describe the formation of the Pacific Cancer Initiative (PCI), and the Cancer Council of the Pacific Islands (CCPI)to address the rising cancer burden in USA PIN. Since their inception, PCI and CCPI have conducted cancer needs assessments, developed strategic cancer plans, and acquired additional cancer program funding for USAPIN. RESULTS: We emphasize the importance of international/regional partnerships and participatory development in assuring sustainability of cancer programs in USAPIN. CONCLUSIONS: The USAPIN speak with a unified voice.

Consumer Advocacy↗

Environmental predictors of pre-European deforestation on Pacific islands.

Some Pacific island societies, such as those of Easter Island and Mangareva, inadvertently contributed to their own collapse by causing massive deforestation. Others retained forest cover and survived. How can those fateful differences be explained? Although the answers undoubtedly involve both different cultural responses of peoples and different susceptibilities of environments, how can one determine which environmental factors predispose towards deforestation and which towards replacement of native trees with useful introduced tree species? Here we code European-contact conditions and nine environmental variables for 81 sites on 69 Pacific islands from Yap in the west to Easter in the east, and from Hawaii in the north to New Zealand in the south. We thereby detect statistical decreases in deforestation and/or forest replacement with island rainfall, elevation, area, volcanic ash fallout, Asian dust transport and makatea terrain (uplifted reef), and increases with latitude, age and isolation. Comparative analyses of deforestation therefore lend themselves to much more detailed interpretations than previously possible. These results might be relevant to similar deforestation-associated collapses (for example, Fertile Crescent, Maya and Anasazi) or the lack thereof (Japan and highland New Guinea) elsewhere in the world.

Altitude↗

The Pacific Island Health Care Project: easing the cancer burden in the United States associated Pacific Islands.

Cancer is a serious and ever increasing problem in the United States Associated Pacific Islands (USAPIs). Nearly 30% of all consultations and referrals are for cancer. Depending on the type of cancer, the prognosis for long-term survival is often poor and the cost of caring for such patients is considerable. Tripler Army Medical Center (TAMC) provides tertiary medical care to patients from the USAPIs in support of Graduate Medical Education (GME) at no cost to the patient or jurisdiction. Continuing its tradition of leading telemedicine initiatives in the Pacific, TAMC has developed a web-based electronic consultation and referral network, the Pacific Island Health Care Project (PIHCP). Ten sites in Micronesia and one in American Samoa were provided with computer equipment. Local clinicians request consultation from TAMC specialists through the internet, attaching supporting imagery. The consults are posted on a secure web page, where they are viewed, evaluated, forwarded, and commented on by the consultants. Experience with more than 2,100 cases indicates that the Internet can be easily used as a store-and-forward consultation format and offers a cost effective means for distance consultation, referral, and learning. This format has provided for a more rational evaluation of all patients but especially patients with cancer. Patients who are terminally ill, have widely metastasized disease, and/or have inoperable tumors or recurrences are excluded so that limited resources can be used for those most likely to benefit. There has been overwhelming enthusiasm for such Internet consultations between referring physicians and consultants. Many Pacific Islander patients have received state-of-the-art medical care through this program. At the same time, the training of TAMC physicians and residents has been enhanced by their opportunity to care for these remarkable and deserving patients from the Pacific.

Education, Medical, Continuing↗

Globalization, food and health in Pacific Island countries.

Pacific Island countries (PICs) are experiencing an epidemic of obesity and consequent chronic diseases. Despite investment in the development of National Plans of Action for Nutrition (NPANs) and interventions to promote healthy eating and physical activity, nutritional status appears to show little improvement. This paper presents a synthesis of the findings from two research papers that were prepared for a 2003 food safety and quality meeting in Nadi, Fiji. The findings indicate that although lifestyle behaviours might be the immediate cause of dietary imbalances, greater attention should focus on omnipresent influences of globalization as a critical element of the nutrition transition in the Pacific. In particular, those aspects of globalization mediated through the World Trade Organization (WTO) Agreements that are placing pressures on food security and fostering increased dependence on imported food of poor nutritional quality. Rapid, significant and sustainable improvements in public health in PICs require interventions that can tackle these underlying contributors to ill health. There are opportunities to explore the use of food regulatory approaches to influence the composition, availability and accessibility of food products. Within the context of the WTO Agreements the legitimacy of food regulatory approaches will depend upon the case to demonstrate the relationship between the intervention and the protection of food security and public health nutrition. The challenges in realising these opportunities are: 1) to have the capacity to construct a case, 2) meet the technical and financial demands to administer and enforce regulatory approaches, and 3) to take advantage of opportunities available and to be able to fully participate in the international policy-making process.

