Exploring the Determinants of Food Choice in Chinese Mainlanders and Chinese Immigrants: A Systematic Review.

Determinants of food choice in Chinese populations have not been systematically synthesised using a cultural lens. This study reviewed qualitative studies exploring food choice determinants of both Chinese mainlanders and Chinese immigrants living in Western countries. Ovid Medline, CINAHL Plus, Web of Science, ProQuest, and China National Knowledge Infrastructure database (CNKI) were searched from database inception to 1 April 2021. Studies were included if they involved qualitative research methods, were written in English or Chinese, investigated the factors influencing food choices, and targeted Chinese mainlanders or Chinese immigrants living in Western countries. Twenty-five studies (24 in English, 1 in Chinese) were included, involving 2048 participants. Four themes were identified; (1) the principles of traditional Chinese medicine (TCM), (2) perceptions of a healthy diet in Chinese culture (e.g., regular eating, eating in moderation, and emphasis on food freshness), (3) the desire to maintain harmony in families/communities, and (4) physical/social environmental factors all significantly influenced Chinese people's food choices. It is important to acknowledge these factors when developing culturally appropriate nutrition programs for promoting health in Chinese mainlanders and Chinese immigrants.

Origin of ethnic groups, linguistic families, and civilizations in China viewed from the Y chromosome.

East Asia, geographically extending to the Pamir Plateau in the west, to the Himalayan Mountains in the southwest, to Lake Baikal in the north and to the South China Sea in the south, harbors a variety of people, cultures, and languages. To reconstruct the natural history of East Asians is a mission of multiple disciplines, including genetics, archaeology, linguistics, and ethnology. Geneticists confirm the recent African origin of modern East Asians. Anatomically modern humans arose in Africa and immigrated into East Asia via a southern route approximately 50,000 years ago. Following the end of the Last Glacial Maximum approximately 12,000 years ago, rice and millet were domesticated in the south and north of East Asia, respectively, which allowed human populations to expand and linguistic families and ethnic groups to develop. These Neolithic populations produced a strong relation between the present genetic structures and linguistic families. The expansion of the Hongshan people from northeastern China relocated most of the ethnic populations on a large scale approximately 5300 years ago. Most of the ethnic groups migrated to remote regions, producing genetic structure differences between the edge and center of East Asia. In central China, pronounced population admixture occurred and accelerated over time, which subsequently formed the Han Chinese population and eventually the Chinese civilization. Population migration between the north and the south throughout history has left a smooth gradient in north-south changes in genetic structure. Observation of the process of shaping the genetic structure of East Asians may help in understanding the global natural history of modern humans.

Mechanism of allergic rhinitis treated by Centipeda minima from different geographic areas.

CONTEXT: The coriander plant Centipeda minima (L.) A. Braun et Aschers (Compositae) is used for the treatment of allergic rhinitis. OBJECTIVE: Analyze the difference of the C. minima volatile oil from 7 geographic areas and its therapeutic effect on allergic rhinitis. MATERIALS AND METHODS: The volatile oils from different geographic areas were extracted and analyzed, the protein and biological pathway for the treatment of allergic rhinitis were predicted by network pharmacology. Established three groups of Sprague-Dawley rat allergic rhinitis models (n = 10). The treatment group was given 100 µL/nostril of 0.1% C. minima volatile oil, the blank and model groups were given the same amount of normal saline. After 15 days, serum inflammatory factors were detected by ELISA. Nasal mucosa tissues were examined by hematoxylineosin staining and immunuhistrochemistry. RESULTS: There are differences in the content of volatile oil in the seven geographic areas. Experiments showed that the concentration of TNF-α in the serum of the administration group decreased from 63.66 ± 2.06 to 51.01 ± 4.10 (pg/mL), IL-4 decreased from 41.90 ± 3.90 to 28.68 ± 3.39 (pg/mL), IgE decreased from 22.18 ± 1.40 to 17.59 ± 1.60 (pg/mL), IL-2 increased from 314.14 ± 10.32 to 355.90 ± 10.01(pg/mL). Immunohistochemistry showed that compared with the model group, the PTGS2 and MAPK3 proteins in the administration group were significantly reduced. DISCUSSION AND CONCLUSIONS: C. minima volatile oil is a multi-target and multi-pathway in the treatment of allergic rhinitis, which provides a new research basis and reference for the treatment of allergic rhinitis.

