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PubMed2000

Smoking among ethnic Chinese patients and their recall of quit advice by Chinese-speaking general practitioners in Sydney.

OBJECTIVES: To collect smoking-related data from Chinese patients attending Chinese-speaking general practitioners (CSGPs), including self-reported smoking status, recall of a question about smoking status during the previous six months by their GP and, for smokers, their recall of quit advice in their most recent consultation. DESIGN: Descriptive research first involving self-administered waiting-room questionnaires and, afterwards, a second self-administered questionnaire to examine behaviour in that most recent consultation. SETTING: Surgeries of 24 CSGPs in Central Sydney. SUBJECTS: 1084 Chinese patients aged 18-70 years. RESULTS: Self-reported smoking prevalence was 25% (95% CI: 21%-29%) for men and 4% (95% CI: 2%-5%) for women. Of 103 smokers who had visited their regular GP during the previous 6 months, 42% recalled a question about smoking status and 38% quit advice. As elicited at follow-up, 72% recalled any discussion in their most recent consultation about smoking although effective techniques were rarely recalled. Patient's sex (OR: 1.78; 95% CI: 1.28-2.47) and smoking status (OR: 1.39; 2.38; 95% CI: 0.85-2.25, 1.49-3.81) independently predicted a question about smoking status. Among smokers, marital status was the only independent predictor of quit advice. As assessed by a stage-of-change scale, significantly more Chinese smokers were not ready to contemplate cessation, compared with Angio-Celtic community survey results. CONCLUSIONS: Our study provides unique information about smoking among ethnic Chinese patients attending CSGPs. Findings also suggest CSGPs need greater support to maximize their clinical opportunities to advise Chinese smokers to quit.

Adult↗

PubMed1998

Genetic heterogeneity for familial hypertrophic cardiomyopathy in Chinese: analysis of six Chinese kindreds.

OBJECTIVE: Familial hypertrophic cardiomyopathy (FHCM) is a primary myocardial disease characterized by unexplained ventricular hypertrophy. The application of the techniques of reverse genetics has identified at least five chromosomal loci as the major causes for FHCM in diverse ethnic populations, suggesting substantial genetic heterogeneity for FHCM. Recently, the defective gene loci of two Chinese families with FHCM have been mapped to chromosome 11 and 14q1, respectively. For further understanding of the molecular basis of FHCM in Chinese, we analyzed the linkage between four other Chinese kindreds and DNA markers from chromosome 14q1. METHODS: Six unrelated Chinese families with FHCM, including two previously reported, were studied. Totally 90 family members were included for analysis. DNA from 80 individuals was extracted and polymerase chain reactions were performed using the primers designed according to the sequences derived from the alpha and beta myosin heavy chain gene. Totally four polymorphisms were studied, including three polymorphic microsatellite sequences and one single strand conformation polymorphism. Genetic linkage analysis were performed using the Linkage program. RESULTS: In the six studied families, 39 of the 90 family members were found to be affected diagnosed either by echocardiography or by clinical evaluation. The pattern of inheritance in all six studied families was most consistent with an autosomal dominant trait with a high degree of penetrance. Genetic linkage analysis using polymorphisms on the alpha and beta MHC genes showed a combined maximal lod score of 6.2 for trinucleotide repeat polymorphism AMHC-I 15 at theta = 0.00 for three studied families without recombination. Exclusion of linkage to the chromosome 14q1 location was noted in two of three other families with the maximal lod score of -2 or less. CONCLUSIONS: These results provide further evidence that FHCM in Chinese is genetically heterogeneous. Chromosome 14q1 locus, probably the beta myosin heavy chain gene, is important as the molecular basis for FHCM in Chinese.

Adolescent↗

PubMed2001

Parents' attitudes and expectations regarding science education: comparisons among American, Chinese-American, and Chinese families.

