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Ichthyosiform Lichen Planus Pigmentosus in a 19-Year-Old Male Patient: Case Report. JMIR DERMATOLOGY 2024; 7:e50429. [PMID: 38640470 PMCID: PMC11069094 DOI: 10.2196/50429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/10/2023] [Accepted: 03/02/2024] [Indexed: 04/21/2024] Open
Abstract
Lichen planus pigmentosus (LPP) is a condition characterized by persistent and asymptomatic brownish-black-to-blue or purple-gray pigmentation, predominantly in the face and sun-exposed areas, commonly in dark-skinned individuals. Several clinical variants of LPP have been reported. However, the ichthyosiform type of LPP has not been reported. We present a 19-year-old male patient who presented with a 7-year history of asymptomatic grayish macules; patches with fine scales on the face, trunk, and upper extremities; and grayish plaques with thick "ichthyosiform" scales on the lower extremities. The diagnosis of LPP was proven by histopathological findings on both the macular and ichthyosiform plaques. Cluster differentiation (CD) 68 stain highlights the same density of pigment-laden macrophages in both the gray macule and the ichthyosiform plaque. The cause of LPP is unknown. Transcription factor anomalies may play a role in increased keratinization of lichen planus lesions. It can be assumed that the mechanism of the altered distribution of keratinization may occur on the ichthyosiform lesions in this patient. The terminology "ichthyosiform lichen planus pigmentosus" is hereby proposed to be added to the clinical variants of LPP.
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Clinical outcomes of 10 years of cardiac screening in elite New Zealand athletes. J Sci Med Sport 2023; 26:659-666. [PMID: 37932202 DOI: 10.1016/j.jsams.2023.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 10/10/2023] [Accepted: 10/16/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES To report findings from the High Performance Sport New Zealand cardiac screening programme, including comparisons between sexes and ethnicities. DESIGN Retrospective cohort study. METHODS Elite Olympic-sport athletes were screened (2012-2022) with personal/family history, physical examination, resting 12-lead ECG and followed from the date of first screening until July 2022. An audit reviewed screening records, including demographic data, ECGs, follow-up and diagnoses. Flagged/equivocal ECGs were re-reviewed (International Criteria). RESULTS 2075 ECGs from 1189 athletes (53 % female, mean age 21 years; 83 % European, 9 % Māori, 5 % Pacific Islander, 3 % other) were included. No athletes retired for cardiac reasons; there were no cardiac deaths or major cardiac incidents (mean follow-up from first screening: 6.1 years (range: 0.6-10.9 years)). Diagnoses included Wolff-Parkinson-White (WPW) syndrome (0.7 %) and cardiomyopathies (0.3 %). Overall, 3.5 % of ECGs were abnormal, with ECGs of females more commonly abnormal (4.4 % vs 2.5 %, p = 0.02) and with a higher proportion of ECGs with abnormal T-wave inversion (TWI) (3.1 % vs 0.9 %, p < 0.001) compared to males. Of the abnormal TWI in females (all aged ≥16 years), 47 % was limited to V1-V3 with no other abnormalities. Abnormality rates were similar between Māori, Pacific Islander and European athlete ECGs. CONCLUSIONS WPW was the most frequent diagnosis, with very little cardiomyopathy found. The proportion of abnormal ECGs was low overall, but higher in females. This was driven by anterior TWI in V1-V3 which was not associated with diagnoses of conditions associated with sudden cardiac death (SCD). There was no difference in the proportion of abnormal ECGs of Māori or Pacific Island athletes compared to European athletes.
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Complete mitogenome sequence of Aedes (Hulecoeteomyia) japonicus japonicus from Hawai'i Island. Mitochondrial DNA B Resour 2023; 8:64-68. [PMID: 36685646 PMCID: PMC9848326 DOI: 10.1080/23802359.2022.2161328] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/18/2022] [Indexed: 01/18/2023] Open
Abstract
We report the first complete mitogenome (Mt) sequence of Aedes japonicus japonicus (Diptera: Culicidae). The sequence was extracted from one adult from the Big Island of Hawai'i Island. The length of the Ae. japonicus japonicus Mt was 16,528bp with 78.1% AT content. Its sequence is most similar to the Mt sequence of Aedes koreicus with 90.81% sequence identity. This is the first full Mt sequence available for this species and provides important genetic resource for studying population genetics and dynamics of this important invasive mosquito species.