Violence in the first millennium BCE Eurasian steppe: Cranial trauma in three Turpan Basin populations from Xinjiang, China.

OBJECTIVES: Violence affected daily life in prehistoric societies, especially at conflict zones where different peoples fought over resources and for other reasons. In this study, cranial trauma was analyzed to discuss the pattern of violence experienced by three Bronze to early Iron Age populations (1,000-100 BCE) that belonged to the Subeixi culture. These populations lived in the Turpan Basin, a conflict zone in the middle of the Eurasian Steppe. METHODS: The injuries on 129 complete crania unearthed from the Subeixi cemeteries were examined for crude prevalence rate (CPR), trauma type, time of occurrence, possible weapon, and direction of the blow. Thirty-three injuries identified from poorly preserved crania were also included in the analyses except for the CPR. Data was also compared between the samples and with four other populations that had violence-related backgrounds. RESULTS: Overall, 16.3% (21/129) of the individuals showed violence-induced traumatic lesions. Results also indicated that most of the injuries were perimortem (81.6%), and that women and children were more involved in conflict than the other comparative populations. Wounds from weapons accounted for 42.1% of the identified cranial injuries. Distribution analysis suggested no dominant handedness of the attackers, and that blows came from all directions including the top (17.1%). Wounds caused by arrowheads and a special type of battle-ax popular in middle and eastern Eurasian Steppe were also recognized. DISCUSSION: A comprehensive analysis of the skeletal evidence, historical records, and archeological background would suggest that the raiding to be the most possible conflict pattern reflected by the samples. The attackers were likely to have been nomadic invaders from the steppe (such as the Xiongnu from historical records), who attacked the residents in the basin more likely for their resources rather than territory or labor force.

Higher 25-hydroxyvitamin D level is associated with increased risk for Behçet's disease.

BACKGROUND & AIM: Previous studies showed a vitamin D deficiency in patients with Behçet's disease, suggesting potential benefits of vitamin D supplementation in the prevention and treatment of Behçet's disease. Interpretation of these studies may be limited by reverse causality or confounding bias. We aim to determine the causal association between serum 25-hydroxyvitamin D [25(OH)D] and the risk of Behçet's disease by Mendelian randomization. METHODS: An allele score formed by four variants (rs2282679, rs10741657, rs12785878 and rs6013897) that were associated with serum 25(OH)D level, was examined using data of genome-wide association study (GWAS) on 999 Behçet's disease and 4417 healthy individuals of Chinese ancestry and validated using data of GWAS on 1215 Behçet's disease and 1278 controls of Turkish ancestry. The primary outcome was the risk of Behçet's disease, evaluated by an inverse variance weighted average of the associations with genetically determined 25(OH)D levels. RESULTS: The inverse variance weighted estimate showed that genetically increased 25(OH)D level was associated with a higher risk of Behçet's disease. In the Chinese cohort, the odds ratio for Behçet's disease in one standard deviation increase of natural log-transformed 25(OH)D level was 3.82 (95% CI: 1.27-11.42). Data from Turkish cohort confirmed the association with Behçet's disease (OR, 95% CI: 4.18, 1.15-15.12). In overall combination of Chinese and Turkish cohorts, the odds ratio for Behçet's disease per standard deviation increase of natural log-transformed 25(OH)D level was estimated to be 3.96 (95% CI: 1.72-9.13; P = 0.001). No significant evidence of pleiotropy and heterogeneity was detected. CONCLUSIONS: On the basis of evidence in 7909 human beings, this study provides the newest indication that a lifelong higher 25(OH)D level is associated with an increased risk of Behçet's disease. Special attention should be paid to the potential harm of long-term or high-dose use of vitamin D supplements in clinical practice.

The treatment of asthma using the Chinese Materia Medica.

