Utilization of Traditional Complementary and Alternative Medicine Across Ethnically Diverse Asian Americans.

We conducted an analysis to identify factors influencing the use of traditional complementary and alternative medicine (TCAM), with a particular emphasis on ethnic variations. Using the 2015 Asian American Quality of Life survey (N = 2,609), logistic regression analyses were performed, considering acculturation, health status, healthcare accessibility/utilization, and socio-demographic factors. Ethnicity, specifically being Chinese or Korean Americans, having chronic medical conditions, experiencing unmet healthcare needs, and having regular check-ups were significant predictors of TCAM use among Asian Americans as a whole. However, when we delved into sub-ethnic groups, different patterns were found. Among Vietnamese and Filipino Americans, having unmet healthcare needs emerged as the most prominent predictor of TCAM use. Furthermore, acculturation level and English proficiency were significant in predicting Vietnamese and Filipino Americans' TCAM use, with the direction varying by sub-ethnicity. Being old emerged as a predictor of TCAM use for Chinese, Indian, Korean, and 'other' Americans. Our findings underscore the importance of adopting an ethnically sensitive approach when addressing the healthcare needs of diverse Asian American populations.

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.

Exploring the Prevalence of Clozapine Phenotypic Poor Metabolizers in 4 Asian Samples: They Ranged Between 2% and 13.

PURPOSE/BACKGROUND: Clozapine clearance is influenced by sex, smoking status, ethnicity, coprescription of inducers or inhibitors, obesity, and inflammation. In 126 Beijing inpatients, we measured repeated trough steady-state serum concentrations and identified 4% (5/126) who were phenotypical poor metabolizers (PMs); none were ultrarapid metabolizers (UMs). They were defined as being 2 SDs beyond the means of total clozapine concentration/dose ratios stratified by sex and smoking. Using this definition, this study explores the prevalence of PMs and UMs using data from 4 already published Asian samples. Three samples were East Asian (Beijing 2, Taipei, and Seoul); one was from South India (Vellore). FINDINGS/RESULTS: The prevalence of phenotypical PMs ranged from 2% to 13%, but inflammation was not excluded. The prevalence was 7% (14/191) for Beijing 2, 11% (8/70) for Taipei, 13% (9/67) for Seoul, and 2% (2/101) for the Vellore sample. Five phenotypic PMs appeared to be associated with extreme obesity. Phenotypic UM prevalence ranged from 0% to 1.6% but may be partly explained by lack of adherence. A Vellore phenotypic UM appeared to be associated with induction through high coffee intake. IMPLICATIONS/CONCLUSIONS: Approximately 10% of Asians may be clozapine PMs and may need only 50 to 150 mg/d to get therapeutic concentrations. Future studies combining gene sequencing for new alleles with repeated concentrations and careful control of confounders including inhibitors, inflammation, and obesity should provide better estimations of the prevalence of phenotypic clozapine PMs across races. Clozapine UM studies require excluding potent inducers, careful supervision of compliance in inpatient settings, and multiple serum concentrations.

Evaluation of human electroencephalogram change for sensory effects of fragrance.

BACKGROUND: The stabilizing effect of lavender and the arousal effect of peppermint essential oils are acknowledged and used widely in aromatherapy and the cosmetics industry. However, no evaluation method confirms the effects of essential oils through quantitative and objective electroencephalogram (EEG) results; instead, only a psychological and subjective method exists. Therefore, this study aims to create a new emotional cosmetic evaluation paradigm using EEG values. Moreover, it enables quantitative interpretation of the results in addition to the subjective survey outcomes. METHODS: For this study, 12 healthy female Korean participants were recruited and three fragrances were used. The EEG results were collected for 3 minutes (1 minute each before, during, and after inhalation of every fragrance). RESULTS: The quantitative EEG outcomes indicate changes in the participant's brainwaves before and after inhalation. Significant changes in the EEG were observed. Based on the results, the effects of fragrances were confirmed to be stabilizing for lavender, and arousing for peppermint and coffee aroma. Furthermore, the subjective questionnaire results indicate similar tendency as that of the quantitative EEG results. CONCLUSION: In addition to psychological and subjective assessments, our emotional evaluation method can verify the cosmetic fragrance effects through quantitative and objective results.

The Effects of Religious Participation and Familial Assistance on Mental Health among Older Chinese and Korean Immigrants: Multiple Mediator Analyses.

