Asian Ethnic Populations Research Articles

Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics.

BackgroundA number of studies have reported low uptake of cancer screening programmes by South Asian populations in the UK. However, studies to date have not adjusted findings for differences in demographics and socio-economic status of these populations.MethodsSubjects: All residents in Coventry and Warwickshire, UK, eligible for screening. Uptakes compared for round 1 (2000–02) and round 2 (2003–05) of a national bowel cancer screening pilot, and for rounds 1, 2 and 5 of the established NHS breast cancer screening programme (commenced 1989).Data: Bowel screening data were analysed for 123,367 invitees in round 1 and 116,773 in round 2 (total 240,140 cases). Breast screening data were analysed for 61,934, 62,829 and 86,749 invitees in rounds 1, 2 and 5 respectively (total 211,512 cases).Analysis: Screening uptake was compared for two broad meta-categories (South Asian and non-Asian) and for five Asian subgroups (Hindu-Gujarati; Hindu-Other; Muslim; Sikh; South Asian Other). Univariate and multivariate analyses examined screening uptake and various demographic attributes of invitees, including age, gender, deprivation and ethnic group.ResultsSouth Asians demonstrated significantly lower (p < 0.001) unadjusted bowel screening uptake; 32.8% vs. 61.3% for non-Asians (round 1). Rates were particularly low for the Muslim subgroup: 26.1% (round 1), 21.5% (round 2). For breast screening, a smaller difference was observed between South Asians and non-Asians; initially 60.8% vs. 75.4% (round 1) and later 66.8% vs. 77.7% (round 5). Thus, the disparity reduced gradually over time, alongside an overall trend of increased uptake. However, figures remained consistently low for Muslims (51% in rounds 1 and 5). After adjusting for age, deprivation (and gender), bowel screening uptake remained significantly lower for all South Asian subgroups. After similar adjustments, breast screening uptake remained lower for all subgroups except Hindu-Gujaratis.For Muslims registered with an Asian (vs. non-Asian) GP, bowel screening uptake was significantly lower (p < 0.001). However, breast screening uptake for Muslims with an Asian (vs. non-Asian) GP showed no difference (p = 0.12) in the same period.Colonoscopy and breast assessment uptakes were similar for both meta-categories, but Asian response time appeared slower for colonoscopy. The percentage of abnormal FOBT results was significantly higher for South Asian invitees. A slight increase in abnormal mammograms was observed for Muslims over time (2.7% to 4.2% in rounds 1 and 5 respectively).ConclusionThe lower cancer screening uptakes observed for the South Asian population cannot be attributed to socio-economic, age or gender population differences. Although breast screening disparities have reduced over time, significant differences remain. We conclude that both programmes need to implement and assess interventions to reduce such differences.

Interethnic differences of PEPT2 (SLC15A2) polymorphism distribution and associations with cephalexin pharmacokinetics in healthy Asian subjects

The aims of this study were to characterize the population frequency of PEPT2 (SLC15A2) polymorphic variants in three Asian ethnic populations, namely Chinese, Malay and Asian Indian, and to investigate the associations of ethnicity (Chinese vs. Asian Indian), PEPT2 haplotype and cephalexin pharmacokinetics in healthy Asian subjects. PEPT2 polymorphisms were screened from a cohort of 96 Chinese, 96 Malay and 96 Asian Indian subjects. Cephalexin (1000 mg, orally) pharmacokinetics was characterized in an additional 15 Chinese and 15 Asian Indian healthy subjects. These 30 subjects were subsequently genotyped for their PEPT2 polymorphisms. In total, ten common single nucleotide polymorphisms (SNPs) were detected in the three populations, forming two PEPT2 haplotypes. There were significant ethnic differences in PEPT2 haplotype distribution: the frequencies of the *1 and *2 alleles were 0.307 and 0.693 in the Chinese population, 0.495 and 0.505 in the Malay population and 0.729 and 0.271 in Asian Indian population, respectively. The C (max) of cephalexin was significantly lower in the Chinese (29.80 +/- 4.09 microg ml(-1)) population than in the Asian Indian one (33.29 +/- 4.97 microg ml(-1); P = 0.045). This difference could be explained by the higher average body weight of the Chinese population. There was no other significant difference in cephalexin pharmacokinetics between either ethnic or PEPT2 genotype groups. PEPT2 polymorphism distributions differ significantly between Chinese, Malay and Asian Indian populations. However, cephalexin pharmacokinetics is not meaningfully different between Chinese and Asian Indians. The association between the PEPT2 haplotype and cephalexin pharmacokinetics could not be confirmed, and future studies under better controlled conditions are needed.