ETHNOPHARMACOLOGICAL RELEVANCE: Asthma is a costly global health problem that negatively influences the quality of life of patients. The Chinese Materia Medica (CMM) contains remedies that have been used for the treatment of asthma for millennia. This article strives to systematically summarize the current research progress so that more comprehensive examinations of various databases related to CMM anti-asthma drugs, can be performed, so as to sequentially provide effective basic data for development and application of anti-asthma drugs based on the CMM. MATERIALS AND METHODS: The research data published over the past 20 years for asthma treatment based on traditional CMM remedies were retrieved and collected from libraries and online databases (PubMed, ScienceDirect, Elsevier, Spring Link, Web of Science, PubChem Compound, Wan Fang, CNKI, Baidu, and Google Scholar). Information was also added from classic CMM, literature, conference papers on classic herbal formulae, and dissertations (PhD or Masters) based on traditional Chinese medicine. RESULTS: This review systematically summarizes the experimental studies on the treatment of asthma with CMM, covering the effective chemical components, typical asthma models, important mechanisms and traditional anti-asthma CMM formulae. The therapy value of the CMM for anti-asthma is clarified, and the original data and theoretical research foundation are provided for the development of new anti-asthmatic data and research for the CMM. CONCLUSIONS: Substantial progress against asthma has been made through relevant experimental research based on the CMM. These advances improved the theoretical basis of anti-asthma drugs for CMM and provided a theoretical basis for the application of a asthma treatment that is unique. By compiling these data, it is expected that the CMM will now contain a clearer mechanism of action and a greater amount of practical data that can be used for future anti-asthma drug research.

The upper limb skeleton and behavioral lateralization of modern humans from Zhaoguo Cave, southwestern China.

OBJECTIVES: Aims of the study are to initially describe and comparatively evaluate the morphology of the new Zhaoguo M1 upper limb remains, and contextualize upper limb functional adaptations among those of other worldwide Upper Paleolithic (UP) humans to make inferences about subsistence-related activity patterns in southwestern China at the Pleistocene-Holocene boundary. MATERIALS AND METHODS: The preserved Zhaoguo M1 skeletal remains include paired humeri, ulnae, and radii, among others. These specimens were scanned using micro-computed tomography to evaluate internal structural properties, while external osteometric dimensions of the Zhaoguo M1 upper limb elements also were acquired. Both sets of measurements were compared to published data on Neandertals, and Middle and Upper Paleolithic modern humans. RESULTS: The upper limb elements of Zhaoguo M1 display a suite of characteristics that generally resemble those of other contemporary Late UP (LUP) modern humans, while robusticity indices generally fall within the upper range of LUP variation. The Zhaoguo M1 upper limb elements display fewer traits resembling those of late archaic humans. The Zhaoguo M1 individual exhibits diaphyseal asymmetry in several upper limb elements suggesting left hand dominance. When evaluating the full range of magnitudes of humeral bilateral asymmetry in the comparative sample, Zhaoguo M1 falls at the lower end overall, but yet is relatively higher than contemporary LUP modern humans specifically from East Eurasia. DISCUSSION: The Zhaoguo M1 individual suggests typical LUP modern human upper limb morphology persisted in southwest China until the end of the last glacial period. Upper limb bone asymmetry of Zhaoguo M1 also indicates that behavioral activities attributed to a hunter-gatherer tradition apparently extended through the Pleistocene-Holocene transition in this region.

Pinellia ternata (Thunb.) Breit: A review of its germplasm resources, genetic diversity and active components.