This study examined the differences in attitudes toward science education among American, Chinese-American, and Chinese parents and students. Parents' expectations for their high school children's science performance were also compared among the three cultural groups. It was found that both Chinese parents and students had more positive attitudes toward science education than did their American counterparts. Chinese parents placed greater emphasis on self-improvement, set higher standards, and more often helped their children to learn science than did American parents. The attitudes of the Chinese-Americans appeared to show the influences of both their Chinese heritage and American culture. Overall, a high positive correlation was found between parents' and students' attitudes toward science education.

Adolescent↗

PubMed1996

Chinese emigration to Europe: combining European and Chinese sources.

"Research into the history of Chinese immigration to Europe has so far basically been conducted on a country-by-country basis and normally restricted to national sources. In order to comprehend early Chinese immigration to Europe, however, a wider approach is necessary with the inclusion of Chinese sources and closer co-operation between Western and Chinese scholars.... This article contains a translation of a chapter in the Qingtian County Gazetteer as an example of the information on immigration that can be found in this kind of Chinese local sources. Finally, the information is discussed and, despite some problems concerning the origin and reliability of the Chinese sources, they are still found to provide European researchers with valuable historical information on the Qingtian phenomenon in European immigration history." (SUMMARY IN FRE AND SPA AND CHI)

Asia↗

PubMed2003

Attitudes of Hong Kong Chinese to traditional Chinese medicine and Western medicine: survey and cluster analysis.

OBJECTIVES: To determine whether within a cohort of Hong Kong out-patients definable subtypes exist based on their attitudes to traditional Chinese medicine and Western medicine. DESIGN: Data were collected using a structured questionnaire. SETTING: The sample of 503 subjects was recruited at two local outpatient clinics in Hong Kong. MAIN OUTCOME MEASURES: The study employs demographic variables, illness status, the Chinese-Western Medical Belief Scale, trust of physicians and subjects' preferences on consultation fees, attitude of health care professional, efficacy of service and waiting time during consultation. RESULTS: A cluster analysis yielded three clusters based on their attitudes towards traditional Chinese and Western medicine. One cluster, 24% of the sample, is noted for being older, poorer, more likely to be female and to have chronic conditions; they are sceptical of western physicians. The second cluster (63% of the sample) is younger and have considerably more belief in Western than traditional Chinese medicine. The third group (14%) is intermediate in age and is noted for a marked faith in both forms of medicine. CONCLUSIONS: A clear profile of these attitudes of Hong Kong Chinese may benefit health care professionals in making appropriate patient-doctor relationships and planning patient care.

Adolescent↗

PubMed1987

Integrating ancient and modern medicine in Chinese hospitals. The interaction among technology, traditional Chinese medicine, and health care.

Modern industrial society and its industrial processes can sometimes discourage the practice of traditional medicine. The existence and use of traditional Chinese medicine for several thousands of years indicates that it has sound elements. As has been true with features of other ancient, highly developed civilizations, the discipline of traditional Chinese medicine offers a valuable resource in the treatment and prevention of disease. Its scientific aspects and valuable experiences must continue to be developed according to Western scientific methodology. China has initiated a program to utilize modern industrialized technology in the integration of the traditional Chinese and modern Western medical systems. The policy and process aimed at integrating traditional Chinese medicine with Western medicine are presented in this paper. These measures have resulted in considerable utilization and development of the traditional Chinese medicine system, and have had a major impact on the development of public health care, as well as medical technology and science. The positive interactions between these fields of study and existing problems are discussed, and some comments on future expectations are presented.

China↗

PubMed2004

Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese Multi-Provincial Cohort Study.