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A temporal assessment of microplastics distribution on the beaches of three remote islands of the Yasawa archipelago, Fiji. MARINE POLLUTION BULLETIN 2022; 185:114202. [PMID: 36265426 DOI: 10.1016/j.marpolbul.2022.114202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
This is the first study that investigated the presence, distribution, and composition of microplastics, MPs (1-5 mm) on beaches in the Yasawa Islands, Fiji. A temporal assessment over three years on six beaches was undertaken to investigate different beach traits on MP abundance. Average MP concentration was 4.5 ± 11.1 MPs·m-2 with significantly higher concentrations were found on east-facing beaches than west (p < 0.001), and higher on the storm line compared to the high tide line (p < 0.001). No difference was found between tourist and local beaches (p = 0.21). These results demonstrate the role of current-driven ocean transport of plastic pollution in this part of The South Pacific. ATR FT-IR analysis showed that across all sites 34 % of MPs were polypropylene (PP), 33 % polystyrene (PS), 25 % polyethylene (PE), and 8 % other polymer types. Further studies are needed to assess the potential impacts of MPs on Fiji's coral reefs and marine life.
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Original Leptospira spp. in island native terrestrial mammals: a case study in Pteropus spp. bats of New Caledonia. Transbound Emerg Dis 2022; 69:e2852-e2862. [PMID: 35730517 DOI: 10.1111/tbed.14635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/18/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022]
Abstract
Leptospirosis is a bacterial zoonosis that occurs in tropical and subtropical regions worldwide. Chiroptera are known to be a formidable reservoir of zoonotic pathogens, including leptospires. The epidemiology of leptospirosis in bats in the Pacific Islands is poorly known, both in terms of prevalence and in terms of the bacterial strains involved. A strong host specificity between leptospiral strains and their mammalian reservoir is recognized. This phenomenon has notably been studied recently in bat communities, providing strong evidence of coevolution. In New Caledonia, a biodiversity hotspot where leptospirosis is endemic and enzootic, Chiroptera are the only indigenous terrestrial mammals. In this study, we aimed to investigate leptospires associated with three flying fox species in New Caledonia. Kidneys and urine samples of Pteropus spp. from captures and seizures were analyzed. Among 254 flying foxes analyzed, 24 harboured pathogenic leptospires corresponding to an observed prevalence of 9.45% with 15.8% on the Main Island and 4.3% on Loyalty Islands. The analysis of the rrs gene, lfb1, MLST sequences evidenced 4 distinct clusters of undescribed strains, likely corresponding to undescribed species. All four strains belong to the Group I of pathogenic Leptospira spp., which includes Leptospira interrogans, Leptospira noguchii and Leptospira kirschneri. We detected pathogenic leptospires in all 3 Pteropus spp. studied (including 2 endemic species) with no evidence of host specificity in two co-roosting species. For a better understanding of Leptospira-host coevolution, notably to genetically characterize and evaluate the virulence of these original bat-associated leptospires, it is essential to improve isolation techniques. Flying foxes are traditionally hunted and eaten in New Caledonia, a massive cause of bat-human interactions. Our results should encourage vigilance during these contacts to limit the spillover risk of these pathogens to humans. This article is protected by copyright. All rights reserved.
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Development and implementation of a Pacific Island-centred COVID-19 Health Worker Safety Guide. Emerg Med Australas 2021; 33:547-551. [PMID: 33715297 PMCID: PMC8250083 DOI: 10.1111/1742-6723.13771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Healthcare workers in Pacific Island Countries face unique workload and infection control hazards because of limited resources, cultural practices and local disease burden. In the context of COVID-19, concern around healthcare worker safety escalated in the region, triggering the need for a relevant resource. METHODS We describe a collaborative, participatory action-research approach with a diverse range of local clinicians in Pacific Island Countries to design, develop and implement a practical guideline assisting clinicians to work safely during the pandemic. RESULTS The resulting Health Worker Safety Guide for COVID-19 is a relevant and usable protocol developed using local knowledge and now available in several Pacific languages. CONCLUSION We recommend a creative approach to facilitate meaningful communication with this group of clinicians, including low resolution technology and use of social media platforms.