ETHNOPHARMACOLOGICAL RELEVANCE: The medicinal plant Pinellia ternata has been widely used in China, Korea, and Japan and has been demonstrated to be highly effective for treating cough, vomiting, infection, and inflammatory diseases. Modern pharmacological investigations have demonstrated its multiple activities, such as antitussive, expectorant, antiemetic, antitumor, antibacterial, and sedative-hypnotic activities. AIM OF THE REVIEW: This review aims to summarize the information about the biological traits, genetic diversity, active components, and continuous cropping obstacle of P. ternata in order to improve its use. MATERIALS AND METHODS: In this review, the relevant literature was gathered by using Pinellia ternata, genetic diversity, active components, and continuous cropping obstacle as the keywords from Google Scholar, PubMed, Springer Link, the Wiley online library, SciFinder, SCOPUS, Baidu Scholar, China national knowledge infrastructure (CNKI), and WANFANF DATA (up to April 2020). RESULTS: P. ternata is the most widely used herb in the Pinellia genus to treat several diseases. The genetic diversity of P. ternata has been extensively studied, and its high genetic diversity level in China has been demonstrated. Modern pharmacological research has indicated that amino acids, alkaloids, and polysaccharides are the main active components supporting P. ternata's medicinal effects. However, an efficient method for determining its active components is still unavailable. The method used to evaluate Pinelliae Rhizoma (PR) quality standards should be further optimized. The continuous cropping obstacle has a significant effect on the quantity and quality of P. ternata. The underlying mechanism of the continuous cropping obstacle needs to be further explored. CONCLUSIONS: P. ternata has emerged as a valuable source of traditional medicine. Some uses of P. ternata in medicine have been validated by pharmacological investigations. However, a more efficient analytical method should be established to evaluate the quality of PR based on multiple quality markers. Furthermore, high-performance liquid chromatography (HPLC) and DNA barcoding should be introduced to identify the authenticity of PR. In addition, the genes involved in the metabolic synthesis pathways of the main active components, population genetic relationships, the quality control of processed PR, and the continuous cropping obstacle need to be further elucidated. We hope this review will allow for better utilization of this valuable herb.

Uniparental Genetic Analyses Reveal the Major Origin of Fujian Tanka from Ancient Indigenous Daic Populations.

The Fujian Tanka people are officially classified as a southern Han ethnic group, whereas they have customs similar to Daic and Austronesion people. Whether they originated in Han or Daic people, there is no consensus. Three hypotheses have been proposed to explain the origin of this group: (1) the Han Chinese origin, (2) the ancient Daic origin, (3) and the admixture between Daic and Han. This study addressed this issue by analyzing the paternal Y chromosome and maternal mtDNA variation of 62 Fujian Tanka and 25 neighboring Han in Fujian. The southern East Asian predominant haplogroups (e.g., Y-chromosome O1a1a-P203 and O1b1a1a-M95, and mtDNA F2a, M7c1, and F1a1) had relatively high frequencies in Tanka. The interpopulation comparison revealed that the Tanka have a closer affinity with Daic populations than with Han Chinese in paternal lineages but are closely clustered with southern Han populations such as Hakka and Chaoshanese in maternal lineages. Network and haplotype-sharing analyses also support the admixture hypothesis. The Fujian Tanka mainly originate from the ancient indigenous Daic people and have only limited gene flows from Han Chinese populations. Notably, the divergence time inferred by the Tanka-specific haplotypes indicates that the formation of Fujian Tanka was a least 1033.8-1050.6 years before present (the early Northern Song dynasty), indicating that they are an indigenous population, not late Daic migrants from southwestern China.

The genus Orobanche as food and medicine: An ethnopharmacological review.

ETHNOPHARMACOLOGICAL RELEVANCE: The genus Orobanche consists of annual, biennial or perennial fleshy parasitic herb species, many of which are in use as traditional medicines and wild gathered foods since a long time. Recently, Orobanche spp. are increasingly accepted as edible medicines with nourishing properties. However, there is a lack of comprehensive understanding of their ethnopharmacological background. AIM OF THE REVIEW: This review focuses on the advancements in botanical classification, and summary of traditional use, phytochemistry, pharmacology and toxicology of Orobanche species, in order to check for scientific support of their traditional uses and the safe treatment of human ailments and diseases. MATERIALS AND METHODS: In this review, the results of a systematic and comprehensive literature survey about Orobanche spp over the past 60 years (from 1960 to 2020) is presented. The selected literature includes periodicals, doctoral dissertations, master dissertations conference papers and various books. The literature was identified through search engine websites and a cross-checked with the Chinese pharmacopeia, classic Chinese and European herbals, regional medicinal monographs, and online ethnobotanical databases. RESULTS: The literature about the traditional uses revealed that Orobanche spp. were used as medicine and food in many regions of the world, but mainly in China and North America while in Europe they were primarily used as food items. Phenylpropanoid derivatives and alkaloids, were reported as their main bioactive compounds, showing antioxidant, immune system enhancing, androgenic, antibacterial and antiviral properties. CONCLUSIONS: Orobanche spp. are increasingly being used for tonic purposes in China. Their ethnopharmacological background suggests potential usages as healthy foods and food supplements. They have the potential to be developed into herbal medicines for tonifying the kidney, against impotence and spermatorrhea, dermatological problems and wounds, as well as infantile diarrhoea. However, the pharmacological studies conducted with extracts derived from Orobanche spp. were not useful for rationally explaining the traditional uses. More investigations are required to provide a pharmacological basis for the traditional claims and the relationship between traditional uses, clinical uses, phytochemistry and pharmacological properties. Additionally, quality control should be emphasized to ensure the safe and effective use of Orobanche derived products.

