Socioeconomic status and quality of life among Chinese American breast cancer survivors: The mediating roles of social support and social constraints.

OBJECTIVE: Literature has well noted ethnic/racial disparities in cancer survival and cancer care. However, socioeconomic disparities in psychosocial adjustment to breast cancer have garnered little attention. This study addresses the research gap by investigating the associations between socioeconomic indicators (ie, education, annual personal, and household income) and quality of life (QOL) and the mediating roles of social support and social constraints (objective and subjective conditions that constrain individuals from disclosing cancer concerns) in these associations among Chinese American breast cancer survivors (CABCS). METHODS: Ninety-six CABCS completed questionnaires assessing these variables. RESULTS: After controlling for stage of cancer, annual personal and household income had indirect effects on QOL through social support, and education showed indirect effect on QOL through social support and social constraints. Subscale analyses indicated that controlling for years of immigration, annual personal and household income showed indirect effect on functional well-being through social support. When controlling for stage of cancer and income, education showed indirect effects on physical well-being through social support and social constraints and showed both direct and indirect effects on breast cancer concerns through social constraints. CONCLUSION: This study suggested that socioeconomic indicators, education, and income could be associated with different aspects of QOL through unique interpersonal mechanisms among CABCS. Our findings implied that increasing social support and reducing social constraints when implementing psychosocial interventions for CABCS may help to address the SES-related health disparities.

Facilitators and barriers to the acceptance of human papillomavirus (HPV) vaccination among adolescent girls: a comparison between mothers and their adolescent daughters in Hong Kong.

BACKGROUND: The aim of this study is to examine knowledge and attitude as facilitators and barriers to the acceptance of HPV vaccination for adolescent girls by mothers and adolescent girls. METHODS: A cross-sectional survey conducted in Hong Kong in January 2010. Adolescent girls aged 12-18, together with their mothers, were recruited to complete two separate questionnaires with similar questions. RESULTS: A total of 170 mother-adolescent girl dyads were recruited. When the daughters and mothers were compared, the mothers were found to be more aware of "the risk of becoming infected with HPV through early sexual intercourse," while more daughters than mothers knew that "the HPV virus cannot be cured with antibiotics." Significantly more daughters perceived that they had a "chance of being infected with HPV and getting cervical cancer without the vaccine," while more mothers were concerned that "vaccinating for HPV will cause a girl to be stigmatized as promiscuous" and thought that their "adolescent daughters are too young to receive the HPV vaccine." The major predictive factor for the acceptance of the HPV vaccine among mothers was "The HPV vaccine is safe" (OR = 10.126, 95% CI 2.47-41.54). Among daughters who accepted the vaccine, the predictive factor was "The HPV vaccine can prevent most HPV infections" (OR = 6.274, 95% CI 1.93-20.42). CONCLUSIONS: The findings provide healthcare professionals with a better understanding of the differences between mothers and adolescent girls in knowledge, attitude, and potential factors associated with acceptance of the HPV vaccine. Health professionals should promote the early prevention of HPV infection and eliminate the stigma surrounding HPV vaccination to increase its acceptance. The government should provide financial support for adolescent girls to receive the vaccination in school.

Initial Validation of the Daily Spiritual Experiences Scale in Chinese Immigrants With Cancer Pain.