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Health and Diet among People Living in an Isolated Area: Case Study of Pingelap Island in Pohnpei State, the Federated States of Micronesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217839. [PMID: 33114690 PMCID: PMC7663602 DOI: 10.3390/ijerph17217839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/05/2020] [Accepted: 10/09/2020] [Indexed: 11/17/2022]
Abstract
Pingelap Island in Pohnpei state is geographically isolated as the nearest island is 70 km away, and such geographical isolation is a challenge for public health due to the limited access to health services. This study aims to reveal the health situation on the island and investigate the influence of geographical isolation on health and diet. For that purpose, the result was compared with those who are living in a community on the main island of Pohnpei state (Mand) with the same ethnic background. Face-to-face interviews were conducted to collect data on demographics, diet, and behavior. Anthropometry and blood pressure measurements were also taken. A total of 98 (Pingelap = 50; Mand = 48) subjects participated in the study. The result showed that females, in particular, had a high prevalence of obesity (80.0% in Pingelap; 75.9% in Mand). However, no significant regional difference was found in both BMI and blood pressure, regardless of gender. Regarding diet, although the geographical location impacted food availability, the consumption of major imported foods did not show a significant regional difference. In conclusion, the geographical isolation did not significantly influence health and diet, but the majority of the study population displayed a high-risk burden of non-communicable diseases.
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The mental health impacts of climate change: Findings from a Pacific Island atoll nation. J Anxiety Disord 2020; 73:102237. [PMID: 32485590 DOI: 10.1016/j.janxdis.2020.102237] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 05/05/2020] [Accepted: 05/05/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Climate change is anticipated to have profound effects on mental health, particularly among populations that are simultaneously ecologically and economically vulnerable to its impacts. Various pathways through which climate change can impact mental health have been theorised, but the impacts themselves remain understudied. PURPOSE In this article we applied psychological methods to examine if climate change is affecting individuals' mental health in the Small Island Developing State of Tuvalu, a Pacific Island nation regarded as exceptionally vulnerable to climate change. We determined the presence of psychological distress and associated impairment attributed to two categories of climate change-related stressors in particular: 1) local environmental impacts caused or exacerbated by climate change, and 2) hearing about global climate change and contemplating its future implications. METHODS The findings draw on data collected in a mixed-method study involving 100 Tuvaluan participants. Data were collected via face-to-face structured interviews that lasted 45 min on average and were subjected to descriptive, correlational, and between-group analyses. RESULTS The findings revealed participants' experiences of distress in relation to both types of stressor, and demonstrated that a high proportion of participants are experiencing psychological distress at levels that reportedly cause them impairment in one or more areas of daily life. CONCLUSIONS The findings lend weight to the claim that climate change represents a risk to mental health and obliges decision-makers to consider these risks when conceptualizing climate-related harms or tallying the costs of inaction.
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Falling into a deep dark hole: Tongan people's perceptions of being at risk of developing type 2 diabetes. Health Expect 2020; 23:837-845. [PMID: 32441864 PMCID: PMC7495076 DOI: 10.1111/hex.13056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 03/09/2020] [Accepted: 03/12/2020] [Indexed: 12/02/2022] Open
Abstract
Background Prediabetes is a precursor for type 2 diabetes. Compared to the New Zealand/European and other population groups (24.6%), the prevalence of prediabetes is higher within Pacific groups (29.8%). The diagnosis of prediabetes presents a potential opportunity to intervene to prevent progression to type 2 diabetes. Objective To develop an understanding of how being ‘at risk’ of developing type 2 diabetes is perceived by Tongan people with prediabetes living in Auckland, New Zealand. Methods The Kakala and Talanga Tongan methodologies underpinned this study. Twelve one‐on‐one, semi‐structured interviews with Tongan patients who had prediabetes from a primary health‐care clinic in Auckland, New Zealand, were conducted. Thematic analysis was used to identify recurrent themes from the data. Results Participants were not aware of their prediabetes diagnosis, emotions associated with the diagnosis reflected fear and disbelief and a perception of imminent danger. Family history informed perceptions of the risk of developing type 2 diabetes. Participants could not differentiate prediabetes from type 2 diabetes, and recollections of being ‘back in the Islands’ of Tonga were consistent with healthy lifestyles. Conclusions Prediabetes appeared to be poorly understood and was believed to be irreversible, which could discourage behaviour change, social and physical improvements in health. Appropriate culturally tailored messages to accompany a prediabetes diagnosis, including cause and management, would be beneficial for Pacific peoples.