Ethnobotanical survey and evaluation of traditional mosquito repellent plants of Dai people in Xishuangbanna, Yunnan Province, China.

ETHNOPHARMACOLOGICAL RELEVANCE: Dengue is one of the most important pervasive diseases in many regions of the world, including China. There is an urgent need for new repellents, including plant derivatives, due to the resistance, toxicity, and non-degradability of synthetic insecticides. Traditional plant-based remedies may provide potential avenues for developing new strategies. AIMS OF THE STUDY: The aims of this study were to 1) document the traditional mosquitoes repellent plants used by the Dai people of Xishuangbanna, China; 2) screen out new efficient mosquito repellent plants as candidates for further study. MATERIALS AND METHODS: During the period August 2016 to July 2017, five field surveys were conducted in 16 villages of Xishuangbanna. A total of 81 informants (44 males and 37 females) were interviewed using semi-structured questions to collect detailed information on the plants they use to prevent mosquito bites. Ten plants with higher popularity and larger resource were collected and extracts were prepared by hydro-distillation or with petroleum ether. Extracts were tested for adult Aedes albopictus repellency using a human-bait cage. Firstly, repellency was determined as the Minimum Effective Dosage (MED) per minute at which 1% of the mosquito bite through the treated cloth. Secondly, five plant extracts with lower MEDs were tested the repellent longevity of different concentrations. RESULTS: Eighteen plants were documented as being used in traditional remedies against mosquitoes. The methods for controlling mosquitoes were diverse: direct burning was used for most plants (16 species), followed by smearing (5 species), and placing (5 species). Laboratory analyses confirmed that ten plants did exhibit mosquito repellent activity. Of them, Artemisia indica, Nicotiana tabacum, Blumea balsamifera, Vitex trifolia, and Chromolaena odorata showed good mosquito repellency with MEDs of 0.015, 0.061, 0.090, 0.090, and 0.105 mg/cm2, respectively. The protection rate provided by A. indica is also the highest among five plants. Although it provides complete protection time of only 30 min at 0.45 mg/cm2 concentration, its repellency within 2 h is not significantly different from that of DEET. CONCLUSION: Dai villagers in Xishuangbanna have a rich, diverse and scientific knowledge of plant-based mosquito repellents. Laboratory experiments screened out several plants as candidates for mosquito repellents, of which Artemisia indica was the most promising candidate plant.

Aucklandia costus (Syn. Saussurea costus): Ethnopharmacology of an endangered medicinal plant of the himalayan region.

