Integrative Nutritional Counseling Combining Chinese Medicine and Biomedicine for Chinese Americans with Type 2 Diabetes: A Mixed-Methods Feasibility Study.

Objectives: This study describes the development and feasibility of Integrative Nutritional Counseling (INC), a Chinese medicine (CM)+biomedicine-based nutrition curriculum for Chinese Americans with type 2 diabetes. Although Chinese Americans often incorporate CM principles into their diet, scant research has explored how to integrate CM with biomedical nutrition standards in a culturally appropriate manner or if such a program could improve diabetes self-management. Design: This is a 1-month pre-post study design including three points of contact: baseline, in-person class, and 1-month follow-up. Subjects: Participants (n = 15) were Cantonese-speaking/reading Chinese Americans diagnosed with type 2 diabetes who had used some form of CM/medicinal foods in the last 12 months. Interventions and Outcome Measures: The INC program included baseline surveys and a CM intake interview conducted by a licensed acupuncturist. The acupuncturist generated a CM diagnosis, which was shared with the participant, and used this diagnosis to tailor brief nutrition education. To bolster this brief education, a bilingual registered dietitian provided a 2-h group education class in Cantonese to all participants, during which time participants also received a Chinese/English INC booklet. Participants completed surveys immediately after the class and at 1-month follow-up, with qualitative exit interviews. Results: Participants reported improved attitudes and dietary habits aligning directly with INC, and improvement in biomedically valued measures of type 2 diabetes, such as weight loss, and CM-valued measures of digestion/elimination and hot/cold feeling. Satisfaction with INC was high, but challenges included confusion with some INC information, structural barriers, and comorbidities. Conclusions: Chinese Americans with type 2 diabetes and interventionists found integrative nutrition approaches acceptable and feasible. Future research should examine INC with a larger population and explore optimal delivery of INC given reported challenges.

Technologies of the Social: Family Constellation Therapy and the Remodeling of Relational Selfhood in China and Mexico.

In this article, we investigate how an increasingly popular therapeutic modality, family constellation therapy (FCT), functions simultaneously as a technology of the self (Foucault, Technologies of the self: a seminar with Michel Foucault, University of Massachusetts Press, Amherst, 1988) as well as what we here call a "technology of the social." In FCT, the self is understood as an assemblage of ancestral relationships that often creates problems in the present day. Healing this multi-generational self involves identifying and correcting hidden family dynamics in high-intensity group sessions where other participants represent the focus client and his/her family members, both alive and deceased. Drawing on ethnographic data collected in multiple FCT workshops in Beijing, China and Oaxaca City, Mexico, we show how FCT ritually reorganizes boundaries between self and other in novel ways, creating a collective space for shared moral reflection on troubling social, historical, and cultural patterns. By demonstrating the ways in which FCT unfolds as both a personal and social technology, this article contributes to ongoing conversations about how to effectively theorize sociality in therapeutic practice, and problematizes critical approaches emphasizing governmentality and commensuration (Mattingly, Moral laboratories family peril and the struggle for a good life, University of California Press, Oakland, 2014; Duncan, Transforming therapy: mental health practice and cultural change in Mexico, Vanderbilt University Press, Nashville, 2018; Matza, Shock therapy: psychology, precarity, and well-being in postsocialist Russia, Duke University Press, Durham, 2018; Pritzker, Presented at "Living Well in China" Conference, Irvine, CA, 2018; Mattingly, Anthropol Theory, 2019; Zigon, "HIV is God's Blessing": rehabilitating morality in neoliberal Russia, University of California Press, Berkeley, 2011).

Factors Affecting Definitions of and Approaches to Integrative Medicine: A Mixed Methods Study Examining China's Integrative Medicine Development.