Older Asian immigrants are one of the fastest growing segments of the U.S. population and a growing number of them reside in non-traditional destination cities. However, there is a paucity of research on older Asian immigrants living in these non-traditional destination cities, and how this residential choice impacts their stress and mental health. In the current study, we examined how stressors and social support contribute to the overall mental health of older Asian immigrants who lack access to culturally responsive formal social support services. Using a convenience sample of older Chinese (n = 120) and Korean (n = 118) immigrants living in Arizona, we conducted multiple mediator analyses, focusing specifically on how ethnicity would differentially influence mediating effects of religious participation and familial assistance in the relationships between physical/acculturative stressors and mental health outcomes. The results showed that among older Chinese immigrants, religious participation significantly mediated the relationships between both physical/acculturative stressors and mental health, while there was no significant mediation effect detected among older Korean immigrants. Although Asian Americans are often perceived as a monolithic homogeneous group, the multiple mediator models suggest significant differences in the use of cultural/information resources in coping with life stressors and their impact on mental health outcomes between the older Chinese and Korean immigrants in our study. The study findings suggest a need for developing and strengthening formal social services in non-traditional destination cities that are culturally and linguistically responsive to those older Asian immigrants.

The Role of Religiousness/Spirituality and Social Networks in Predicting Depressive Symptoms among Older Korean Americans.

This study (1) examined the effects of religiousness/spirituality and social networks as predictors of depressive symptoms in older Korean Americans and (2) compared the best predictors of depressive symptoms. A cross-sectional survey was conducted with 200 older Korean Americans residing in the New York City area in 2009. Best-subsets regression analyses were used to evaluate the best predictors of depressive symptoms. Nearly 30% of older Korean participants reported mild or severe depressive symptoms. The best model fit for depressive symptoms involved four predictors: physical health status, religious/spiritual coping skills, social networks, and annual household income. Social networks and religious/spiritual coping skills contributed significantly to the variance of depressive symptoms. Adding additional variables to the model did not enhance predictive and descriptive power. Religiousness/spirituality and social networks are important for coping with life stress and may be useful in developing effective health care strategies in the management of depression among older Korean Americans. Health education and intervention could be framed in ways that strengthen such coping resources for this population. Future research is needed to best guide prevention and intervention strategies.

Cultivating Medical Intentionality: The Phenomenology of Diagnostic Virtuosity in East Asian Medicine.

This study examines the perceptual basis of diagnostic virtuosity in East Asian medicine, combining Merleau-Ponty's phenomenology and an ethnographic investigation of Korean medicine in South Korea. A novice, being exposed to numerous clinical transactions during apprenticeship, organizes perceptual experience that occurs between him or herself and patients. In the process, the fledgling practitioner's body begins to set up a medically-tinged "intentionality" interconnecting his or her consciousness and medically significant qualities in patients. Diagnostic virtuosity is gained when the practitioner embodies a cultivated medical intentionality. In the process of becoming a practitioner imbued with virtuosity, this study focuses on the East Asian notion of "Image" that maximizes the body's perceptual capacity, and minimizes possible reductions by linguistic re-presentation. "Image" enables the practitioner to somatically conceptualize the core notions of East Asian medicine, such as Yin-Yang, and to use them as an embodied litmus as the practitioner's cultivated body instinctively conjures up medical notions at clinical encounters. In line with anthropological critiques of reductionist frameworks that congeal human existential and perceptual vitality within a "scientific" explanatory model, this article attempts to provide an example of various knowing and caring practices, institutionalized external to the culture of science.

Coffee Intake and Liver Enzyme Association in Korean Immigrants and Japanese: A Comprehensive Cross-Sectional Study.

OBJECTIVES: Significant inverse association between coffee intake and the levels of liver enzymes has been reported. We demonstrated higher prevalence of metabolic syndrome in Korean immigrants (KIs) than in indigenous Japanese (IJs). The aim of this study was to investigate whether the association between coffee intake and liver enzyme levels was different between the 2 ethnic groups. METHODS: This study is a cross-sectional study including a total of 966 subjects comprising KIs and IJs. The association between the quintiles of coffee intake and dichotomous values of liver enzymes was evaluated by logistic regression analysis in KIs, IJs, a high-risk group (current smokers or alcohol drinkers ≥45 g/day), and a low-risk group (non-smokers and alcohol drinkers <45 g/day). RESULTS: In KIs, a significant inverse association between coffee intake and serum aspartate aminotransferase (AST) levels was observed. In the IJs, a significant inverse association between coffee intake and serum alanine aminotransferase levels was observed. In the high-risk group, a significant inverse association between coffee intake and serum AST and gamma-glutamyltransferase levels was observed. CONCLUSION: No difference was observed between KIs and IJs regarding the association between coffee and liver enzymes. Coffee might inhibit hepatic damage by alcohol drinking and smoking.

