ABSTRACT
BACKGROUND: Chewing betel nut is a tradition extending from Southeast Asia to the Pacific. Globally, betel nut is the fourth main psychotropic substance containing a stimulant, arecoline, that has a similar effect to nicotine. In Palau, there is broad acceptance of betel nut chewing. One of the largest immigrant groups in Hawaii is the Palauans. Chewing betel nut has significant social implications that make it difficult for those who engage in this practice to separate potential oral disease from the social importance. However, little is known about the social impact of oral disease from chewing betel nut on Palauans in Hawaii. AIM: The study aimed to describe the perceptions of betel-chewing Palauans in Hawaii regarding betel nut and to determine the social impact of oral disease among these individuals. METHODS: Descriptive study conducted on the island of Oahu, Hawaii with 30 adult Palauans. Data were collected using the Oral Health Impact Profile-14 to measure perceptions of social impact of oral disease on well-being. Demographic and general health information was collected. RESULTS: Participants perceived little negative social impact of oral disease on well-being. DISCUSSION: Families, peers and society exert a strong influence on the decision to chew betel nut, a known carcinogen. Participants in this study showed little concern on the impact of betel nut chewing on their oral health. They continue the habit in spite of the awareness of potential for oral disease. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurses face challenges in educating Palauans about the negative aspects of betel nut, particularly those related to oral health especially when they do not perceive problems. Nurses must be involved in the development of health policies to design and implement strategies to promote behavioural change, and to ensure clinical services that are culturally sensitive to betel nut chewers.
Subject(s)
Areca , Attitude to Health , Mouth Diseases/chemically induced , Psychological Distance , Adult , Female , Hawaii/epidemiology , Humans , Male , Mouth Diseases/epidemiology , Palau/ethnology , Risk FactorsABSTRACT
PURPOSE: This paper focuses on the role of adoption and family relations as moderators of genetic risk for psychotic disorders. METHODS: Participants included 184 adolescents in the Republic of Palau identified to be at genetic risk for schizophrenia and other psychotic disorders. Palau is an island nation in Micronesia with a lifetime prevalence of 1.99% for schizophrenia and 2.67% for psychotic disorders more broadly defined. In Palauan culture, kinship adoption is a common cultural practice; 47 of the 184 participants had been adopted at an early age. The current study was designed to test the hypothesis that adoption would function as a protective factor among Palauan youth at genetic risk for the development of psychotic symptoms. Participants were evaluated for psychotic and other psychiatric symptoms using KSADS-PL. Concurrently, the Youth Self Report was used to assess the perceived quality of family relationships. RESULTS: Results indicated that adopted adolescents were more likely to develop psychotic symptoms than non-adopted adolescents. However, perceived family relations moderated the association between adoption status and psychotic symptoms, such that adopted adolescents with poorer family relations reported disproportionately higher rates of psychotic symptoms. Family relations also moderated the association between level of genetic risk and psychotic symptoms, independently of adoption status. CONCLUSION: Consistent with previous research, adolescents at high genetic risk who reported more positive family relations also reported fewer psychotic symptoms.
Subject(s)
Adoption/ethnology , Ethnicity/genetics , Family Relations , Genetic Predisposition to Disease/genetics , Psychotic Disorders/genetics , Schizophrenia/genetics , Adolescent , Adult , Culture , Female , Genotype , Humans , Male , Palau/epidemiology , Palau/ethnology , Prevalence , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Psychotic Disorders/epidemiology , Risk Factors , Schizophrenia/diagnosis , Schizophrenia/epidemiology , Social Environment , Surveys and QuestionnairesSubject(s)
Aging , Bone and Bones/anatomy & histology , Dwarfism , Fossils , Hominidae/anatomy & histology , Models, Biological , Animals , Biological Evolution , Burial , Child , Geography , Hominidae/classification , Humans , Motion Pictures , Palau/ethnology , Reproducibility of Results , Time FactorsABSTRACT
International travel and migration will continue to contribute to the changing patterns of Hansen's disease (HD) in the United States. The majority of cases will be immigrants and refugees entering the country from leprosy-endemic regions. The Compact of Free Association, through its provision of free travel between the Freely Associated States and the United States without need for health screening, has created new public health issues. This cluster of HD cases in Kona, Hawaii, U.S.A., highlights the difficulties in detecting and monitoring the spread of disease in immigrant populations. This is a growing problem only likely to worsen in the coming years. In groups with cultural, language or other socioeconomic barriers, special and creative methods may be needed to tackle the problems of detection, treatment and education. Clinicians must remain mindful of the diagnosis of HD in high-risk groups.