Root and canal morphology of the mesiobuccal and distal roots of permanent first molars in a Kuwait population – a clinical study

To identify the number of roots and canal configurations in permanent first molars of the indigenous Kuwaiti sub-population and compare them against a similar group of non-Kuwaiti population in different age groups and gender, and to determine the frequency of a second canal in the mesiobuccal root of maxillary first molars and distal root of mandibular first molars that could be located and treated in routine practice without using magnification or special lighting conditions. A total of 220 permanent first molar teeth of patients scheduled for root canal treatment over a period of 1 year were included. Patients were identified and grouped according to their nationality as Kuwaiti and non-Kuwaiti (which included Filipinos, Indonesian Indians, Srilankans, Egyptians, Saudi Arabians and Syrians). In both nationality groups, patients were successively distributed into four groups based on their age. The first age group included patients below 20 years, the second 21-30 years, the third 31-40 years and the fourth were over 40 years. The first three groups comprised of 15 male and 15 female patients whilst the fourth group had 10 patients of each gender. Teeth with open apices, resorptions and calcification were excluded from the study. The teeth included were both clinically and radiographically examined for number of roots, the canal configuration and the presence of the additional mesiobuccal and distal canals and recorded. The simplified classification of canal configurations proposed by Weine was utilized. The incidence of a second canal in the mesiobuccal (MB) root of maxillary first molars and the distal root of mandibular first molars was not influenced significantly by nationality and gender. All the 110 maxillary first molars treated had three roots; 58% of MB root had one canal and 42% had two canals. The majority of the mesial roots had Weine type II canal configuration when the second mesiobuccal canal was present. All distobuccal and palatal roots had a single or type I canal configuration. Of the 110 mandibular first molars that were treated, 96% had two roots and 4% had three roots. When present, the third root was located either buccal or lingual to the main distal root. Overall 51% of the single distal roots had one canal whilst 49% had two canals. The mesial root frequently had a Weine type II canal configuration as did the distal root when a second canal was present. Pearson's correlation analysis of both molars revealed a significant (P < 0.05) negative correlation (r = -0.274, r = -0.144) between age and number of canals as well as the type of canal. The incidence of a second canal in distal roots of permanent mandibular first molars was 49% in the Kuwaiti population and this was similar to other Asian ethnic populations. Adopting modified access and troughing procedures revealed a 42% frequency of MB2 canals in maxillary first molars. The incidence of a second canal in both mesiobuccal roots of maxillary molars and distal roots of mandibular molars decreased significantly with age; no differences were noticed amongst the nationalities and gender studied. The possibility of extra roots should be anticipated in mandibular molars.

Demographic Profiles of Asian Immigrant Elderly Residing in Metropolitan Ethnic Enclave Communities

This study reports the demographic characteristics of six groups of Asian American elders (Chinese, Korean, Indian, Filipino, Vietnamese, and Japanese) in a regional probability sample (n = 407). The findings confirm the heterogeneity of the Asian American elderly population, who differ in terms of demographics, immigration and acculturation experiences, language proficiency, educational attainment, and financial status. Findings point to the importance of taking careful consideration of the specific needs of different population groups of Asian American elders when planning social and support services. Additionally, cultural competence training for health and social service professionals is needed in order to address the special needs, variability, and differences among these Asian ethnic populations.

