Search

The oceanic nation of Palau has been geographically and culturally isolated over most of its 2000 year history. As part of a study of the genetic basis of schizophrenia in Palau, we genotyped five large, multigenerational schizophrenia pedigrees using markers every 10 cM (CHLC/Weber screening set 6). The number of affected/unaffected individuals genotyped per family ranged from 11/21 to 5/5. Thus the pedigrees varied in their information for linkage, but each was capable of producing a substantial LOD score. We fitted a simple dominant and recessive model to these data using multipoint linkage analysis implemented by Simwalk2. Predictably, the most informative pedigrees produced the best linkage results. After genotyping additional markers in the region, one pedigree produced a LOD = 3.4 (5q distal) under the dominant model. Seven of nine schizophrenics in the pedigree, mostly 3rd-4th degree relatives, share a 15-cM, 7-marker haplotype. For a different pedigree, another promising signal occurred on distal 3q, LOD = 2.6, for the recessive model. For two other pedigrees, the best LODs were modest, slightly better than 2.0 on 5q and 9p, while the fifth pedigree produced no noteworthy linkage signal. Similar to the results for other populations, our results suggest there are multiple genes conferring liability to schizophrenia even in the small population of Palau (roughly 21 000 individuals) in remote Oceania. [ABSTRACT FROM AUTHOR]

Background: Although millions of people with schizophrenia live in betel chewing regions, the effects of betel chewing on their symptoms are unknown. Betel nut alkaloids include potent muscarinic cholinomimetics: recent research suggests that these agents may be therapeutic in schizophrenia.Aims: To compare the primary and extrapyramidal symptom profiles and substance-using habits of betel chewing v. non-chewing people with schizophrenia.Method: A cross-sectional study of 70 people with schizophrenia. Symptom ratings measured by the Positive and Negative Syndrome Scale (PANSS) and Extrapyramidal Symptom Rating Scale (ESRS), and demographic and substance-use data, were compared for 40 chewers and 30 non-chewers of betel nut.Results: Betel chewers with schizophrenia scored significantly lower on the positive (P = 0.001) and negative (P = 0.002) sub-scales of the PANSS than did non-chewers. There were no significant differences in extrapyramidal symptoms or tardive dyskinesia.Conclusions: Betel chewing is associated with milder symptomatology and avoidance of more harmful recreational drugs. These initial results indicate that longitudinal research is merited. [ABSTRACT FROM AUTHOR]

While liability to schizophrenia (Scz) is due to genetic and environmental factors, specific factors are largely unknown. We postulate a two-hit model for Scz, in which initial liability is generated during fetal brain development: this "hit" is precipitated by environmental stressors biologically interacting with maternal genetic vulnerability to the stress. Additional liability to Scz is generated by individual genetic vulnerability. To evaluate these putative levels of vulnerability, we search in the genome of both affected individuals and their mothers for variation that differs, statistically, from that in the general population. For parental analyses, mothers were treated as "affected," rather than their offspring, and the fathers were treated as "controls". We used a sample from the Palauan population: 175 individuals diagnosed with Scz, broadly defined; 87 mothers and 45 fathers of affected individuals. Pedigree and diagnostic data were available on 2,953 living and deceased subjects. DNA from 553 individuals was genotyped for short tandem repeats (STR) spaced approximately every 10 cM across the genome. We tested for association between affection status and STR alleles; such an approach was reasonable, despite the widely spaced markers, because this population has far-ranging linkage disequilibrium (LD). Results for the truly affected individuals were modest, whereas results from the maternal generation were promising. For a recessive model and a test for excess allele matching across mothers, significant findings occurred for D20S481, D10S1221, D6S1021, D13S317, and D18S976. Regions in which at least two adjacent markers produced substantial association statistics include 2p12-11.2, 2q24.1-32.1, 6q12-14.1, 10q23.2-24.21, 12q23.2-24.21 and 17q23.2-23.3.

Objective: This study tested the findings of a prior study indicating a therapeutic relationship between consumption of betel nut and symptoms of schizophrenia., Method: The subjects were 65 outpatients with diagnoses of schizophrenia or schizoaffective disorder. Symptoms rated with the Positive and Negative Syndrome Scale were compared between high- and low-consumption betel chewers in a repeated-measures design. Movement disorders were assessed with the Abnormal Involuntary Movement Scale and Simpson-Angus Rating Scale. Global health and social functioning were assessed with the Medical Outcomes Study 12-item and 36-item Short-Form Health Surveys, respectively., Results: Male high-consumption betel chewers had significantly milder positive symptoms than low-consumption chewers over 1 year. Betel chewing was not associated with global health, social functioning, or movement disorders. Betel chewing was associated with tobacco use but not with cannabis or alcohol., Conclusions: These findings have clinical significance in betel-chewing regions and broader implications for theory of muscarinic neurophysiology in schizophrenia.

Many Pacific Islands Countries (PICs) by their geographic location, isolation, and lack of resources, are at risk for both environmental and man-made disasters. Disaster management (DM) and mitigation is frustrated by the general underdevelopment of DM planning and lack of adequate emergency medical services (EMS) to deal with daily emergencies let alone large-scale emergencies and disasters. To address this, the U.S. Centers for Disease Control and Prevention (CDC) developed and implemented the Pacific Emergency Health Initiative (PEHI) to review and make recommendations regarding the current level of DM/EMS development of select PICs. As a practical next step, a collaborative demonstration project--the CDC--Palau Community College Pacific Center for Emergency Health--was established in the Republic of Palau with the purpose of providing training and technical assistance in DM/EMS development for the region. In September 2001 the Center conducted two simultaneous training programs addressing Public Health Disaster Planning (one-week) and pre-hospital First Responder Care (two-weeks). Sixty participants included public health planners, physicians, and fire and police officials from eleven PIC jurisdictions and representatives from the Secretariat of the Pacific Community, South Pacific Applied Geoscience Commission, and the Fiji School of Medicine. Eleven country and state public health disaster plans were initiated. Post 9-11 the Center has increased relevance. Through CDC's PEHI additional Center training programs are planned through FY 2003.