CONTEXT: Evaluating religious/spiritual influences in the growing Chinese-American population may inform the development of culturally relevant palliative care interventions. OBJECTIVES: We assessed the psychometric properties and acceptability of the Daily Spiritual Experiences Scale-Chinese (DSES-C) in Chinese Americans with cancer-related pain. METHODS: The translated 16-item DSES-C was administered as part of a symptom intervention for Chinese-American cancer patients. Patients were recruited from four New York community oncology practices. RESULTS: Of 321 patients, 78.7% were born in Mainland China, 79.1% spoke Cantonese, and 70.2% endorsed a religious affiliation (Ancestor worship, 31.7%; Chinese God worship, 29.8%; Buddhism, 17.1%; Christianity, 14.0%). In total, 82.6% completed the DSES-C (mean age = 57.7 years; 60.8% women) and 17.4% declined (mean age = 59.3 years; 52.0% women). Reasons for declining included low religiosity or perceived relevance of the scale items and difficulties separating spirituality from religiosity terms. Individuals having a religious affiliation were more likely to complete the DSES-C, whereas those not engaging in individual spiritual/religious practices or frequent group spiritual/religious practices tended to decline (all P < 0.05). The DSES-C (mean total score = 43.6, SD = 19.3) demonstrated high reliability (alpha = 0.94). Exploratory factor analysis suggested a one-factor solution, with significant loadings (>0.40) across items except Item 14 ("Accept others"). Construct validity was suggested by a positive association between DSES-C scores and having a religious affiliation (P < 0.05). CONCLUSION: In Chinese Americans with cancer pain, the DSES-C demonstrated acceptable psychometrics. Some participants experienced linguistic or cultural barriers preventing completion. Future investigations should provide additional validation in different Asian subgroups and those with varied medical conditions.

Entangled in Big Events: Rise of Heroin Use Among Children of Ex-Gurkhas in Hong Kong.

Big event models have been developed to demonstrate the relationships between wars and socioeconomic political transitions, and between rise of drug use and HIV epidemic outbreaks. This ethnographic interview-based study of a Nepali, Hong Kong community, carried out between 2009 and 2011, explored increased heroin use among the children of Hong Kong's Nepali ex-Gurkhas since its political transition in 1997. Data from its 59 informants were coded and analyzed using the grounded-theory approach. Three derived themes influencing drug use among ex-Gurkha children were identified: (1) reorganization of social networks, (2) redefinition of social norms, and (3) renegotiation of self-identity. Their associated processes crossed the boundaries of time and space. These findings document that big event modeling variables can and do overlap, are interconnected in many different ways, and their relationships are dialectical and are culturally shaped even as individuals may and do influence these processes and outcomes. Study's limitations are noted.

Maca reduces blood pressure and depression, in a pilot study in postmenopausal women.

OBJECTIVE: Lepidium meyenii (Maca) has been used for centuries for its fertility-enhancing and aphrodisiac properties. In an Australian study, Maca improved anxiety and depressive scores. The effects of Maca on hormones, lipids, glucose, serum cytokines, blood pressure, menopausal symptoms and general well-being in Chinese postmenopausal women were evaluated. METHODS: A randomized, double-blind, placebo-controlled, cross-over study was conducted in 29 postmenopausal Hong Kong Chinese women. They received 3.3 g/day of Maca or placebo for 6 weeks each, in either order, over 12 weeks. At baseline, week 6 and week 12, estradiol, follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), thyroid stimulating hormone (TSH), full lipid profiles, glucose and serum cytokines were measured. The Greene Climacteric, SF-36 Version 2, Women's Health Questionnaire and Utian Quality of Life Scales were used to assess the severity of menopausal symptoms and health-related quality of life. RESULTS: There were no differences in estradiol, FSH, TSH, SHBG, glucose, lipid profiles and serum cytokines amongst those who received Maca as compared to the placebo group; however, significant decreases in diastolic blood pressure and depression were apparent after Maca treatment. CONCLUSIONS: Maca did not exert hormonal or immune biological action in the small cohort of patients studied; however, it appeared to reduce symptoms of depression and improve diastolic blood pressure in Chinese postmenopausal women. Although results are comparable to previous similar published studies in postmenopausal women, there might be a cultural difference among the Chinese postmenopausal women in terms of symptom reporting.

Social determinants of health information seeking among Chinese adults in Hong Kong.