Chronic Disease↗

New species of Balantidium and Paracichlidotherus (Ciliophora) inhabiting the intestines of four surgeonfish species from the Tuvalu Islands, Pacific Ocean.

Four species of adult herbivorous surgeonfishes (Family Acanthuridae) were collected from the remote South-Pacific island system of Tuvalu. Their intestinal contents were examined, and of four populations of ciliated protists, two new species were discovered and are described. Ciliates were examined after protargol staining and, in some cases, scanning electron microscopy. Members of each population were examined and 10 characters measured for the balantidia, and 13 for the paracichlidotherids. A new Balantidium is described which has an unusually large dextr-oral field of cilia. A new species of Paracichlidotherus was discovered which has a macronucleus significantly smaller and well anteriad the cytoplasmic portion of the oral polykinetids relative to the type species.

Animals↗

Contemporary patterns of Pacific Island mortality.

BACKGROUND: The Pacific Island countries are at different stages of the demographic and epidemiological transitions. The availability of accurate and current mortality data is of vital importance for priority setting in health. Available mortality data generally underestimate death rates among both children and adults. In many Pacific Island populations, little is reliably known about levels and causes of death, particularly among adults. METHODS: The results of two comprehensive approaches to obtaining mortality estimates are reported. First, a systematic review of available life expectancy and infant mortality information reported by countries from 1990 onwards was undertaken and evaluated with respect to quality, and a final "best estimate" was established. Methods were based on registered deaths and indirect demographic methods. The second approach consisted of a demographic evaluation of vital registration data for completeness, with death rates adjusted accordingly, or where vital registration was not available, the application of new model life table methods to generate life tables from estimates of child mortality, as used by the World Health Organisation (WHO). RESULTS: This analysis reveals substantial uncertainty about mortality conditions in Pacific Island populations. In some countries, life expectancy variations of 10 years or more were recorded in the 1990s, depending on the source. Best approaches suggest that life expectancy (at birth) varied considerably, from levels of around 55-60 years in some Melanesian and Micronesian states to levels above 70 years in low-mortality countries. The principal issues with regard to uncertainty around mortality levels include underenumerated vital registration data; annual stochastic fluctuations in mortality in small populations; errors in the imputation of adult mortality from infant and childhood rates; implausible results from indirect demographic methods; use of possibly inappropriate model life tables to adjust death data or for indirect methods; and inadequately described and implausible projections. The WHO model life table method based on adjusted vital registration generally yielded results similar to those suggested by an evaluation of published data, with some exceptions, which are further discussed. CONCLUSIONS: This study indicates the urgent need to improve infrastructure, training, and resources for routine mortality estimation in many Pacific Island countries in order to better inform and evaluate health and public policy.

Adult↗

The role of the Picasso phone system in distance consultation for remote Pacific Islands.

The U.S. affiliated Pacific Island nations spend an average of over 10% of total health budget on off-island referral care to tertiary centers. Tripler Army Regional Medical Center (TAMC) has been the major provider of this service for many years. Prior to 1995 communication to consultants at TAMC was by long distance telephone, fax and regular mail. Connecting to a specialist sometimes took hours and clearly a better communication link was needed. The AT&T Picasso phone, an instrument the size of a small briefcase was developed to reliably transmit still images over the regular phone. Freeze-frame images captured at the sending end by a cam recorder were transmitted to a remote receiver unit, where they were displayed and stored. A typical medical consultation involved about three images, with each transmission over the 28.8 Kbps modem taking about one minute. A separate consultation form submitted by fax to TAMC was attached to the transferred images. Four Picasso phones were used to test their usefulness in linking isolated Pacific islands to a metropolitan medical center. For the first time ever, coloured patient images, data, X-rays etc were transmitted with a faxed written medical report. The Picasso phone was the spark of the Telemedicine development in the US affiliated Pacific islands.

