Areca Nut Use among a Chinese Ethnic Minority, and Its Health Implications.

Objectives: Most of the world's areca nut users reside in south and southeast Asia, but research is scarce. We examine areca nut use among Dai, a Chinese ethnic minority, and its implications. Results: The history, common knowledge, traditional medical applications, social functions, and changing epidemiology of areca nut use are reviewed. Importantly, areca nut use is embedded in complex social meanings and practices, and is changing as long-standing customs are being shaped by new fashions. Its declining popularity among Dai has important implications for the management of substance misuse, as changing contextual factors such as customs and social norms have been more important than interventions or policies and laws. Conclusions/Importance: The findings contribute to future strategies to curb the consumption of areca nut, and also help to explain unsuccessful control in China of other substances such as tobacco which overlooked social context. It is imperative that health professionals and researchers engage with the culture, health beliefs, and society of specific populations to formulate culturally appropriate and innovative oral health strategies.

'A real man smells of tobacco smoke'--Chinese youth's interpretation of smoking imagery in film.

Previous studies have associated youth's exposure to filmic images of smoking with real-life smoking acquisition; initial research in low- and middle-income countries confirms this relationship. The present study in Yunnan, southwest China sought answers to the following questions: How do young people in China make sense of smoking imagery they have seen in film? How are these perceptions shaped by the cultural and social context of images? How do these understandings relate to real-life tobacco use? A study with focus groups and grounded theory was conducted in 2010 and 2011 (Sept-Jan) with middle-school students ages 12 and 13 (n=68, focus groups=12, schools=6). Films and media literacy were important means through which knowledge about smoking was constructed and communicated. Film representations of smoking concurred with Chinese social behaviour (Confucian social networks, face-making, and the notion of society as a harmonious social unit), and were interpreted as congruent with real-life smoking. This pattern, in turn, was intertwined with perceived gender identities of smokers, gender-specific social behaviour, and willingness of girls to explore issues of gender equity. These findings lend new insights into interaction between smoking imagery in film and Chinese youth's smoking beliefs. Tobacco control programs in China should consider young people's interpretations of smoking and the ways they are nested in cultural and social milieu.

Mental health nurses' experiences of schizophrenia rehabilitation in China and India: a preliminary study.

Nursing methods based on Western models may not be culturally relevant to patients from ethnic minority groups or other countries. In order to meet the needs of all patients, more research is needed to understand the cultural and social factors that influence nursing approaches. This paper reports preliminary open-ended discussions with mental health nurses in China and India in order to gain insights into the cultural and social issues that surround social rehabilitation of patients with schizophrenia. Rehabilitation methods included cognitive behavioural therapy, psychosocial methods, and employment/vocational training. Several cultural and social issues drive the rehabilitation process in both countries, including the use of traditional medicine and healers, emphasis on family involvement, stigma, gender inequality, and lack of resources. Participants in both countries were working hard to tackle some of these issues, but also expressed need for improved resources. The study provides an insight into the cultural and social factors that shape schizophrenia rehabilitation in China and India, and serves as a baseline for further research about nursing across cultures. The study also highlights the marked differences in attitudes, values, and behaviours across cultural groups that need to be considered by nursing professionals to ensure that services are culturally competent.