ETHNOPHARMACOLOGICAL RELEVANCE: Aucklandia costus Falc. a medicinal plant is native to the Himalayan region and synonymous with Saussurea costus, Saussurea lappa, and Aucklandia lappa. It has an ancient background of being used ethnopharmacologically for various body ailments. According to Ayurveda, Unani, Siddha, and Traditional Chinese Medicine, Costus roots are recommended for leukoderma, liver, kidney, blood disorders, Qi stagnation, and tridosha. Root and powder are used orally with warm water to cure gastric problems, and the paste is applied to the inflamed area to relieve pain. Root paste is applied on the skin to cure boils, blisters, and leprosy. AIM OF THE STUDY: The aim of the present review is to establish a correlation among the ethnopharmacological uses and scientific studies conducted on A. costus with chemical constituents, safety & toxicity data including future directions for its conservation with higher yield and effect. MATERIALS AND METHODS: The study was conducted by studying books, research papers, and literature in history, agroforestry, phytopharmacology of Himalayan plants using international databases, publication, Red data book, and reports. The search engines: Pubmed, Scopus, Wiley Inter-science, Indian Materia Medica, Science Direct, and referred journals are referenced. RESULTS: The literature collected from databases, journals, websites, and books mentioned the use of costus roots in local and traditional practices. CITES included A. costus in a critically endangered category due to lack of cultural practices and overexploitation from wild. A. costus roots are known since 13th century for use in ancient Ayurvedic products but the scientific evaluation is of future research interest. A correlation of traditional uses with scientific studies has been explored to assess the effect of root powder, extract, oil and isolated constituents: Costunolids, Saussureamine B and Dehydrocostus lactone etc. in gastric ulceration and lesions; inhibition of antigen-induced degranulation, mucin production, number of immune cells, eosinophils, and expression and secretion of Th2 cytokines (IL-4 and IL-13) in asthma. The inhibition of pro-inflammatory mediators is also reported by Cynaropicrin, Alantolactone, Caryophyllene, Costic acid. Also, the sesquiterpene lactones has profound effect in inhibition of inflammatory stages and induced apoptotic cascades in cancer. Very few data on the safety and toxicity of plant parts have been noted which needs to be evaluated scientifically. CONCLUSION: A. costus have been noted to have remarkable effect for gastric, hepatic, inflammatory, respiratory, cancer, skin problems but there were several errors in selection of plant material, authentification, selection of dose, assessment, selection of standard and control have been identified. Therefore, a schematic drug development and research strategy exploiting the potential of plant extract, fraction, products and probable constituents, costunolide, dehydrocostus lactone, cynaropicrin, saussureamine assuring dose-response relationship and safety may be determined under pre-clinical which may be extrapolated to clinical level. An evaluation of phytochemicals in A. costus collected from different geographical location in Himalayas may be drawn to identify and conserve the higher yielding plant.

Effectiveness of diet and physical activity interventions among Chinese-origin populations living in high income countries: a systematic review.

BACKGROUND: This review examines the effectiveness of diet and physical activity interventions to reduce cardiometabolic risk among Chinese immigrants and their descendants living in high income countries. The objective of this review is to provide information to help build future interventions aimed at improving diet and increasing physical activity levels among Chinese immigrants. METHODS: Outcomes included BMI, weight, waist circumference (WC), waist-hip ratio (WHR), cholesterol (LDL, HDL), systolic and diastolic blood pressure (SBP, DBP), hemoglobin A1c (HgbA1c), fasting blood glucose (FBG), and HOMA-IR. Six databases were systematically searched from database inception to date of search (February 2020). Meta-analyses used random effect models to estimate pooled effects of outcomes with 95% confidence intervals. The outcomes assessed were changes in mean outcomes (post-intervention versus baseline) among the intervention group versus control groups. RESULTS: Twenty-one articles were included for synthesis, and eight of these were included in the meta-analysis. Among children/adolescents, there were no significant effects of intervention for any of the outcomes having sufficient data for meta-analysis (BMI, WHR, SBP, and DBP). Among adults, the pooled effect including three studies showed significant changes in BMI (effect size = - 1.14 kg/m2; (95% CI: - 2.06, - 0.21), I2 = 31%). There were also significant effects of intervention among adults in terms of changes in SBP and DBP, as the pooled effect across three studies was - 6.08 mmHg (95% CI - 9.42, - 2.73), I2 = 0% and - 3.81 mmHg (95% CI: - 6.34, - 1.28), I2 = 0%, respectively. Among adults there were no other significant effects among the meta-analyses conducted (weight, WC, LDL, HgbA1c, and FBG). CONCLUSIONS: This review is the first to summarize the effectiveness of diet and physical activity interventions specifically designed for Chinese immigrants living in high income countries. There were clinically meaningful changes in BMI and blood pressure among adults, but evidence was weak for other cardiometabolic outcomes (weight, WC, LDL, HgbA1c, and FBG), and among children, there was no evidence of effect for any cardiometabolic outcomes. Given our mixed findings, more work is needed to support the design of successful interventions, particularly those targeting children and their families. TRIAL REGISTRATION: The systematic review protocol was registered in PROSPERO on December 17, 2018, the international prospective register of systematic reviews (registration number: CRD42018117842 ).