Humans↗

Picture imperfect: hidden problems among Asian Pacific islander elderly.

Asian Pacific Islander (API) elderly represent the fastest growing group of ethnic elderly in the United States, yet their social and health needs remain little understood in the field of ethnogerontology. Existing literature generally portrays API elderly as in equal or better health compared to whites. However, aggregate API data cloud the bimodal distribution in socioeconomic and health status. We review existing literature on API elderly, and examine selected national data to illustrate the effects of a bimodal distribution on our understanding of API elderly socioeconomic and health status. Implications for research and policy are discussed.

Activities of Daily Living↗

Comparison of tobacco, alcohol and illegal drug usage among school students in three Pacific Island societies.

BACKGROUND: Many Pacific Island countries are in social and epidemiological transition, but there are little population data about drug and alcohol usage among adolescents in this region. METHODS: Random samples of school students aged 11-17 years completed surveys in three populations: Pohnpei State in the Federated States of Micronesia (n=1495), Tonga (n=2808) and Vanuatu (n=4474). RESULTS: Among 15-year-olds, boys in Tonga reported the highest prevalence of weekly smoking (29%), followed by boys in Pohnpei (17%). Kava use at a potentially harmful level (i.e. daily) was low in all countries. Drunkenness on two or more occasions was much more common among 15-year-old boys in Pohnpei (51%) than same-age youth in the other countries. Marijuana use was most often reported by boys (20%) and girls (20%) in Pohnpei, while solvents had been used most often by boys in Pohnpei (15%), and methylated spirits by boys in Tonga (20%). In all countries bullying of other students was independently related to regular smoking, while bullying behaviour and strong relationships with peers and others outside of the family were related to past drunkenness and use of illegal drugs in Tonga and Vanuatu. CONCLUSIONS: Overall, levels of adolescent substance use were consistently higher in Tonga and Pohnpei than in Vanuatu. These unique data provide a basis for setting priorities and evaluating action to address the health risks posed by substance use in these Pacific Island societies.

Adolescent↗

AIDS among Asians and Pacific Islanders in the United States.

OBJECTIVE: To characterize Asians and Pacific Islanders in the United States with reported acquired immunodeficiency syndrome (AIDS). METHODS: AIDS surveillance data reported through June 1998 were analyzed. Characteristics of cumulative case patients, rates of AIDS incidence in 1996 through 1997, and trends from 1982 through 1996 were analyzed. RESULTS: Through December 1998, 4,928 Asian and Pacific Islander adults and 46 Asian and Pacific Islander children with AIDS were reported in the United States. Of the total cases, 89% were in men, and 79% of those were in men who have sex with men (MSM). Five states, which account for 63% of the Asian and Pacific Islander population in the United States, reported 78% of the cases: California (45%), Hawaii (12%), New York (15%), Texas (3%), and Washington (3%). Of the 92% of Asian and Pacific Islander patients with country of birth information, 59% were foreign-born, a percentage that corresponds to the distribution in the general population. The overall incidence rate per 100,000 for 1996 through 1997 was 12.8 (21.3 for men; 3.3 for women). The highest rate was in the Northeast (15.9), followed by the West (13.8), South (10.6), and Midwest (5.7). Tuberculosis, reported for 6% of Asians and Pacific Islanders, was higher among foreign-born than among U.S.-born Asians and Pacific Islanders (8% and 4%, respectively). Between 1982 and 1996, AIDS incidence among MSM increased and peaked in 1994. Among heterosexual contacts and injection drug users, incidence has increased but remained low. CONCLUSIONS: The AIDS epidemic among Asians and Pacific Islanders in the United States has primarily affected MSM and is concentrated in a few states where most Asians and Pacific Islanders reside. Prevention activities should include consideration of cultural diversity and an understanding of cultural norms regarding sexuality. Additional information on risk behaviors and seroprevalence among Asian and Pacific Islander MSM is needed to better guide prevention planning.