Join or be excluded from biomedicine? JOINS and Post-colonial Korea.

This paper discusses re-emergence of Korean medicine(s) in the global context with a focus on a natural drug JOINS, a highly contentious drug regarding its legal status. By following through its life world, the paper contends that the drug is the embodiment of the postcolonial anxiety that crosses the intersections between the aspiring nation and globalizing strategies of the bio-pharmaceutical industry. JOINS is a natural drug prescribed to alleviate the symptoms of degenerative arthritis. SK Chemicals, Ltd., a giant domestic pharmaceutical company developed the drug by utilizing the knowledge of traditional pharmacopeia and put it on the market in 2001. In the domestic market, the drug is treated as a prescription drug, implying that Western medicine-trained doctors (as opposed to Korean medicine doctors) are entitled to prescribe drugs. It also indicates that the drug has undergone a series of lab tests such as toxicity, efficacy, and clinical trials in compliance with regulatory guidelines. However, the domestic standards are not rigorous enough to satisfy international standards, so that it is exported as a nutritional supplement abroad. The government, the pharmaceutical industry, and the Western medicine profession are happy with how the drug stands domestically and internationally. Rather, it is Korean doctors who try to disrupt the status quo and reclaim their rights to traditional knowledge, who have been alienated from the pharmaceuticalization of traditional knowledge. Thus, the JOINS tablet embodies the complex web of modern Korean society, professional interests, the pharmaceutical industry, and globalization.

Association between the awareness of osteoporosis and the quality of care for bone health among Korean women with osteoporosis.

BACKGROUND: The prevalence of osteoporosis is increasing and is a socio-economic burden worldwide. Although screening tests for osteoporosis in Korea are easily accessible, this condition remains undertreated. Evaluating post-diagnostic behavior changes may be helpful for improving the quality of care for bone health in osteoporotic patients. METHODS: After reviewing the Fourth Korean National Health and Nutrition Examination Survey 2008-2009, 1,114 women with osteoporosis aged >50 years were included in this cross-sectional study. Factors related to bone health were categorized into the following groups: (1) behavioral health (smoking, alcohol consumption, and physical activity); (2) measured factors (lean body mass [kg], appendicular skeletal muscle mass [kg], and serum vitamin D level [nmol/L]); and (3) nutritional factors (calcium intake, vitamin/mineral supplementation, and healthy supplementary food). Logistic regression analysis and analysis of covariance was conducted after adjusting for age, education, income, residential area, height, weight, and self-perceived health using a weighted method. RESULTS: Doctors diagnosed 39.5% of patients with osteoporosis, and these patients were compared with the control group. The awareness group, who had been diagnosed with osteoporosis by a doctor, had a lower proportion of smokers and higher serum vitamin D level than the control group, who had never been diagnosed with osteoporosis. No other associations were found for quality of bone health care variables. The awareness group had higher odds ratios of vitamin/mineral replacement and healthy supplementary food but no other differences were observed, indicating the patients' beliefs in bone health care do not follow the recommended clinical guidelines (e.g. higher physical activity, lower alcohol consumption). CONCLUSION: To improve the quality of care for bone health in osteoporotic patients, an initial step should be the development of post-diagnostic procedures such as patient counseling and education through a multi-team care approach.

Self-transcendence, spiritual perspective, and sense of purpose in family caregiving relationships: a mediated model of depression symptoms in Korean older adults.

OBJECTIVES: This study used structural equation modeling to test the mediated model of late-life depression to understand the mechanisms that account for the direct and indirect effects of spiritual variables and purpose in life on depression within the context of Korean family caregiving relationships. METHOD: A secondary analysis study design used data from a study that tested a theory of family interdependence of 157 Korean elder-family caregiver dyads in Seoul, Korea. RESULTS: Both caregivers' and elders' self-transcendence was positively related to their own sense of purpose in life. However, only elders' spiritual perspective was related to purpose in life. Also, elders' purpose in life was positively associated with caregivers' purpose in life. Furthermore, there was a strong negative relationship between elders' purpose in life and their depressive symptoms, but there was not a significant negative relationship between caregivers' purpose in life and elders' depressive symptoms. Last, elders' purpose in life mediated the negative effects of elders' self-transcendence and spiritual perspective and of caregivers' self-transcendence and purpose in life on elders' depression. CONCLUSION: The findings suggest that purpose in life for both the caregiver and elder played an important role in elders' depression. Self-transcendence also was related to decreased depression in elders. It is suggested that more attention be given to caregiver and elder purpose in life in developing interventions to reduce or avoid elder depression in Korean elders.