Perceptions of the osteopathic profession in New York City's Chinese Communities.

Objective: The purpose of this study was to assess knowledge of and barriers to osteopathic medicine in Chinese immigrant communities in New York City (NYC). Design: A cross-sectional study was designed in which a culturally appropriate survey in Chinese and English versions was administered anonymously to measure immigrant perceptions and knowledge of osteopathic medicine. Setting: Data collection occurred in the municipal delineations for the Chinatown neighbourhood within the New York, New York borough of Manhattan. Participants: Community members were selected using convenience sampling from high-density areas to participate. Information gathered from the survey included demographics, education level, healthcare habits and knowledge of the osteopathic profession. Results: 120 surveys were conducted with 68 males and 52 females, with an average age=40. Respondents in the age range of 18-29 years, those with fluent English-language proficiency, and participants with graduate-level education status demonstrated a higher proportion of knowledge of osteopathic manipulative medicine and osteopathic physicians (doctors of osteopathic medicine) among the study variables. Conclusion: Compared with research on the general US population, a general lack of knowledge of osteopathic medicine exists within NYC's Chinese immigrant community. Although this difference may be ascribed to linguistics and ethnosociological factors, greater outreach and education is needed in urban minority communities to make immigrants aware of all healthcare resources available during the current shortage of US primary care physicians.

Proposing a conceptual framework of spiritual care competence for Chinese nurses.

Spiritual care competence of nurses is crucial to satisfy the spiritual needs of the clients, but the dearth of conceptual frameworks has hindered the clarification of the construct, especially for nurses in the People's Republic of China. This article developed a 3*3*3 matrix framework to clarify the components of spiritual care competence for Chinese nurses through the synthesis of existing empirical and theoretical work, which includes three aspects (awareness, understanding, and application) on three levels (intrapersonal, interpersonal, and transpersonal) of three contents of spirituality (namely, worldview, connectedness, and transcendence). The proposed framework can be used as a model to promote spiritual care competence of nurses in China. Adoption of the framework to guide studies would allow for the design of interventions for the attainment of this competence.

Food, culture, and identity in multicultural societies: Insights from Singapore.

The choice of food practices can be influenced by one's identity in many societies, but has mostly been evaluated in light of the maintenance of cultural identity in migrant populations. This study focused on understanding the influence of identity on food practices among individuals in multicultural societies. We conducted 18 focus group discussions (n = 130) among Indian, Chinese and Malay women in Singapore. Focus group transcripts were analysed using Thematic Analysis both inductively and deductively. Deductive analysis was framed within a Social Representations Approach, a social psychological theory that allows a deeper understanding of the contextual aspects of identity. Participants highlighted the central position of food in social events, cultural celebrations, and persistent traditional beliefs about health (such as 'hot-cold balance'). These beliefs extended to the perception of certain traditional foods possessing medicinal properties. Importantly, the consumption of these traditional foods was accepted as necessary for the maintenance of health by the women. We propose that while cultural food practices are integral to identity preservation and identity continuity for Singaporean women from all three racial groups, this is different to other multicultural societies such as Canada where communities preserve their cultural food practices, in part, due to fear of cultural identity loss. In addition, cross-cultural food practices are readily adopted in participants' daily lives for a number of reasons such as the promotion of health, convenience, and variety. At times, this adoption blurred boundaries between different cultural cuisines. Food practices in multicultural societies like Singapore are thus a reflection of everyday multiculturalism, multicultural social policies, and attitudes towards traditional healthful food practices, and these aspects need to be considered in the development of public health policies and interventions.

A Classification Method of Oracle Materials Based on Local Convolutional Neural Network Framework.