We report on linkage analysis of a completely ascertained population of familial psychosis derived from the oceanic nation of Palau. Palau, an archipelago of islands in the Southern Pacific, currently has a population of approximately 23,000 individuals. The peoples of Palau populated these islands recently in human history, approximately 2,000 years ago. As both historical and genetic evidence suggest, the population is far more homogeneous than most other populations undergoing genetic studies, and should therefore prove quite useful for mapping genetic variants having a meaningful impact on susceptibility to psychotic disorders. Moreover, for our study, essentially all on-island schizophrenics (150) and individuals with other psychotic disorders (25) participated. By analysis of narrow (only schizophrenia) and broad (all psychosis) diagnostic schemes, two-point linkage analyses suggest that two regions of the genome harbor genetic variants affecting liability in most families, 3q28 (LOD = 3.03) and 17q32.2 (LOD = 2.80). Results from individual pedigrees also support 2q37.2, 2p14, and 17p13 as potentially harboring important genetic variants. Most of these regions have been implicated in other genetic studies of psychosis in populations physically quite distant from this Oceanic population, although some (e.g., 3q28) appear to be novel results for schizophrenia linkage analyses.

Many Pacific Islands Countries (PICs) by their geographic location, isolation, and lack of resources, are at risk for both environmental and man-made disasters. Disaster management (DM) and mitigation is frustrated by the general underdevelopment of DM planning and lack of adequate emergency medical services (EMS) to deal with daily emergencies let alone large-scale emergencies and disasters. To address this, the U.S. Centers for Disease Control and Prevention (CDC) developed and implemented the Pacific Emergency Health Initiative (PEHI) to review and make recommendations regarding the current level of DM/EMS development of select PICs. As a practical next step, a collaborative demonstration project--the CDC--Palau Community College Center for Emergency Health--was established in the Republic of Palau with the purpose of providing training and technical assistance in DM/EMS development for the region. In September 2001 the Center conducted two simultaneous training programs addressing Public Health Disaster Planning (one-week) and pre-hospital First Responder Care (two-weeks). Sixty participants included public health planners, physicians, and fire and police officials from eleven PIC jurisdictions and representatives from the Secretariat of the Pacific Community, South Pacific Applied Geoscience Commission, and the Fiji School of Medicine. Eleven country and state public health disaster plans were initiated. Through CDC's PEHI additional Center training programs are planned through FY 2003.

Linkage disequilibrium (LD) between alleles on the same human chromosome results from various evolutionary processes and is thus telling about the history of populations. Recently, LD has garnered substantial interest for its value to map and fine-map disease genes. We examine the distribution of LD between short tandem repeat alleles on autosomes and sex chromosomes in the Remote Oceanic population of Palau to evaluate whether the data are consistent with a recent hypothesis about the origins of genetic variation in Palau, specifically that the population experienced extensive male-biased gene flow following initial settlement. Consistent with evolutionary theory based on effective population size, LD between X-linked alleles is stochastically greater than LD between autosomal alleles, however, small but detectable LD occurs for autosomal markers separated by substantial distances. By contrast, while Y-linked alleles experience only one-third the effective population size of X-linked alleles, their mean value for pairwise LD is only slightly larger than X-linked alleles. For a small population known to experience at least two extreme bottlenecks, 56 six-locus Y haplotypes exhibit remarkable diversity (0.96), comparable to Y diversity of Europeans, however, autosomal and X-linked markers display significantly less diversity, as measured by heterozygosity (4.1% less). Palauan Y haplotypes also fall into distinct clusters, again unlike that of Europe. We argue these data are consistent with waves of male-biased gene flow.

Objective: Providing culturally sensitive definitions of child abuse is difficult as perceptions of what constitutes abuse can vary around the world. This study was undertaken to assess how teachers in the Republic of Palau perceived the severity of potentially abusive incidents and what types of recommendations, if any, they would have for situations judged as severely abusive. Attitudes about child rearing practices were also evaluated., Methods: Teachers (n = 141 ) were given: (1) a questionnaire consisting of 25 vignettes describing parent/child interactions that were potentially abusive and asked to rate the severity of abuse and recommended interventions for each vignette; and (2) a 40-item parenting styles questionnaires to evaluate attitudes about child-rearing practices., Results: Teachers identified and recommended interventions for more severe forms of abuse at rates similar to other international samples. For less severe parental misconduct, teachers were reluctant to involve nonfamily and outside agencies. Sexual abuse was rated as the most serious type of abuse and when identified, intervention was highly recommended. Some traditional Palauan parenting practices that might be considered maltreatment by other cultures were not considered abusive. For parenting styles, older individuals were more likely to use guilt induction and less likely to use methods of acceptance. Aggressive parenting styles were negatively correlated with all forms of abuse, suggesting that teachers who used aggressive disciplinary styles were less likely to perceive abusive situations as harmful., Conclusions: These results indicate that cultural values and practices play important roles in shaping the definition and interpretation of child maltreatment.