Stressors, coping resources, functioning, and role limitations among older korean immigrants: gender differences.

This study explored the differential impacts of stressors and coping resources on the functioning and roles of 246 older Korean immigrant men and women. Older Korean immigrant women were significantly more likely than men to have acculturation and socioeconomic stressors, physical/social functioning problems, and role limitations. English-language barriers and lack of transportation were significantly related to lower functioning and higher role limitations of older Korean women compared to those of older men. Providing social and health care services with bilingual and transportation services to older Korean immigrant women is recommended to increase their physical/social functioning and role performance.

Typology of religiosity/spirituality in relation to perceived health, depression, and life satisfaction among older Korean immigrants.

OBJECTIVES: The objectives of this study were (1) to identify distinct subtypes of older Korean immigrants based on their levels of religiosity/spirituality (R/S) and (2) to determine if the identified subtypes differed by demographic characteristics, perceived health, depression, and life satisfaction. METHOD: Factor mixture models were evaluated with a nonprobability sample of older Korean immigrants (N=200) residing in the New York City area in 2009 to classify typologies of R/S. Multiple regression was used to test the associations between the R/S subtypes and outcomes (perceived health, depression, and life satisfaction) while controlling for demographics. RESULTS: Two substantively distinct latent profiles were identified: normally religious/spiritual ('average R/S') and minimally religious/spiritual ('low R/S'). The average R/S subgroup (74.4%) showed higher means than those in the low R/S subgroup (25.6%) on all six R/S class indicators. Subtypes did not differ on age, education, income, marital status, living arrangements, or years in the USA. However, males were more likely than females to be 'average R/S.' The 'average R/S' subtype had significantly greater life satisfaction than their 'low R/S' counterpart. No differences between the two subtypes were found on perceived health or depression. CONCLUSION: Findings highlight the importance of the classifications of R/S for mental health outcomes, and they indicate that relationships among R/S, various demographic characteristics, and physical/mental health are complex. Future research should validate and refine this classification of R/S in order to help identify particular sources of health risks/behaviors, relevant treatments, and health-promoting interventions within homogenous subtypes of older Korean immigrants.

Health behavior changes following breast cancer treatment: a qualitative comparison among Chinese American, Korean American, and Mexican American survivors.

This study explored how Chinese American, Korean American, and Mexican American women modify their health behaviors following breast cancer treatment and identified motivators and barriers that influence their changes. An exploratory, descriptive, qualitative study was undertaken using six focus groups. Discussions were transcribed and translated for content analysis. Significant differences among the ethnic groups were noted in the following health behavior practices which were most commonly stated as changed behaviors after a breast cancer diagnosis: 1) eating habits, 2) physical activity, 3) alternative medicine, 4) sleeping, 5) social activity, 6) weight control, and 7) alcohol consumption. Family, financial concerns, environment, and religious faith were commonly mentioned as motivators of and/or barriers to changes in health behaviors. Findings provide insight into different perspectives related to changes in health behaviors by ethnicity, which is critical for developing culturally tailored behavioral interventions to improve underserved breast cancer survivors' quality of life and to reduce health disparities.

Prevalence, awareness, and treatment of osteoporosis among Korean women: The Fourth Korea National Health and Nutrition Examination Survey.