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Depressed mood, suicidal behaviors, and health risk behaviors among youths in the Commonwealth of the Northern Mariana Islands: the 2017 CNMI Youth Risk Behavior Survey. BMC Public Health 2020; 20:489. [PMID: 32293384 PMCID: PMC7161215 DOI: 10.1186/s12889-020-08663-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 04/06/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The current study investigated the prevalence of depressed mood, suicide ideation, suicide plan, and suicide attempt and their associations with health risk behaviors among high school adolescents in the Commonwealth of the Northern Mariana Islands (CNMI). METHODS This is a cross-sectional study analyzing self-reported data from the 2017 CNMI Youth Risk Behavior Survey (n = 1943). Modified Poisson regression models were used to identify the associations between 17 health risk behavior variables, including violence-related behaviors, substance use behaviors, sexual behaviors, and early risk-taking behaviors, and four variables related to depressed mood and suicidal behaviors. RESULTS 40.7% adolescents reported being depressed, 25.0% reported suicide ideation, 22.8% reported formulating a suicide plan, and 13.6% attempted suicide. Female adolescents were more likely to report depressed mood and all included suicidal behaviors (p < 0.001). Being in a physical fight and forced sexual intercourse were associated with depressed mood, suicide ideation, suicide plan, and suicide attempt for both female and male adolescents. Use of "soft drugs" such as current smoking was associated with depressed mood (ARR = 2.33, 95% CI = 1.56-3.45, p < 0.001), suicide ideation (ARR = 1.23, 95% CI = 1.08-1.43, p < 0.001), suicide plan (ARR = 1.19; 95% CI = 1.05-1.35; p < 0.001), and suicide attempt (ARR = 1.18; 95% CI = 1.06-1.30; p < 0.001) for females, whereas use of "hard drugs" such as heroin was associated with depressed mood (ARR = 2.27, 95% CI = 1.37-3.85, p < 0.01), suicide ideation (ARR = 1.30, 95% CI = 1.01-1.67, p < 0.05), suicide plan (ARR = 1.82; 95% CI = 1.22-2.70; p < 0.01), and suicide attempt (ARR = 2.78; 95% CI = 1.47-5.26; p < 0.01) for male adolescents. CONCLUSION The prevalence of depressed mood, suicide ideation, suicide plan, and suicide attempt among CNMI adolescents was high, especially in female adolescents. While there were gender differences, many of the health risk behaviors were associated with depressed mood and suicidal behaviors. As sociodemographic factors are difficult to change, modifiable factors should be targeted to improve the mental health of adolescents.
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Creeping towards the mutual: lessons from a modest initiative to improve mental health systems capacity in Pacific Island nations. Australas Psychiatry 2020; 28:8-10. [PMID: 31637920 DOI: 10.1177/1039856219881958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the evolution of the Leadership in Mental Health: Island Nations (LMH:IN) course. METHOD Using Transformation Theory the focus on Island Nations mental health capacity building through seven Creating Futures conferences is explored and directions for the future considered. CONCLUSION Experience and evaluation identify a set of key factors informing the ongoing development of the LMH:IN course.