Competing interests: Toronto's Chinese immigrant associations and the politics of multiculturalism

AbstractSocial service agencies and advocacy groups have played an integral role in mediating between the Asian ethnic populations. In the Canadian institutional setting, associations become a means of political expression. Canada incorporates new immigrants into its national institutions. However, these neo‐liberal institutions and policies have not redressed major problems arising in the settlement process. Under Canada's discourse of enlightened multiculturalism, social service agencies are funded to help to integrate diverse peoples. The policy of multiculturalism meshes well with the liberal ideology underlying loose coupling, encouraging people to retain their cultural identities while settling and participating in national processes. These policies are designed to be sensitive to clients' cultural backgrounds; however, there are unforeseen consequences. In this system, different groups are granted different amounts of social, cultural and economic capital along with differential access to this capital, which affects their position and potential for action in other arenas. In particular, we find that the social service approach treats new Chinese immigrants as similar, thereby fostering competition between subgroups over leadership, funds and representation. Our data come from interviews with key figures in the Chinese‐Canadian community and associations, and reviews of press and other media. Copyright © 2006 John Wiley &amp; Sons, Ltd.

Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography

The incidence of postsurgical venous thromboembolism is thought to be low in Asian ethnic populations. We studied the incidence of deep-vein thrombosis (DVT) in Asian patients undergoing major orthopedic surgery of the lower limbs. We performed a prospective epidemiological study in 19 centers across Asia (China, Indonesia, South Korea, Malaysia, Philippines, Taiwan, and Thailand) in patients undergoing elective total hip replacement (THR), total knee replacement (TKR) or hip fracture surgery (HFS) without pharmacological thromboprophylaxis. The primary endpoint was the rate of DVT of the lower limbs documented objectively with bilateral ascending venography performed 6-10 days after surgery using a standardized technique and evaluated by a central adjudication committee unaware of local interpretation. Overall, of 837 Asian patients screened for this survey, 407 (48.6%, aged 20-99 years) undergoing THR (n = 175), TKR (n = 136) or HFS (n = 96) were recruited in 19 centers. DVT was diagnosed in 121 of 295 evaluable patients [41.0%, (95% confidence interval (CI): 35.4-46.7)]. Proximal DVT was found in 30 patients [10.2% (7.0-14.2)]. Total DVT and proximal DVT rates were highest in TKR patients (58.1% and 17.1%, respectively), followed by HFS patients (42.0% and 7.2%, respectively), then THR patients (25.6% and 5.8%, respectively). DVT was more frequent in female patients aged at least 65 years. Pulmonary embolism was clinically suspected in 10 of 407 patients (2.5%) and objectively confirmed in two (0.5%). The rate of venographic thrombosis in the absence of thromboprophylaxis after major joint surgery in Asian patients is similar to that previously reported in patients in Western countries.

Asian American Nonprofit Organizations in U.S. Metropolitan Areas

This article analyzes the characteristics of Asian American nonprofit organizations in major U.S. metropolitan areas. The data are based on Internet archives of nonprofit organization Form 990 and related information. Asian American nonprofits are less than twenty years old on average. They remain a relatively small part of the nonprofit sector. Religious organizations are generally the largest group among Asian American nonprofits, followed by cultural organizations, service agencies, and public interest associations of similar proportions. Asian American secular organizations as a group tend to be younger, are more likely to be in central cities, in wealthy and poor communities, as well as in metropolitan areas with a more homogeneous Asian ethnic population and a relatively more active general population in community organizing. The opposite is true for religious Asian American organizations. The pattern is less consistent among Asian American cultural, service, and public interest organizations. Regar...

Asian American Nonprofit Organizations in U.S. Metropolitan Areas

This article analyzes the characteristics of Asian American nonprofit organizations in major U.S. metropolitan areas. The data are based on internet archives of nonprofit organization Form 990 and related information. Asian American nonprofits are less than 20 years old on average. They remain a relatively small part of the nonprofit sector. Religious organizations are generally the largest group among Asian American nonprofits, followed by cultural organizations, service agencies, and public interest associations of similar proportions. Asian American secular organizations as a group tend to be younger, are more likely to be in central cities, in wealthy and poor communities, as well as in metropolitan areas with a more homogenous Asian ethnic population and a relatively more active general population in community organizing. The opposite is true for religious Asian American organizations. The pattern is less consistent among Asian American cultural, service, and public interest organizations. Regarding organization size, more established Asian American nonprofits, Pan Asian American organizations, and those agencies located in communities with larger Asian American population have more total assets and annual revenue.