CONTEXT: The Framingham Heart Study helped to establish tools to assess coronary heart disease (CHD) risk, but the homogeneous nature of the Framingham population prevents simple extrapolation to other populations. Recalibration of Framingham functions could permit various regions of the world to adapt Framingham tools to local populations. OBJECTIVE: To evaluate the performance of the Framingham CHD risk functions, directly and after recalibration, in a large Chinese population, compared with the performance of the functions derived from the Chinese Multi-provincial Cohort Study (CMCS). DESIGN, SETTING, AND PARTICIPANTS: The CMCS cohort included 30 121 Chinese adults aged 35 to 64 years at baseline. Participants were recruited from 11 provinces and were followed up for new CHD events from 1992 to 2002. Participants in the Framingham Heart Study were 5251 white US residents of Framingham, Mass, who were 30 to 74 years old at baseline in 1971 to 1974 and followed up for 12 years. MAIN OUTCOME MEASURES: "Hard" CHD (coronary death and myocardial infarction) was used as the end point in comparisons of risk factors (age, blood pressure, smoking, diabetes, total cholesterol, and high-density lipoprotein cholesterol [HDL-C]) as evaluated by the CMCS functions, original Framingham functions, and recalibrated Framingham functions. RESULTS: The CMCS cohort had 191 hard CHD events and 625 total deaths vs 273 CHD events and 293 deaths, respectively, for Framingham. For most risk factor categories, the relative risks for CHD were similar for Chinese and Framingham participants, with a few exceptions (ie, age, total cholesterol of 200-239 mg/dL [5.18-6.19 mmol/L], and HDL-C less than 35 mg/dL [0.91 mmol/L] in men; smoking in women). The discrimination using the Framingham functions in the CMCS cohort was similar to the CMCS functions: the area under the receiver operating characteristic curve was 0.705 for men and 0.742 for women using the Framingham functions vs 0.736 for men and 0.759 for women using the CMCS functions. However, the original Framingham functions systematically overestimated the absolute CHD risk in the CMCS cohort. For example, in the 10th risk decile in men, the predicted rate of CHD death was 20% vs an actual rate of 3%. Recalibration of the Framingham functions using the mean values of risk factors and mean CHD incidence rates of the CMCS cohort substantially improved the performance of the Framingham functions in the CMCS cohort. CONCLUSIONS: The original Framingham functions overestimated the risk of CHD for CMCS participants. Recalibration of the Framingham functions improved the estimates and demonstrated that the Framingham model is useful in the Chinese population. For regions that have no established cohort, recalibration using CHD rates and risk factors may be an effective method to develop CHD risk prediction algorithms suited for local practice.

Adult↗

PubMed1994

Cancer mortality in Chinese immigrants to New York City. Comparison with Chinese in Tianjin and with United States-born whites.

BACKGROUND: Cancer rates in immigrant populations are frequently found to be intermediate between the country of origin and the adopted country. Such observations play an important role in establishing the environmental origin of cancer. Chinese now constitute the third largest group immigrating to New York City. METHODS: Cancer deaths in New York City (1986-90) among 706 male and 412 female foreign-born Chinese were compared using proportional cancer mortality ratios (PCMR) with Chinese who died of cancer in Tianjin, China (19,461 deaths, 1983-87), and with United States-born whites in New York City (32,293 deaths). RESULTS: Cancer sites were divided into those for which the age-adjusted PCMR were significantly higher in Tianjin Chinese (TC) compared with New York City whites (NYW), and those for which PCMR were significantly lower in TC compared with NYW. PCMR for Chinese immigrants usually fell between those of TC and NYW, but some were closer to those of TC (e.g., liver, gallbladder, female lung) whereas other sites were closer to those of NYW (e.g., esophagus, colon, rectum). CONCLUSIONS: These data provide additional support for the concept that much cancer originates with and can be modified by environmental factors.

China↗

PubMed2001

Development of scales to measure dietary acculturation among Chinese-Americans and Chinese-Canadians.