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Multiplexed Nanopore Sequencing of HLA-B Locus in Māori and Pacific Island Samples. Front Genet 2018; 9:152. [PMID: 29760718 PMCID: PMC5936980 DOI: 10.3389/fgene.2018.00152] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 04/12/2018] [Indexed: 11/13/2022] Open
Abstract
The human leukocyte antigen (HLA) system encodes the human major histocompatibility complex (MHC). HLA-B is the most polymorphic gene in the MHC class I region and many HLA-B alleles have been associated with adverse drug reactions (ADRs) and disease susceptibility. The frequency of such HLA-B alleles varies by ethnicity, and therefore it is important to understand the prevalence of such alleles in different population groups. Research into HLA involvement in ADRs would be facilitated by improved methods for genotyping key HLA-B alleles. Here, we describe an approach to HLA-B typing using next generation sequencing (NGS) on the MinION™ nanopore sequencer, combined with data analysis with the SeqNext-HLA software package. The nanopore sequencer offers the advantages of long-read capability and single molecule reads, which can facilitate effective haplotyping. We developed this method using reference samples as well as individuals of New Zealand Māori or Pacific Island descent, because HLA-B diversity in these populations is not well understood. We demonstrate here that nanopore sequencing of barcoded, pooled, 943 bp polymerase chain reaction (PCR) amplicons of 49 DNA samples generated ample read depth for all samples. HLA-B alleles were assigned to all samples at high-resolution with very little ambiguity. Our method is a scaleable and efficient approach for genotyping HLA-B and potentially any other HLA locus. Finally, we report our findings on HLA-B genotypes of this cohort, which adds to our understanding of HLA-B allele frequencies among Māori and Pacific Island people.
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Abstract
Increased lupus nephritis has been reported in Pacific Island and Maori populations. Previous studies suggest ethnic variation in response to immunosuppression treatment; however this has not been assessed in Pacific Island and Maori cohorts. This retrospective study reviewed class 3, 4 and 5 lupus nephritis outcomes and response to induction immunosuppression over a 10-year period in a New Zealand multi-ethnic cohort with high Pacific Island representation. This included 49 renal biopsies in 41 patients; by ethnicity Pacific Island 53.7%, Asian 31.7%, Caucasian 12.2%, and New Zealand Maori 2.4%. There were 11 class 3, 24 class 4 and 17 class 5 either alone or in combination with class 3/4. There were no statistically significant differences in renal function or proteinuria between ethnic groups at baseline. Pacific Island class 3/4 showed similar rates of renal remission with intravenous cyclophosphamide (6/8) and mycophenolate (4/7) induction treatment; results were comparable to the overall study group. There were no deaths or permanent dialysis requirements in the first six months of treatment, and no increased risk of adverse outcomes when stratified by ethnicity. Five lupus nephritis relapses occurred during maintenance treatment and there was no apparent ethnicity bias. CONCLUSION Pacific Island people disproportionately present with increased lupus nephritis; and had comparable renal remission rates with intravenous cyclophosphamide and oral mycophenolate which were similar to the whole study cohort.
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Epidemiology of fatal and hospitalised injuries among youth in Fiji (TRIP 15). J Paediatr Child Health 2016; 52:1026-1031. [PMID: 27565748 PMCID: PMC5111600 DOI: 10.1111/jpc.13250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 02/20/2016] [Accepted: 04/13/2016] [Indexed: 11/28/2022]
Abstract
AIM To determine the burden and characteristics of fatal and hospitalised injuries among youth in Fiji. METHODS We conducted a cross-sectional analysis of the Fiji Injury Surveillance in Hospitals database - a prospective population-based trauma registry - to examine the incidence and epidemiological characteristics associated with injury-related deaths and hospital admissions among youth aged 15-24 years. The study base was Viti Levu, Fiji, during the 12-month period concluding on 30 September 2006. RESULTS One in four injuries in the Fiji Injury Surveillance in Hospitals database occurred among youth (n = 515, incidence rate 400/100 000). Injury rates were higher among men, those aged 20-24 years compared with 15- to 19-year-olds, and indigenous Fijians (iTaukei) compared with Indians. The leading causes among indigenous Fijians were being hit by a person/object (men) and falls (women), whereas for Indians, it was road traffic injuries (men) and intentional poisoning (women). Most injuries occurred at home (39%) or on the road (22%). Of the 63 fatal events, 57% were intentional injuries, and most deaths (73%) occurred prior to hospitalisation. Homicide rates were four times higher among indigenous Fijians than Indians, whereas suicide rates were five times higher among Indians compared with indigenous Fijians. CONCLUSIONS Important ethnic-specific differences in the epidemiology of fatal and serious non-fatal injuries are apparent among youth in Fiji. Efforts to prevent the avoidable burden of injury among Fiji youth thus requires inter-sectoral cooperation that takes account of important sociocultural, environmental and health system factors such as unmet mental healthcare needs and effective pre-hospital trauma services.