Do ethnicity and gender have an impact on pain thresholds in minor dermatologic procedures? A study on thermal pain perception thresholds in Asian ethinic groups.

The perception of pain is a personal experience influenced by many factors, including genetic, ethnic and cultural issues. Understanding these perceptions is especially important in dermatologic patients undergoing minor surgical operations and who often differ in their pain response to surgical treatments. Little is known about how these differences affect the perception of experimental pain. The purpose of this study was to determine experimental pain perception differences in three distinct East Asian ethnic populations. Pain thresholds were examined with a psychophysical computerized quantitative thermal sensory testing device (TSA 2001) in healthy volunteers recruited from three different Asian ethnic groups. Using the methods of limits, experimental pain perception threshold was measured on the forehead and volar aspect of the forearm in 49 healthy subjects. The measurements were then repeated after skin barrier perturbation with adhesive tape stripping of the stratum corneum. All three ethnic groups were analyzed separately with respect to age, gender educational level and skin type. A total of 20 Chinese, 14 Malay and 15 Indian subjects completed the study. Thermal pain thresholds were similar in all three ethnic groups before and after tape strippings. No significant differences were noted between genders. Using quantitative sensory thermal testing, we demonstrated that no significant differences in pain occur between different races and genders.

Evaluation of patient characteristics and utilisation of invasive cardiac procedures in a UK ethnic population with unstable angina pectoris

Objectives: To evaluate patient characteristics and utilisation of invasive cardiac procedures in a UK ethnic population with unstable angina pectoris (UAP). Design: Retrospective, observational study. Setting: Tertiary referral cardiology centre in the United Kingdom serving a large Asian ethnic population. Subjects: White and Asian patients undergoing PTCA for UAP over a 2.5-year period at a UK referral cardiology centre from a comprehensive PTCA database. Data were also collated for all emergency admissions with unstable angina, or angina (type unspecified), to our institute. Main outcome measures: Demographic and angiographic characteristics of patients undergoing PTCA. Frequency of usage of invasive cardiac procedures was determined in emergency angina admissions. Results: From January 1997 to July 1999, 435 White and 36 Asian patients underwent PTCA for UAP at our institute. Asian patients were on average 4.4 years younger ( P=0.015), had 19.3% more diabetes ( P=0.003) and 19.7% less smoking ( P=0.007). Trends to more single vessel disease in Whites and more double vessel disease in Asians were observed, with similar rates of triple vessel disease. Interestingly, Asians also had trends towards more left-sided coronary artery disease and revascularisation, smaller vessels and less bail-out stenting. Asian patients were significantly less likely to undergo coronary angiography, OR 0.64 (CI 0.45–0.91, P=0.012), during the index admission, and showed a trend to less PTCA. Conclusions: Asian patients with unstable angina pectoris appear to have clinical and angiographic differences from their White counterparts, and are less likely to have invasive cardiac procedures deployed. The reasons for these observations require elucidation and the prognostic significance of these findings is uncertain.

Measuring Depression in Korean Immigrants: Assessing Validity of the Translated Korean Version of CES-D Scale

Results are reported about the validity of a translated Korean version of the Center for Epidemiologic Studies-Depression Scale (CES-D), a self-report or interview measure of depressive sympto matology used widely in Asian and other ethnic populations. Compared to Euro-Americans, Asians are more reluctant to endorse CES-D items that tap subjective experiences of positive affect, a response bias resulting in observations of more depressive symptoms among Asians. Thus, it was previously recommended that the four positive affect items be deleted when assessing depressive symptoms in Asian populations, including Chinese and Koreans. This recommendation is reassessed here by comparing psychometric properties of alternate forms of the translated Korean version of the CES-D scale: the original 20-item scale, the 16-item scale in which positive affect items were deleted, and a revised 20-item scale in which positive items were rephrased in negative terms. Results revealed that reliability and validity were highest in the revised 20-item scale.

A study of sexual abuse in an Asian community.

Sexual abuse in Asian ethnic minority populations in the UK has not previously been investigated. There remain professionals as well as lay people who deny its existence on the basis of assumptions about culture and religion. This retrospective study highlights the existence and difference in the incidence, pattern of presentation, and management in cases of Asian sexual abuse compared with that reported on the indigenous population.