PURPOSE: This study aimed to assess the factors associated with the prevalence, awareness, and treatment of osteoporosis in a representative sample of Korean women. METHODS: Data were obtained from dual energy X-ray absorptiometry measurement of the lumbar vertebrae and femoral neck, and from a standardized questionnaire in 2870 Korean women aged 50years and older who participated in the Fourth Korea National Health and Nutrition Examination Survey 2008-2009. Osteoporosis was defined by World Health Organization T-score criteria, and awareness and treatment were defined by self-report of an osteoporosis diagnosis and self-report of current anti-osteoporotic medication use, respectively. We assessed the relationship between multiple risk factors and prevalence, awareness, and treatment. RESULTS: Osteoporosis was reported in 39.1% of Korean women. Among those with osteoporosis, only 37.5% were aware of their diagnosis and 23.5% received pharmacological treatment. Despite higher prevalence among respondents who were older, of lower body weight, calcium intake, physical activity, and education levels, the awareness and treatment rates of these groups were similar or lower than that of the low-risk controls in multivariate logistic regression models. Moreover, easily identifiable risk factors (e.g., history of fracture, falls, height loss, familial osteoporosis) were not associated with awareness and treatment. Participants who had undergone health screening in the previous 2years exhibited increased awareness and treatment rates independently of other demographic factors. CONCLUSIONS: Osteoporosis was highly prevalent in this Korean study but was underdiagnosed and undertreated. Routine health screenings could be an effective strategy to increase osteoporosis awareness and treatment.

Countercurrents from the West: "blue-eyed" Zen masters, Vipassana meditation, and Buddhist psychotherapy in contemporary Korea.

One surprising and yet relatively unknown aspect of contemporary Korean Buddhism is the significant influence of American and European Buddhism. Between 1989 and 2009, South Koreans witnessed well-educated "blue-eyed" monastic residents via the Korean media, and the emergence of new bestsellers by authors like Thich Nhat Hahn and Jack Kornfield, written initially for Western audiences but since translated into Korean. The new teachings from the West have inspired a sudden growth of interest in vipassana meditation as an "alternative" to Kanhwa Son practice, and the emergence of a new academic field: Buddhist psychotherapy. This new wave of transnational influence from the West has changed not only the way Koreans practice Buddhism but also how they perceive Buddhist history and their own identities. In addition, the perceived "prestige" of Buddhism in the West has provided a new rhetorical strategy to defend Buddhism against other religions, particularly Korean evangelical Christianity.

[The meaning of illness among Korean Americans with chronic hepatitis B].

PURPOSE: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. METHODS: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. RESULTS: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. CONCLUSION: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

The Meaning of Illness among Korean Americans with Chronic Hepatitis B

PURPOSE: This ethnography was done to explore the meaning of illness in Korean Americans with chronic hepatitis B. METHODS: The participants were 6 patients with chronic hepatitis B and 6 general informants who could provide relevant data. Data were collected from iterative fieldwork with ethnographic interviews within Korean communities in two cities in the United States. Data were analyzed using causal chain analysis developed by Wolcott. RESULTS: The analyses revealed three meanings for the illness: hidden disease, intentionally hidden disease, and inevitably hidden disease. The contexts of meaning of illness included characteristics of the illness, social stigma, structure of health care system and communication patterns and discourse between health care providers and clients. CONCLUSION: The meaning of illness was based on folk illness concepts and constructed in the sociocultural context. Folk etiology, pathology and interpretation of one's symptoms were factors influencing illness behavior. These findings could be a cornerstone for culture specific care for Korean Americans with chronic hepatitis B.

The effects of religiosity, spirituality, and social support on quality of life: a comparison between Korean American and Korean breast and gynecologic cancer survivors.

PURPOSE/OBJECTIVES: To examine the differences in religiosity, spirituality, and quality of life (QOL) between Korean American and Korean breast and gynecologic cancer survivors and investigate the effect of religiosity, spirituality, and social support on QOL. DESIGN: Cross-sectional design. SETTING: Participants were recruited from hospitals and community-based support groups in the areas of Southern California and Seoul, Korea. SAMPLE: 161 women diagnosed with breast and gynecologic cancer (110 Koreans and 51 Korean Americans). METHODS: Participants completed a mailed questionnaire. To identify the QOL outcomes, religiosity, spirituality, and social support, four standardized measures were used. MAIN RESEARCH VARIABLES: QOL outcomes, religiosity, spirituality, religious involvement, and social support. FINDINGS: Religiosity and spirituality were related to some QOL outcomes in different patterns in Korean American and Korean breast and gynecologic cancer survivors. The effect on QOL, however, was not strong after controlling for covariates. Social support partially mediated the effect of spirituality on QOL but only among the Korean American cancer survivors. CONCLUSIONS: The findings provide evidence that the effect of religiosity and spirituality on QOL varied between Korean American and Korean survivors. The mediating effect of social support between spirituality and QOL for Korean Americans also was demonstrated. IMPLICATIONS FOR NURSING: The results present nursing practice and research implications that religiosity, spirituality, and social support need to be considered in developing services for enhancing QOL of immigrant cancer survivors.