Acquired Immunodeficiency Syndrome↗

Increased nitric oxide production in the respiratory tract in asymptomatic pacific islanders: an association with skin prick reactivity to house dust mite.

BACKGROUND: Exhaled nitric oxide (NO) is increased in asthma and may also be increased in subclinical airway inflammation. The relationship between atopy and subclinical airway inflammation in the pathogenesis of asthma remains unclear. We have evaluated the relationship between exhaled NO levels and skin prick test reactivity to 8 common allergens in 64 asymptomatic adult Pacific Islanders. Pacific Islanders were studied as a racial group with major morbidity from asthma. OBJECTIVE: Our purpose was to determine whether asymptomatic subjects with skin prick test reactivity to common allergens have elevated NO levels. METHODS: All subjects underwent full lung function testing and skin prick testing. Exhaled and nasal NO levels were measured by chemiluminescence (Logan LR2000 analyzer) with use of the single-breath and breath-holding techniques, respectively. RESULTS: House dust mite (HDM) reactivity was seen in 38 of 64 (56%). Exhaled NO levels (median 8.9 ppb, range 2.9-47.3 ppb) and nasal NO levels (527.5 +/- 181.5 ppb) lay above the normal European range in 30% and 25% of subjects, respectively. HDM reactivity was associated with higher exhaled NO levels (P <. 0005) and higher nasal NO levels (P =.01). In HDM-sensitive subjects the wheal size for HDM correlated with exhaled NO levels (r = 0.35, P =.04) and nasal NO levels (r = 0.40, P =.01). On multivariate analysis, exhaled NO levels were independently and positively related to the severity of HDM reactivity (P =.01) and nasal NO levels (P <.02), equation R(2) = 0.27. CONCLUSION: NO levels are elevated in a significant proportion of asymptomatic Pacific Islanders and are associated with HDM sensitivity. This may denote subclinical airway inflammation in this population and suggests that exposure to HDM in atopic individuals might play an important role in the early pathogenesis of asthma.

Adolescent↗

Legacy of the Pacific Islander cancer control network.

The groundwork for the Pacific Islander cancer control network (PICCN) began in the early 1990s with a study of the cancer control needs of American Samoans. The necessity for similar studies among other Pacific Islander populations led to the development of PICCN. The project's principal objectives were to increase cancer awareness and to enhance cancer control research among American Samoans, Tongans, and Chamorros. PICCN was organized around a steering committee and 6 community advisory boards, 2 from each of the targeted populations. Membership included community leaders, cancer control experts, and various academic and technical organizations involved with cancer control. Through this infrastructure, the investigators developed new culturally sensitive cancer education materials and distributed them in a culturally appropriate manner. They also initiated a cancer control research training program, educated Pacific Islander students in this field, and conducted pilot research projects. PICCN conducted nearly 200 cancer awareness activities in its 6 study sites and developed cancer educational materials on prostate, colorectal, lung, breast, and cervical cancer and tobacco control in the Samoan, Tongan, and Chamorro languages. PICCN trained 9 students who conducted 7 pilot research projects designed to answer important questions regarding the cancer control needs of Pacific Islanders and to inform interventions targeting those needs. The legacy of PICCN lies in its advancement of improving cancer control among Pacific Islanders and setting the stage for interventions that will help to eliminate cancer-related health disparities. Cancer 2006. (c) 2006 American Cancer Society.

American Samoa↗

Incidence of cancer among Pacific Island people in New Zealand.