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Lean Mass and Body Fat Percentage Are Contradictory Predictors of Bone Mineral Density in Pre-Menopausal Pacific Island Women. Nutrients 2016; 8:nu8080470. [PMID: 27483314 PMCID: PMC4997383 DOI: 10.3390/nu8080470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 07/12/2016] [Accepted: 07/22/2016] [Indexed: 01/10/2023] Open
Abstract
Anecdotally, it is suggested that Pacific Island women have good bone mineral density (BMD) compared to other ethnicities; however, little evidence for this or for associated factors exists. This study aimed to explore associations between predictors of bone mineral density (BMD, g/cm2), in pre-menopausal Pacific Island women. Healthy pre-menopausal Pacific Island women (age 16–45 years) were recruited as part of the larger EXPLORE Study. Total body BMD and body composition were assessed using Dual X-ray Absorptiometry and air-displacement plethysmography (n = 83). A food frequency questionnaire (n = 56) and current bone-specific physical activity questionnaire (n = 59) were completed. Variables expected to be associated with BMD were applied to a hierarchical multiple regression analysis. Due to missing data, physical activity and dietary intake factors were considered only in simple correlations. Mean BMD was 1.1 ± 0.08 g/cm2. Bone-free, fat-free lean mass (LMO, 52.4 ± 6.9 kg) and age were positively associated with BMD, and percent body fat (38.4 ± 7.6) was inversely associated with BMD, explaining 37.7% of total variance. Lean mass was the strongest predictor of BMD, while many established contributors to bone health (calcium, physical activity, protein, and vitamin C) were not associated with BMD in this population, partly due to difficulty retrieving dietary data. This highlights the importance of physical activity and protein intake during any weight loss interventions to in order to minimise the loss of muscle mass, whilst maximizing loss of adipose tissue.
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An innovative community organizing campaign to improve mental health and wellbeing among Pacific Island youth in South Auckland, New Zealand. Australas Psychiatry 2015. [PMID: 26224699 DOI: 10.1177/1039856215597539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine whether being an organizer in a community organizing program improves personal agency and self-reported mental health outcomes among low-income Pacific Island youth in Auckland, New Zealand. METHOD Counties Manukau Health initiated a community organizing campaign led and run by Pacific Island youth. We used interviews, focus groups and pre- and post-campaign surveys to examine changes among 30 youths as a result of the campaign. RESULTS Ten youths completed both pre- and post-campaign surveys. Eleven youths participated in focus groups, and four in interviews. Overall, youths reported an increased sense of agency and improvements to their mental health. CONCLUSIONS Community organizing has potential as a preventive approach to improving mental health and developing agency over health among disempowered populations.
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Diseases of livestock in the Pacific Islands region: setting priorities for food animal biosecurity. Acta Trop 2015; 143:66-76. [PMID: 25572609 DOI: 10.1016/j.actatropica.2014.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 12/18/2014] [Accepted: 12/26/2014] [Indexed: 10/24/2022]
Abstract
Most Pacific Island countries and territories (PICTs) have developing economies and face a critical shortage of veterinarians with limited financial resources allocated to their animal disease surveillance programmes. Thus, animal health authorities have to set priorities for better focusing their scarce resources. The main objective of this study was to identify animal diseases perceived to be of importance by decision makers within selected PICTs, at the regional and national levels, to ensure better targeting of animal health resources. A second objective was to investigate whether the targeted surveillance programmes resulting from this rationalized approach would also benefit the local communities engaged in livestock production. A multi-criteria prioritization process was developed, involving local experts, to score and rank 132 animal diseases based on their priority at the regional and national levels for four PICTs: Fiji, Papua New Guinea, Solomon Islands, and Vanuatu, which form part of a regional Food Animal Biosecurity Network. In parallel interviews with farmers and field animal health and production workers were conducted to assess their perception of animal diseases. The list of the top-twenty ranked diseases for the Pacific Islands region shows a mix of endemic zoonotic diseases (such as leptospirosis ranked first; brucellosis third; tuberculosis sixth; and endoparasites and ectoparasites, respectively eleventh and thirteenth) with exotic diseases (such as HPAI ranked second, FMD fifth, and rabies ninth). There were different disease ranking lists for each of the four targeted PICTs, confirming different strategies of disease prevention and control may be required for each country, rather than a regional approach. Interviewed animal health and production workers were unfamiliar with most of the prioritized diseases and a majority acknowledged that they would not be able to recognize clinical signs if outbreaks were to occur in their area. Leptospirosis, which is endemic and identified as the top priority disease at the regional level, was never mentioned by any interviewed farmer. Farmers did not name any emerging infectious diseases as priorities. Instead, they identified endemic diseases (parasites, flu, coccidiosis, and scabies) as the most important. While animal disease priorities appear to differ widely between the targeted regions and countries, it also varies significantly between experts and farmers. Better targeted surveillance programmes may thus result in more rational and transparent allocation of resources, and thus enhanced food security, but may not directly match the needs of the local communities.