OBJECTIVE: To develop simple scales to measure a Chinese immigrant's adoption of Western eating patterns (dietary acculturation). STUDY DESIGN AND PARTICIPANTS: Data are from 244 less-acculturated women of Chinese ethnicity living in Seattle, Wash, and Vancouver, British Columbia, Canada. Interviewers collected information on sociodemographic characteristics, acculturation indices, items that reflect Western and Chinese dietary behavior, and consumption of fruits, vegetables, and fat. STATISTICAL ANALYSES: Analysis of variance and linear regression analyses examined associations among dietary measures and acculturation variables, controlling for age, education, and city of residence. RESULTS: We developed 2 scales to assess dietary acculturation: the Western Dietary Acculturation Scale and the Chinese Dietary Acculturation Scale, measuring Western and Chinese eating behavior, respectively. Although the population in this study was a less-acculturated sample, most participants reported some Western dietary practices, such as drinking milk (78%), eating cheese (78%), eating at Western fast-food restaurants (56%), and eating between meals (72%). Younger, highly educated women employed outside the home had the highest Western dietary acculturation scores (P < .001). Women with high scores on the Western scale reported higher-fat dietary behaviors and had increased fruit and vegetable intake since immigration compared to those with lower scores (P < .001). There was good agreement between the dietary acculturation scales and traditional acculturation indicators (P < .001). APPLICATIONS: Nutrition programs for immigrant/minority groups may be more effective if they are tailored to level of dietary acculturation. Therefore, the ability to accurately assess dietary acculturation is an important component of nutrition education, interventions, and counseling in these populations.

Acculturation↗

PubMed2000

Pain response in Chinese and non-Chinese Canadian infants: is there a difference?

This study was designed to compare the behavioural pain responses of 2-month-old Canadian-born Chinese babies receiving a routine immunization to those of non-Chinese infants in similar situations. Two groups of 26 infants were obtained from a pediatric clinic held by a Chinese pediatrician and a suburban pediatric practice of a large Canadian city. Facial expression using the Neonatal Facial Coding System (Grunau, R.V.E., Craig, K.D., 1987. Pain expression in neonates: facial action and cry. Pain, 28, 395-410.) and cry using the Fast Fourier Transform were measured during 30 s following the insertion of the needle. Acculturation in Chinese mothers, circadian rhythm, gender, height and weight in infants were assessed. Multivariate analysis of variance revealed significant differences in pain response between these two groups with the Chinese babies showing greater response. No significant effect of circadian rhythm and gender was identified. These results suggest the presence of differences in acute pain response in relation to culture by at least 2 months of age.

Adult↗

PubMed2006

Is the Chinese number-naming system transparent? Evidence from Chinese-English bilingual children.

Chinese-speaking children have been shown to have an advantage over English-speaking children in a variety of mathematical areas, including counting. One possible explanation for the advantage in counting is that the Chinese number-naming system is relatively transparent, compared to English, in that number names typically are directly indicative of base-10 structure (e.g., 12 is named "ten-two" rather than "twelve"). To determine whether the transparency of the Chinese number-naming system influences counting in bilingual children, we tested 25 Chinese-English bilingual children between the ages of 3 and 5 years, both in English and in Chinese. Children were asked to count as high as they could (abstract counting) and also to count objects in small, medium, and large arrays (object counting). No evidence was found for transparency or for transfer from one language to the other. Instead, relative proficiency in the two languages influenced counting skill. These results are discussed in terms of linguistic and cultural variables that might account for cross-linguistic differences in counting.

Alberta↗

PubMed1999

Heterogeneity of HLA-DR2 haplotypes in Caucasoid Americans, African Americans, Chinese Americans, Native Americans and Xiamen Chinese.