The classification of materials of oracle bone is one of the most basic aspects for oracle bone morphology. However, the classification method depending on experts' experience requires long-term learning and accumulation for professional knowledge. This article presents a multiregional convolutional neural network to classify the rubbings of oracle bones. First, we detected the "shield grain" and "tooth grain" on the oracle bone rubbings, then complete the division of multiple areas on an image of oracle bone. Second, the convolutional neural network is used to extract the features of each region and we complete the fusion of multiple local features. Finally, the classification of tortoise shell and animal bone was realized. Utilizing the image of oracle bone provided by experts, we conducted an experiment; the result show our method has better classification accuracy. It has made contributions to the progress of the study of oracle bone morphology.

Issues in internet-based support for chinese-american breast cancer survivors.

Objective: The incidence of breast cancer in Chinese-Americans is increasing. This article aims to present and discuss the challenges encountered in implementing an Internet-based coaching/support program for Chinese-American breast cancer survivors and to provide direction for future Internet-based interventions targeting this specific population.Methods: The data were collected from (a) interventionists' diaries written during individual coaching/support sessions with survivors, (b) minutes taken during research meetings, and (c) written records of issues discussed during the interventions. The data were analyzed using content analysis.Results: The issues were categorized into eight themes. The following six themes were identified among the survivors: (1) low computer literacy, (2) ambivalent attitudes towards study participation (e.g., joining the project to maintain a harmonious relationship with the gatekeepers versus lack of trust in the project), (3) reticence to share opinions and experiences, (4) struggles with family affairs (e.g., intergenerational cultural dissonance), (5) overvaluing Traditional Chinese Medicine, and (6) specific participants' preferences (e.g., language, font size, timing). Among the interventionists, the following two themes were identified: (1) recruitment and retention of interventionists and (2) language barriers.Conclusions: Culture-specific challenges need to be considered when designing and implementing an Internet-based coaching/support program for Chinese-American breast cancer survivors.

Anxiety Symptoms, Depressive Symptoms, and Traditional Chinese Medicine Use in U.S. Chinese Older Adults.

This study examined the association between anxiety symptoms, depressive symptoms, and Traditional Chinese Medicine (TCM) use among U.S. Chinese older adults. Data was obtained from the Population Study of Chinese Elderly in Chicago (N = 3157; mean age = 72.8). Anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS-A). Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9). TCM modalities included herbal products, acupuncture, massage therapy, Taichi, and other types of TCM. Although not significant, there was a trend indicating that higher levels of anxiety symptoms showed a higher rate of acupuncture use and massage therapy. Older Chinese Americans with depressive symptoms were more likely to use acupuncture and massage therapy; and they were less likely to use other TCM. Future research is needed to identify reasons for TCM use; and how these factors mediate or moderate the relationship between psychiatric symptoms and TCM use.

Utilization of healthcare services among Chinese migrants in Kenya: a qualitative study.

BACKGROUND: The number of Chinese migrants in Sub-Saharan Africa (SSA) is increasing, which is part of the south-south migration. The healthcare seeking challenges for Chinese migrants in Africa are different from local people and other global migrants. The aim of this study is to explore utilization of local health services and barriers to health services access among Chinese migrants in Kenya. METHODS: Thirteen in-depth interviews (IDIs) and six focus group discussions (FGDs) were conducted among Chinese migrants (n = 32) and healthcare-related stakeholders (n = 3) in Nairobi and Kisumu, Kenya. Data was collected, transcribed, translated, and analyzed for themes. RESULTS: Chinese migrants in Kenya preferred self-treatment by taking medicines from China. When ailments did not improve, they then sought care at clinics providing Traditional Chinese Medicine (TCM) or received treatment at Kenyan private healthcare facilities. Returning to China for care was also an option depending on the perceived severity of disease. The main supply-side barriers to local healthcare utilization by Chinese migrants were language and lack of health insurance. The main demand-side barriers included ignorance of available healthcare services and distrust of local medical care. CONCLUSIONS: Providing information on quality healthcare services in Kenya, which includes Chinese language translation assistance, may improve utilization of local healthcare facilities by Chinese migrants in the country.