BACKGROUND: Health communication inequalities were observed in Western population but less is known about them among the Chinese. We investigated health information seeking behaviours and its social determinants among Chinese adults in Hong Kong. METHODS: Probability-based sample surveys over telephone were conducted in 2009, 2010/11 and 2012 to monitor family health and information use. Frequency of health information seeking from television, radio, newspapers/magazines and Internet were recorded and dichotomised as ≥1 time/month and <1 time/month (reference). Logistic regression was used to yield adjusted odds ratios (aOR) of health information seeking for different demographic characteristics, socioeconomic status (education, employment and income), chronic disease and behaviours (smoking, drinking and physical activity). RESULTS: Among 4553 subjects in all surveys, most (85.1%) had sought health information monthly from newspapers/magazines (66.2%), television (61.4%), radio (35.6%) or Internet (33.2%). Overall, being male, lower education attainment, lower household income, ever-smoking and physical inactivity were associated with less frequent health information seeking (all P <0.05). Compared with younger people, older people were less likely to search health information from Internet but more like to obtain it from radio (both P for trend <0.001). Having chronic diseases was associated with frequent health information seeking from television (aOR  =  1.25, 95% CI: 1.07-1.47) and Internet (aOR  =  1.46, 95% CI: 1.24-1.73). CONCLUSIONS: This study has provided the first evidence on health information inequalities from a non-Western population with advanced mass media and Internet penetration. Socioeconomic inequalities and behavioural clustering of health information seeking suggested more resources are needed for improving health communication in disadvantage groups.

Heterozygous familial hypercholesterolemia in Hong Kong Chinese. Study of 252 cases.

BACKGROUND: Earlier studies reported that Chinese subjects with heterozygous familial hypercholesterolemia (heFH) living in Mainland China or in Western countries had lower plasma low-density lipoprotein cholesterol (LDL-C) levels and lower prevalence of xanthomata or coronary heart disease (CHD) than Caucasians with heFH and a greater proportion went unrecognized. We characterized the features of Hong Kong Chinese with heFH identified by cascade screening. METHODS: Potential probands with primary hypercholesterolemia manifesting total cholesterol (TC) greater than 7.5 mmol/L or LDL-C greater than 4.9 mmol/L were selected from a lipid clinic in a public hospital in Hong Kong. After screening of 132 unrelated potential probands and their relatives, 252 subjects from 87 pedigrees were clinically diagnosed as heFH. RESULTS: In 252 heFH patients (mean age 37 ± 17 years, 100 males), the plasma TC and LDL-C were 9.1 ± 1.5 mmol/L and 7.2 ± 1.5 mmol/L, respectively. In subjects aged ≥ 18 years, the prevalence of xanthomata and corneal arcus was 40.6% and 81.2% in males, and 54.8% and 66.9% in females respectively. The overall incidence of CHD was 9.9% in males and 8.5% in females in patients aged over 18 years with CHD history available. Multiple logistic regression analysis showed that advanced age and presence of xanthelasmata were significantly associated with increased risk of CHD. CONCLUSIONS: This study is the first to characterize the epidemiologic features of heFH in Hong Kong Chinese, which provides new population-specific information on this genetic disorder. This may presage how this condition will manifest in China in the near future.

The production of erotica: photobooks of teenage models in Hong Kong.

This article examines the production of erotica in a Chinese cultural context. It takes the photo books featuring teenage models published in Hong Kong in 2010 as case studies in which a total of 2,205 photographs of teenage models were analyzed. In-depth interviews were conducted with six producers of these images. It was found that the set of erotic pictures was characterized by three distinctive features. First, they emphasized a look of innocence that suggested purity, fragility, and delicacy. Second, albeit being sexy and desirable, the girls were often presented as if they were unaware of their sexiness. The implication was that their sexiness was unintentional and, thus, the girls were not to blame. Finally, a sense of intimacy was purposefully built between the models and readers by constituting a direct gaze and presenting models as ordinary "girls next door." All these echoed the emphasis of female chastity in Chinese culture. It appears that in Hong Kong, where sexuality issues often provoke debates, the producers of sexy images have benefited from media controversies. By heightening expectations of potential customers, they fuel the "erotic" imagination of the readers. The production of erotica is, hence, completed through a collaboration between teenage models, producers, marketers, and consumers.

A prospective cohort study comparing early opioid requirement between Chinese from Hong Kong and Caucasian Australians after major abdominal surgery.