Aim. This study identifies existing definitions and approaches among China's integrative medicine (IM) experts and examines relationships with key characteristics distinguishing individual experts. Methods. Snowball sampling was used to select 73 IM experts for semistructured interviews. In this mixed methods study, we first identified definitions and approaches through analyzing core statements. Four key factors, including age, education, practice type, and working environment, were then chosen to evaluate the associations with the definitions. Results. Four unique definitions were identified, including IM as a "new medicine" (D1), as a combination of western medicine (WM) and Chinese medicine (CM) (D2), as a modernization of CM (D3), and as a westernization of CM (D4). D4 was mostly supported by those working in WM organizations, while D3 was more prominent from individuals working in CM organizations (P = 0.00004). More than 64% clinicians had D2 while only 1 (5.9%) nonclinician had D2. Only 1 clinician (1.8%) had D4 while almost 30% nonclinicians had D4 (P = 0.0001). Among nonclinicians working in WM organizations, 83.3% of them had D4 (P = 0.001). Conclusion. Findings indicate that institutional structure and practice type are factors affecting IM approaches. These results carry implications for the ways in which western countries move forward with the definition and implementation of IM.

Introducing considerations in the Translation of Chinese Medicine.

This article introduces the document, Considerations in the Translation of Chinese Medicine, published in PDF form online in both Chinese and English. This 20-page document includes several sections describing why the Considerations is necessary, the specificity of texts in Chinese medicine; the history of translation in Chinese medicine; who constitutes an ideal translator of Chinese medicine; what types of language exist in Chinese medicine; and specific issues in the translation of Chinese medicine, such as domestication versus foreignization, technical terminology, period-specific language, style, polysemy, and etymological translation. The final section offers a brief advisory for consumers, and concludes with a call to further discussion, and action, specifically in the development of international collaborative efforts towards the creation of more rigorous guidelines for the translation of Chinese medicine. The current article provides an overview of several of these sections, and includes links to the original document.

Building an Evidence-Base for TCM and Integrative East-West Medicine: A Review of Recent Developments in Innovative Research Design.

There are many challenges to developing an evidence base for Traditional Chinese Medicine and Integrative East-West Medicine. This article offers a review of these challenges alongside an introduction and review of several innovations in healthcare research that have successfully been applied to the study of Traditional Chinese Medicine and Integrative Medicine. Such innovations include developments in Whole Systems Research, Comparative Effectiveness Research, Health Services Research, and qualitative Social Sciences Research. Each of these approaches expands upon conventional approaches to clinical research and can also be combined with clinical trial data to yield a mixed-methods approach. We conclude with a commentary on the necessity for such mixed methods studies in the continued establishment of an evidence base for TCM and IM.

Assessing depressive symptoms in persons who die of suicide in mainland China.

BACKGROUND: The potential insensitivity to depression of translated diagnostic instruments makes it difficult to assess the relationship of depressive symptoms to suicide in non-Western cultures. METHODS: Addition of culturally sensitive probes and other modifications were made to the depression section of the Chinese version of the SCID; the standard SCID probes and the expanded-probes are separately used to assess each symptom of depression, the resultant diagnoses and the overall severity of depression. This modified SCID was included in the psychological autopsy interviews with family members and, separately, close associates of 887 suicides and 721 non-suicidal decedents from 23 regions of mainland China. RESULTS: Compared to the standard interview, the expanded-probe method increased reported prevalence of major depressive episode among suicide decedents from 26.4% (234/887) to 40.2% (357/887) and for other deaths from 1.0% (7/721) to 2.1% (15/701). The additional 131 cases identified using the expanded-probe method had substantial social impairment and a greatly elevated risk of suicide compared to those with no depressive symptoms (OR=37.0, 95% CI=17.6-77.6). Inter-observer reliability for major depressive episode between the two independent interviews was greater for the expanded probe method (ICC=0.77 vs. 0.67, P<0.001). For both interview methods there was a strong dose-response relationship between suicide risk and the number and severity of depressive symptoms. LIMITATIONS: This study uses proxy informants to obtain information about the psychological status of deceased subjects; the value of this expanded-probe method for the diagnosis of depression in non-Western cultures needs to be confirmed with living subjects. CONCLUSIONS: Adding culture-appropriate probes about depressive symptoms to standardized diagnostic instruments identifies many Chinese subjects with unrecognized depression. Dimensional measures of depressive symptoms are more powerful predictors of suicide risk than categorical diagnoses.

[Investigation on bei die.]

Overseas doctors hold that depression has the symptom of "inappropriate guilt" and TCM has no discussions and treatment on it. This article discusses the origin and development, etiology and pathogenesis, therapeutic principles, prescription of Bei Die, revealing that TCM has had quite comprehensive record on the symptoms and treatment of "inappropriate guilt."