Our multicultural island community is unique in that many young mothers live in multigenerational households. In this qualitative study, we examined the factors that influenced young mothers' infant-feeding practices in Hilo, a small rural town in the Hawaiian Islands. The study participants consisted of young mothers, health care professionals, and educators. Our findings suggest that both the young mother's mother and her partner are very influential in the infant-feeding decision. Many young women in our study bottle fed to obtain assistance in caretaking, and to facilitate public breastfeeding. Additionally, we explored young mother's views of sexuality and breastfeeding, and their health promotion implications.

The results, based on self-reporting of menopausal symptoms, indicate that Japanese-American women report fewer hot flashes and night sweats than European-American women. Japanese-American women reported a higher intake of soy, but soy intake was not associated with fewer vasomotor symptoms.

Objective-Many studies have found a significantly lower frequency of reported hot flashes (HFs) in Japanese and Japanese American (JA) populations, leading to speculation about possible dietary, genetic, or cultural differences. These studies have relied upon subjective reports of HFs. Accordingly, the purpose of this study was to compare both reported and objective HFs measured by sternal and nuchal skin conductance among JA and European American (EA) women.Design-Two surveys of hot flash frequencies were carried out among women of either EA or JA ethnicity, aged 45-55, living in Hilo, Hawaii, and not using exogenous hormones. The first was a postal questionnaire (N=325), the second was carried out during a clinical study of hot flashes (N=134). Women in the second group underwent 24-hour ambulatory and 3-hour laboratory monitoring for objective HFs measured through skin conductance at sternal and nuchal sites. Subjective HFs were recorded on the monitor, or in a diary.Results-JAs were significantly less likely to report having had HFs in the previous two weeks compared with EAs (postal sample: JAs: 30.9%, EAs: 43.9%, χ 2 =6.9, p < .01; monitored sample: JAs: 26.1%, EAs: 46.6%, χ 2 =5.3, p < 0.05). JAs were also significantly less likely to report experiencing other symptoms (15 out of 30 in the postal sample; 6 of 30 in the monitored sample) than EAs. However, JAs did not significantly differ in likelihood of reporting subjective HFs during the 24-hour ambulatory period (JAs: 51.1%, EAs: 55.8%, χ 2 =0.3, ns), nor in percentage of individuals displaying one or more objective HFs as measured by the skin conductance monitor (JAs: 77.8%, EAs: 72.1%, χ 2 =0.5, ns). JAs also did not have a significantly fewer number of objective HFs (t=0.2, ns) nor of subjective HFs (t = 0.8, ns) during the monitoring period, and these results were unchanged when analyses controlled for menopausal status and BMI.Conclusions-The common finding of fewer reported HFs in people of Japanese ancestry may be a consequence of reporting bias: JAs report fewer symptoms of many conditions compared to people from other ethnic groups. This is likely due to cultural conceptions of what is appropriate to report.

Objectives A lifespan approach was used to evaluate age at menopause, and determinants of surgical and natural menopause, in the multi-ethnic community of Hilo, Hawaii. Study design Participants aged 40–60 years (n=898) were drawn from a larger, randomly-generated sample recruited by postal questionnaires. Median age at natural menopause was computed by probit analysis. Logistic regression analysis was applied to examine determinants of hysterectomy, and Cox regression analysis was used to examine risk factors for an earlier age at menopause. Main outcome measures History of hysterectomy, Age at menopause Results Frequency of hysterectomy was 19.2% at a mean age of 40.5 years. The likelihood of hysterectomy increased with older ages, lower education, mixed ancestry, having been overweight at age 30, and married 20 years prior to survey. Median age at natural menopause was 53.0 years. Smoking and not being married 10 years before survey were associated with an earlier age at menopause. Conclusions Median age at menopause was later than the national average. Ethnicity and education were determinants of hysterectomy, but not associated with age at natural menopause. Events later in the lifespan (e.g., smoking and not being married 10 years prior to the survey) were more important than earlier events (e.g., childhood residence) in relation to age at menopause. The timing of weight gain and marital status appear to be important in relation to surgical menopause, and the timing of marital status appears to be important in relation to the timing of natural menopause.