BACKGROUND: The relationship between ethnicity and early opioid consumption is not well understood. Our prospective cohort study tested whether Chinese patients in Hong Kong require less opioid after major abdominal surgery compared with Caucasian patients in Australia. METHODS: Matched cohorts of patients from Hong Kong (n=68) and Australia (n=68) were recruited. Patient attitudes and expectations to pain management documented. After operation, all patients received i.v. morphine using a patient-controlled analgesia device. Postoperative opioid consumption, pain intensity, and incidence of opioid-related side-effects were recorded. RESULTS: The average (sd) opioid requirement (i.v. morphine equivalent) at 72 h after surgery was significantly less among Chinese patients [86.8 (62.6) mg (95% CI 71.8, 101.8)] compared with Caucasian patients [130.6 (71.9) mg, (P<0.0005) (95% CI 113.4, 147.8)]. Numeric rating scale pain score (0-10) was, however, higher in Chinese patients compared with Caucasian Australians, 5.3 (2.7) vs 4.4 (2.3) (P=0.029). The incidence of pruritus among Chinese patients was significantly higher than Caucasians at 24-48 h (P=0.001) and 48-72 h (P=0.001). Chinese patients also reported a strong preference for others to manage their pain, and their nurse carers were more likely to expect severe pain after surgery. CONCLUSIONS: Chinese patients in Hong Kong required less opioid and experienced greater pain intensity and pruritus than Caucasian patients. Clinicians should consider differences in the side-effect profile of morphine and patient expectations related to pain control when planning postoperative analgesia for patients of Chinese ethnicity.

Can intensity-modulated radiotherapy preserve oral health-related quality of life of nasopharyngeal carcinoma patients?

PURPOSE: To investigate the changes in salivary function and oral health-related quality of life for patients with nasopharyngeal carcinoma treated by intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: A total of 57 patients with early-stage nasopharyngeal carcinoma received IMRT. The parotid and whole saliva flow was measured, and the Medical Outcomes Study 36-item short form, European Organization for Research and Treatment of Cancer Quality of Life questionnaire-C30, European Organization for Research and Treatment of Cancer Quality of Life questionnaire 35-item head-and-neck module, and Oral Health Impact Profile questionnaires were completed at baseline and 2, 6, 12, 18, and 24 months after IMRT. RESULTS: Parotid saliva flow recovered fully after 1 year and maintained. Whole saliva flow recovered partially to 40% of baseline. A general trend of deterioration in most quality of life scales was observed after IMRT, followed by gradual recovery. Persistent oral-related symptoms were found 2 years after treatment. CONCLUSION: IMRT for early-stage nasopharyngeal carcinoma could only partially preserve the whole salivary function and oral health-related quality of life.

Association between HLA-B*58:01 allele and severe cutaneous adverse reactions with allopurinol in Han Chinese in Hong Kong.

BACKGROUND: Allopurinol has been reported as a common cause of severe cutaneous adverse reactions (SCARs). Recent studies in various populations suggest that HLA-B*58:01 is a strong genetic marker for allopurinol-induced SCAR, especially in populations with a high frequency of HLA-B*58:01. OBJECTIVES: To confirm the association link between HLA-B*58:01 and hypersensitivity reactions attributed to allopurinol use in Han Chinese patients in Hong Kong. METHODS: We performed a case-control study to investigate whether the HLA-B*58:01 allele predisposes to allopurinol-induced SCAR in Han Chinese patients in Hong Kong. The HLA-B*58:01 genotyping was performed in 20 patients with allopurinol-induced SCAR or erythema multiforme major (EMM; n = 1) and in 30 patients tolerant to allopurinol. RESULTS: All of the 19 patients with allopurinol-induced SCAR examined but not the patient with EMM carried HLA-B*58:01 whereas only four (13%) of the control patients had this allele. The positive rate of the HLA-B*58:01 was significantly higher in the cases than in the allopurinol-tolerant control group [odds ratio (OR) 123·5, 95% confidence interval (CI) 12·8-1195·1; P < 1 × 10(-4) ] and was even higher after removal of the patient with EMM (OR 229·7, 95% CI 11·7-4520·4). The sensitivity and specificity of the HLA-B*58:01 allele for prediction of allopurinol-induced SCAR were 100% and 86·7%, respectively. CONCLUSIONS: This study confirmed the strong association between the HLA-B*58:01 and allopurinol-induced SCAR in Hong Kong Han Chinese patients. A screening test for the HLA-B*58:01 allele should effectively reduce the risk for allopurinol-induced SCAR in Chinese populations.