AIM: to describe the epidemiology of new cancer registrations among Pacific Island people in New Zealand with a view to identifying important cancers for preventive activities. METHODS: new cancer cases registered with the New Zealand Cancer Registry of the Health Statistical Services for the decade 1979-88 were analysed. Cancer cases among Pacific Island people were compared with cancer cases among Maori and the remainder of the New Zealand population (other). RESULTS: while the number of cases reported among Pacific Island people was relatively small (1884), age standardised rates for cancer of all sites were much higher than age standardised rates for Maori and other populations. The age standardised rate (per 100,000 person years) for cancer of all sites among males in all age groups was 400 for Pacific Island, 308.8 for Maori and 295.3 for others. The age standardised rate for cancer of all sites among women in all age groups was 373.3 for Pacific Island women, 324.2 for Maori and 313.4 for other women. Liver cancer was more common among Pacific Island men than could be explained by temporary migration from the Pacific Islands for treatment. The age standardised rate for liver cancer was 28.2 for Pacific Island men, 11.4 for Maori and 1.9 for other men. Cancer of the cervix was the leading site among Pacific Island women as in Maori women, compared with breast cancer among women in the rest of the population. The age standardised rate for cervical cancer was 61.8 for Pacific Island, 69.0 for Maori and 59.3 for other women. CONCLUSION: in the decade 1979-88 there was an excess number of new registrations for some cancers described among Pacific Island people compared with Maori and other ethnic groups. Temporary migration from the Pacific Islands for treatment may explain some of the excess cases.

Adolescent↗

Do young New Zealand Pacific Island and European children differ in bone size or bone mineral?

Although Pacific Island adults have been shown to have larger bones and greater bone mineral density than caucasians, no previous studies have been undertaken to determine whether differences are present in prepubertal children. Forty-one Pacific Island children (both parents of Pacific Island descent) and 38 European children, aged 3 to 7 years, living in New Zealand were studied. Heights and weights were determined by simple anthropometry and body mass index (BMI, kg/m2) was calculated. Body composition, bone size, and bone mineral content (BMC, g) were measured by dual energy X-ray absorptiometry (DXA) of the total body and the non-dominant forearm. Compared to European children, in data adjusted for age and gender, Pacific Island children had significantly greater (P < 0.05) BMC in the total body (12%), the ultradistal radius (16%), and the 33% radius (8%), and also greater total body bone area (10%). Bone mineral density (BMD, g/cm2) was higher only at the ultradistal radius (11%). However, after adjustment for body weight, in particular lean mass, no differences were seen between Pacific Island and European children in any bone measure. The larger bone area and BMC of young Pacific Island children can be explained by their greater height and weight. Therefore, this study has shown that prepubertal Pacific Island children do not have greater bone size or BMC for their weight.

Absorptiometry, Photon↗

Dietary intakes of middle-aged European, Maori and Pacific Islands people living in New Zealand.

AIM: To compare dietary intakes of Maori, Pacific Islands and European men and women in New Zealand. METHODS: A food frequency questionnaire was used to calculate nutrient intakes of 5523 New Zealand workers aged 40 years and over (3997 men, 1524 women) from a cross-sectional survey carried out between 1988 to 1990. RESULTS: Compared with European men and women, Maori women and Pacific Islands men and women consumed larger amounts of total energy per day. Age-adjusted nutrients expressed as percentage contribution to total energy intakes showed that Maori and Pacific Islands men and women consumed less carbohydrate, fibre and calcium, and more protein, fat, saturated fat and cholesterol than European men and women, respectively. These results were consistent with fewer servings of cereal and cheese per month, and more servings of red meats, fish and eggs in Maori and Pacific Islands participants compared with Europeans, after adjusting for age and total energy intakes. Pacific Islands men and women also consumed more servings of chicken, fewer cups of milk and fewer servings of fruit per month compared to Europeans. Maori men and women consumed more slices of bread and fewer servings of vegetables per month compared to European men and women. CONCLUSIONS: There were striking differences in dietary habits, food selections and cooking practices between European, Maori and Pacific Islands participants. Dietary intakes of Maori workers were closer to those of Europeans than those of Pacific Islands participants. Ethnic differences were due to larger portion sizes and increased frequency of most foods in Maori and Pacific Islands participants.

Adult↗