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Abstract
INTRODUCTION/BACKGROUND US Associated/Affiliated Pacific Islands (USAPI) include three freely associated states: Marshall Islands, Federated States of Micronesia, Palau, and three Territories: American Samoa, Guam, and Commonwealth of the Northern Mariana Islands. OBJECTIVE The Pacific Island Health Care Project (PIHCP) provides humanitarian medical referral/consultation/care to >500,000 indigenous people of these remote islands. METHODS In the mid-1990s, we developed a simple store-and-forward program to link the USAPI with Tripler Army Medical Center. This application allowed image attachment to email consultations. RESULTS More than 8000 Pacific Islanders have benefited from the program. Three thousand Pacific Islanders prior to telemedicine (1990-1997) and since store-and-forward telemedicine (1997-present), the PIHCP has helped an additional 5000. Records post dynamically and are stored in an archival database. CONCLUSION The PIHCP is the longest running telemedicine program in the world delivering humanitarian medical care. It has bridged the Developing World of the remote Pacific Islands with advanced medical and surgical care available at a major US military teaching hospital. (The opinions expressed here are those of the author and not that of the Army, Department of Defense, or the US Government.).
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A review of domestic animal diseases within the Pacific Islands region. Acta Trop 2014; 132:23-38. [PMID: 24388793 DOI: 10.1016/j.actatropica.2013.12.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 12/19/2013] [Accepted: 12/21/2013] [Indexed: 12/01/2022]
Abstract
The Pacific Island countries and territories (PICTs) are reported to be free of the most serious infectious livestock diseases which are prevalent in other parts of the globe, such as Highly Pathogenic Avian Influenza, Foot and Mouth Disease or Rabies. Yet there is a lack of scientifically based evidence to confirm this animal health status. This paper reviews what has been published on diseases of domestic animals in the Pacific Islands region with a particular focus on data from the last 20 years (1992-2012). Relevant published papers were identified by a computerized literature search of two electronic databases (PubMed and Web of Knowledge). The latest reports on the animal health situation submitted by the PICTs to the World Organisation for Animal Health (OIE) were accessed on the World Animal Health Information Database (WAHID) interface and included in this review. Additionally, paper searches of resources were undertaken at the library of the Secretariat of the Pacific Community (SPC) in Fiji to retrieve any relevant grey literature for this review. The study eligibility criteria included qualitative or quantitative information on any disease (bacterial, viral, parasitic and other health disorders) affecting domestic terrestrial animals (mammals, reptiles, birds and bees) in any of the 22 PICTs members of the SPC. A total of 158 eligible references were retrieved of which only 77 (48.7%) were published since 1992 and analysed in more details. One hundred and one diseases and pathogens were reported on for bee, bird, carabao, cat, cattle, crocodile, deer, dog, donkey, goat, horse, pig, pigeon, poultry and sheep in the Oceania region and in 17 PICTs in particular. The paper gives information about known animal diseases, their reported prevalence and diseases not reported within the Pacific Islands region. The study found retrieved literature on animal diseases in PICTs was scarce and no longer up to date. There is a need to improve the published knowledge on the current animal disease status in the region.
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