HLA-DR, -DQ specificities were determined by PCR amplification with SSOP in 4560 individuals: Caucasoid Americans (CA), African Americans (AA), Chinese Americans (ChA), Native Americans (NA) and Xiamen Chinese (XC). DR2 subtypes were compared amongst the five ethnic populations. The DRB1*1501-DRB5*0101 haplotype was found to be the most frequent in all populations except African Americans, in which DRB1*1503-DRB5*0101 was the predominant haplotype, accounting for 65% of DR2 subtypes. In contrast to Caucasoid Americans, the DRB1*1602 is strongly associated with the DRB5*0101 allele in Chinese populations. The presence of DRB5*0203 and DRB1*1602-DRB5*0101 haplotypes in Chinese populations, especially in Xiamen Chinese, suggests that various DR2 haplotypes may be generated via multiple gene conversion events together with point mutations and reciprocal recombination. The strong DR and DQ associations are found in DRB1*1501/DQB1*0602 (66.22%) for CA, DRB1*1503/DQB1*0602 (56.58%) for AA, DRB1*1501/DQB1*0602 (30.20%) and DRB1*1602/DQB1*0502 (15.76%) for ChA, DRB1* 1501/DQB1*0602 (41.55%) and DRB1*1602/DQB1*0301 (40.25%) for NA, and DRB1*1501/DQB1*0602 (30.26%) and DRB1*1602/DQB1*0502 (25.81%) for XC.

Alleles↗

PubMed1997

A comparison of perinatal mortality between ethnic Chinese and ethnic whites: why the Chinese rate was lower.

OBJECTIVES: To confirm the observation that has been occasionally reported in the literature that perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and to assess the reasons for this lower perinatal mortality rate. METHODS: Secondary-analysis based on published data. RESULTS: This exercise demonstrates that the perinatal mortality rate was lower in ethnic Chinese than in ethnic whites. The birth weight distribution in ethnic Chinese was more favourable with reduced births at two extremes of the distribution, and the exposure to risk factors for perinatal death by their mothers was also lower. CONCLUSION: Perinatal mortality rate is lower in ethnic Chinese than in ethnic whites, and the lower perinatal mortality rate in ethnic Chinese is probably caused by their favourable birth weight distribution and lower exposure to risk factors of perinatal death by their mothers.

Adult↗

PubMed2006

Influence of traditional Chinese beliefs on cancer screening behaviour among Chinese-Australian women.

AIM: This paper reports a study exploring how traditional Chinese life philosophy, including fatalism, influences understanding of the concepts of health and illness, and the impact of these concepts on cancer screening behaviour. BACKGROUND: The language of risk is central to contemporary Western understanding of health and illness. Women aged over 50 years are considered at risk of developing breast cancer and are highly recommended to undergo regular mammographic screening. However, screening rates among Chinese women are consistently lower than for most other groups. METHODS: In-depth interviews, in Cantonese, were conducted with a convenience sample of 20 Chinese-Australian women, and the data analysed thematically, using case summaries, coding and matrix tables. The data were collected in 2001. FINDINGS: The findings revealed that when dealing with cancer prevention, Chinese-Australian women are heavily influenced by cultural traditions related to the life-cycle and disease prevention. Informants believed that contracting disease, including cancer, is inevitable and that there is no way to prevent it. Fatalism appears to be a significant barrier to their participation in cancer screening services. CONCLUSION: Our findings suggest that the effects of breast cancer screening and other health promotion programmes, which are general and do not take account of cultural variations may be compromised when it comes to cultural minorities. In the case of older Chinese-Australian women, breast cancer screening promotion programmes may overcome acceptance of fatalistic philosophy if they emphasize increased risk following immigration.

Aged↗

PubMed2005

Functional disabilities profile of chinese elderly people with Alzheimer's disease - a validation study on the chinese version of the disability assessment for dementia.

This study aimed to determine the validity and applicability of the Chinese version of the Disability Assessment for Dementia (CDAD) in the Chinese elderly population. The original English version was translated and modified to a 47-item scale to suit the societal and cultural background of the Chinese population. The CDAD was administered to 169 community-residing Chinese elderly people with Alzheimer's disease (AD) and demonstrated high internal consistency (Cronbach's alpha=0.91), excellent test-retest reliability (intraclass correlation, ICC=0.99) and excellent interrater reliability (ICC=0.98). The functional disabilities profile of the same sample was examined. The CDAD had a high negative correlation with the Global Deterioration Scale (GDS; Spearman's rho=-0.89, p<0.001). ANOVA and post hoc comparisons showed there were significant differences in the mean CDAD scores across different GDS stages. To study the construct validity, the CDAD was administered concurrently with several instruments. The Instrumental Activities of Daily Living subscore of the CDAD had a high correlation with the Instrumental Activities of Daily Living Scale (r=0.94,p<0.001), and the Activities of Daily Living subscore of the CDAD had a high correlation with the Modified Barthel Index (r=0.82, p<0.001). A moderate correlation (r=0.60, p<0.001) with the Cantonese version of the Mini Mental State Examination was also found. Analysis of the relationship with sociodemographic factors indicated that the CDAD was not correlated with gender and education, and that the correlation with age was low. The CDAD was shown to be a reliable and valid instrument in assessing the functional disabilities of community-residing elderly subjects with AD in the Chinese population.