Trajectories of body image and sexuality during the first year following diagnosis of breast cancer and their relationship to 6 years psychosocial outcomes.

We examined degree and determinants of change in body image and sexuality over the first year following breast cancer diagnosis to differentiate body image and sexuality trajectories, and then explored if differences in trajectories predicted 6 years' psychosocial outcomes. 363/405 (90%) Chinese women receiving surgery for BC were assessed at 5-days (Baseline), 1-month, 4-months, and 8-months post-surgery. Psychological distress, treatment decision making (TDM) difficulties, satisfaction with treatment outcome, optimism, and self-efficacy were assessed at Baseline. Self-image and sexuality were recorded at each follow-up assessment. Latent growth mixture modeling identified trajectories of self-image and sexuality. Multinominal logistic regression identified factors predicting trajectory patterns. Six years later 211/363 (58%) of the original patients were successfully traced and their psychosocial status assessed. Three distinct trajectories of self-image and sexuality were identified: high-stable, recovery, and high-deteriorating. Most women (64% self-image; 58% sexuality) showed stable levels of self-image and sexuality scores. TDM difficulties, satisfaction with treatment outcomes, physical symptom and psychological distress predicted trajectory patterns. Self-image trajectories over the first year diagnosis predicted 6-years psychosocial outcomes. Women with high-stable level of self-image had the best 6-year self-image and sexuality; women with initial low level of self-image had significantly greater long-term psychological distress. Low TDM difficulties and high treatment outcome satisfaction predicted high and stable self-image and sexuality. Type of surgery showed little impacts on self-image and sexuality. Self-image during acute illness phase predicted long-term outcomes. Interventions should focus on minimizing self-image decrement.

Ketamine-induced biliary dilatation: from Hong Kong to New York.

Ketamine is a popular drug of abuse in China, especially for young adults between the 18 and 30 years. It produces desirable short-term sensations of excitement, dream-like states, hallucinations, and vivid imagery, but is also responsible for untoward effects of the gastrointestinal and urinary tracts. Abusers often present with severe abdominal pain and dysuria. In addition to its excretion in urine, ketamine is also excreted in bile and can lead to biliary dilatation. Sixteen reports of this phenomenon have been described in the literature, mostly in China. To date, this phenomenon has not been described in the United States. We present 2 cases of ketamine-induced biliary dilatation in young adult Asian patients. It is a new entity in the United States but should be recognized early, as it may prevent unnecessary investigation with blood work, imaging, therapeutic endoscopy, or even surgery.

Thyrotoxic hypokalemic periodic paralysis is a rare but potentially fatal emergency: case report and literature review.

We report a case of a 39 year-old Asian man in whom profound lower limb paralysis, along with severe hypokalemia and electrocardiographic changes, were the presenting features of Graves' disease (GD)-related thyrotoxicosis. Rapid recognition and management of the disorder were the key factors to avoid fatal hypokalemia-induced cardiac arrhythmias and promptly restore patient's capacity to ambulate.

Cultural and linguistic isolation: the breast cancer experience of Chinese-Australian women - a qualitative study.

OBJECTIVES: Although Chinese-Australian women are at higher risk of developing breast cancer after migration to Australia, information on their experience is limited. This paper explores Chinese-Australian women's perceptions of the meaning and experience of a breast cancer diagnosis, treatment and coping mechanism. METHODS: Three focus groups were conducted with 23 Chinese-Australian women diagnosed with breast cancer in their native language (Cantonese or Mandarin). Following transcription and translation, interview data was analysed by content analysis. RESULTS: Culturally specific values, beliefs and language barriers played a significant role in shaping the women's breast cancer experiences and their response to the diagnosis. Of note these women found the experience isolating and distressing, factors that were compounded by the lack of culturally sensitive resources and information. CONCLUSIONS: In providing information for Chinese-Australian women with breast cancer, culture, language and migration experience need to be taken into account.