Activities of Daily Living↗

PubMed2006

Higher median levels of free beta-hCG and PAPP-A in the first trimester of pregnancy in a Chinese ethnic group. Implication for first trimester combined screening for Down's syndrome in the Chinese population.

OBJECTIVE: To study the effect of ethnic Chinese on the medians of free beta-hCG and PAPP-A in the first trimester of pregnancy. METHODS: The data of 943 women undergoing first trimester combined screening for fetal Down syndrome were analysed to derive the Chinese-specific medians. The calculated risk of Down syndrome based on these Chinese-specific medians was compared with that based on the original algorithm of the Fetal Medicine Foundation (FMF). RESULTS: The maternal serum levels of multiples of median of free beta-hCG and PAPP-A were significantly higher among the Chinese than among the Caucasians. The weight-adjusted gestation-specific medians were developed. Without adjustment for ethnicity, the original FMF algorithm underestimated the risk of Down syndrome by a median of 1%. Adjustment by ethnicity increased the false-positive rate by 10% (from 5.3 to 5.9%). CONCLUSION: Ethnic Chinese have a significantly higher maternal serum level of free beta-hCG and PAPP-A in the first trimester, which could not be explained by differences in maternal weight. Adjustment for ethnicity may be necessary for these biochemical markers in a first trimester screening program.

Biomarkers↗

PubMed1988

Who seeks mental health care in China? Diagnoses of Chinese outpatients according to DSM-III criteria and the Chinese classification system.

The authors gave DSM-III diagnoses to 116 Chinese psychiatric outpatients in Shanghai and compared them with the diagnoses of the same patients made by a Chinese psychiatrist according to Chinese criteria. Affective disorders were the most common DSM-III diagnoses, accounting for 26.7% of the sample. A full range of psychopathology, including schizophrenia, organic mental disorders, adjustment disorders, anxiety disorders, and paranoid disorders, was seen. Some consistent differences in diagnosis by Chinese and Western standards, especially in the area of major depression, were found. The authors discuss the implications for interpreting psychiatric studies from China and for future cross-cultural research comparing U.S. and Chinese diagnoses.

Adult↗

PubMed2003

Validation assessment of the Chinese-version Chronic Ear Survey: a comparison between data from English and Chinese versions.

The Chronic Ear Survey (CES) is a valid, disease-specific measure for the evaluation of health status and treatment effectiveness for adults with chronic suppurative otitis media (CSOM). This study compares the validation properties of the English and Chinese versions of the CES. The CES was translated into Mandarin Chinese by means of a parallel model. The Chinese version of the CES (CCES) was administered to 103 patients in a prospective manner, then was validated according to established criteria for reliability, validity, and longitudinal sensitivity. The CCES demonstrated good test-retest reliability and internal consistency (Cronbach's a = 0.81). The CCES significantly correlated with the Mandarin Chinese (Taiwan) version of the generic 36-Item Short-Form Health Survey (TSF-36). The standardized response mean for the CCES total score was 2.1, indicating excellent sensitivity to clinical change. This validation study demonstrated that the performance characteristics of the CCES were equivalent to those of the English-version CES. The CCES is a valid tool for evaluation of adults with CSOM among the Chinese-speaking population.

Activities of Daily Living↗