Using a population-based approach to prevent hepatocellular cancer in New South Wales, Australia: effects on health services utilisation.

BACKGROUND: Australians born in countries where hepatitis B infection is endemic are 6-12 times more likely to develop hepatocellular cancer (HCC) than Australian-born individuals. However, a program of screening, surveillance and treatment of chronic hepatitis B (CHB) in high risk populations could significantly reduce disease progression and death related to end-stage liver disease and HCC. Consequently we are implementing the B Positive pilot project, aiming to optimise the management of CHB in at-risk populations in south-west Sydney. Program participants receive routine care, enhanced disease surveillance or specialist referral, according to their stage of CHB infection, level of viral load and extent of liver injury. In this paper we examine the program's potential impact on health services utilisation in the study area. METHODS: Estimated numbers of CHB infections were derived from Australian Bureau of Statistics data and applying estimates of HBV prevalence rates from migrants' countries of birth. These figures were entered into a Markov model of disease progression, constructing a hypothetical cohort of Asian-born adults with CHB infection. We calculated the number of participants in different CHB disease states and estimated the numbers of GP and specialist consultations and liver ultrasound examinations the cohort would require annually over the life of the program. RESULTS: Assuming a 25% participation rate among the 5,800 local residents estimated to have chronic hepatitis B infection, approximately 750 people would require routine follow up, 260 enhanced disease surveillance and 210 specialist care during the first year after recruitment is completed. This translates into 5 additional appointments per year for each local GP, 25 for each specialist and 420 additional liver ultrasound examinations. CONCLUSIONS: While the program will not greatly affect the volume of local GP consultations, it will lead to a significant increase in demand for specialist services. New models of CHB care may be required to aid program implementation and up scaling the program will need to factor in additional demands on health care utilisation in areas of high hepatitis B sero-prevalence.

A simple risk score to identify Southern Chinese at high risk for diabetes.

AIMS: To develop a simple scoring system for identifying Southern Chinese at risk of diabetes. METHODS: The score was derived from a risk factor matching cohort for Type 2 diabetes in Hong Kong Chinese (cohort 1, 2448 subjects without a history of diabetes; age, mean +/- sd 37.2 +/- 8.9 years, median 36.0 years; 1649 had risk factors for diabetes and 799 were age-matched control subjects from the community). Two other cohorts were used to validate the risk score (cohort 2, 3734 subjects with risk factors for diabetes; and cohort 3, 1513 participants of a community diabetes survey). All subjects had a 75 g oral glucose tolerance test (OGTT). RESULTS: In cohort 1, 270 (11%) of the subjects were found to have diabetes on OGTT. A risk score system was derived using the beta values of the corresponding predictors in the logistic regression analysis. The area under the curve (95% confidence intervals) of the score system was 0.735 (0.705, 0.765). The application of a risk score of > or = 16 increased the detection rate 2.5-4 times in all three cohorts. A high post-test probability of diabetes of > 60% was derived from a risk score of > or = 20. Only 10-20 and approximately 5% with a score of > or = 12 and > or = 16, respectively, are indicated for OGTT. This will considerably improve the yield of OGTT screening. CONCLUSIONS: A simple risk score identifies young-to-middle-aged Southern Chinese at high risk for diabetes. Subjects with a score of 16 or above (out of 30) should undergo OGTT for definitive diagnosis of diabetes.

A phone-counseling smoking-cessation intervention for male Chinese restaurant workers.

We sought to develop a smoking-cessation intervention for male Chinese restaurant workers in New York City that required no seeking out by participants; provided support over a relatively long period of time; and was responsive to participants' cultural backgrounds and daily lives. The resulting intervention consisted of a minimum of 9 proactive phone counseling sessions within a 6-month period for each participant recruited at his worksite. All activities were conducted in Chinese languages. The efficacy of this proactive phone-counseling intervention was assessed in a pretest/posttest design comparing baseline smoking with smoking 6 months after the intervention ended. Of 137 male employees recruited at their restaurants, 101 (median age 40.5) participated in the phone-counseling intervention in 2007-2008, with 75 completing the program with at least 9 counseling calls. We found a linear increase in smoking cessation from 0% at Call 1 to 50.7% at Call 9 for 75 men who completed the program, and we found for all 101 participants a 32.7% intent-to-treat cessation rate for 6 months post-end of program, adjusted to 30.8% by saliva cotinine assessments. The results indicate that combining field outreach with phone counseling over an extended period of time can facilitate smoking cessation for population groups whose environments do not support efforts to quit smoking.

Dietary habits and health beliefs of Chinese Canadians.

PURPOSE: The relationships among dietary behaviours, traditional health beliefs (THB), and demographic characteristics of Chinese Canadians living in Toronto were examined, as were their primary sources of nutrition information. METHODS: Through the use of probability sampling, 106 adult subjects who originated from China, Hong Kong, or Taiwan were recruited from five Chinese community organizations. A telephone interview, employing a tested questionnaire, was conducted in Cantonese or Mandarin. All data were analyzed with MS Excel and SPSS statistical software. RESULTS: Dietary acculturation is gradual and individual. Participants reported regular intakes of fruits and vegetables and fat-reducing behaviours. Most used both Chinese and Western cooking methods. Practices based on traditional Chinese health beliefs (THB), such as balancing yin and yang foods to promote health, were prevalent. Participants were grouped as THB-strong, THB-moderate, or THB-weak, on the basis of their health belief scores. Various significant relationships among the variables were identified. Chinese media, friends, and family were the primary sources of nutrition information; dietitians were identified by only 12%. CONCLUSIONS: This is the first study to apply a THB grouping for Chinese Canadians. Results will provide an important basis for nutrition interventions to encourage immigrants to make healthy food choices, using both traditional and Western foods.

The genetic variability of MDR1 C3435T polymorphisms in four Southern Chinese populations.

OBJECTIVES: To investigate the genetic variability of multiple drug resistant 1 (MDR1) gene C3435T polymorphism in four Southern Chinese populations. METHODS: Using discrimination real-time PCR, we determined the MDR1 C3435T polymorphism in three ethnic minority groups Lahu (n=104), Wa (n=101) and Bulang (n=100) in Yunnan Province, and Han Chinese (n=199) in Hong Kong. All of them were residents in Southern China. RESULTS: For 3435 CC genotype, the frequency in Han Chinese in Hong Kong (44.7%) is significantly higher than in Lahu (16.3%) and Wa (29.7%) minorities, P<0.05. For 3435 CT genotype, the frequency in Han Chinese in Hong Kong (44.2%) is lower than in Lahu (58.7%), P<0.05. For 3435 TT genotype, frequency in Han Chinese in Hong Kong (11.1%) is lower than in Lahu (25%) and Wa (20.8%), P<0.05. For 3435 C allele, frequency in Han Chinese in Hong Kong (66.8%) is higher than in Lahu (45.7%) and Wa (54.5%), P<0.01. For 3435T allele, frequency in Han Chinese in Hong Kong (33.2%) is lower than in Lahu (54.3%) and Wa (45.5%), P<0.01. For MDR1 3435T allele, the frequencies are significantly higher in our four Southern Chinese populations than in African population (P<0.001) and significantly lower than in South-west Asians (P<0.05); Han Chinese in Hong Kong displayed significant difference from all the other ethnic populations except Japanese (P<0.05); compared with Caucasian and other ethnic Asians, Lahu minority showed no frequency difference (P>0.05) between Caucasian and other Asians (except Japanese). CONCLUSIONS: This is the first study to show the C3435T polymorphism of MDR1 in Southern Chinese populations. The frequency of C3435T, an important determinant for multidrug resistance, displays significant difference in ethnics. It may help for individualizing therapy for cancer, HIV and other common diseases.