Ethanol (0.4 to 0.8 g/kg in 30 minutes) was given by mouth to 102 healthy young volunteers (37 Caucasian men, 21 Caucasian women, 20 Chinese men and 24 Ojibwa men). Venous blood concentrations of ethanol and acetaldehyde 60, 90, 120 and 150 minutes after the end of drinking were measured by gas chromatography. The calculated rates of ethanol metabolism in the Caucasian men and women did not differ, but the overall group means for subgroups of Caucasians (103.6 mg/kg-h), Chinese (136.6 mg/kg-h) and Ojibwa (182.7 mg/kg-h) with decreasing postabsorption values differed significantly from each other. Mean acetaldehyde values paralleled the rates of ethanol metabolism: Ojibwa, 14.6 mug/ml; Chinese, 10.0 mug/ml; and Caucasians, 9.4 mug/ml. The high rate of ethanol metabolism in Amerind subjects differs from previous findings. Habitual level of alcohol consumption, proportion of body fat and genetic factors appear to account for most of the group differences.
To identify and describe barriers to access to mental health services encountered by ethnoracial seniors.
A multiracial, multicultural, and multidisciplinary team including a community workgroup worked in partnership with seniors, families, and service providers in urban Toronto Chinese and Tamil communities to develop a broad, stratified sample of participants and to guide the study. This participatory, action-research project used qualitative methodology based on grounded theory to generate areas of inquiry. Each of 17 focus groups applied the same semistructured format and sequence of inquiry.
Key barriers to adequate care include inadequate numbers of trained and acceptable mental health workers, especially psychiatrists; limited awareness of mental disorders among all participants: limited understanding and capacity to negotiate the current system because of systemic barriers and lack of information; disturbance of family support structures; decline in individual self-worth; reliance on ethnospecific social agencies that are not designed or funded for formal mental health care; lack of services that combine ethnoracial, geriatric, and psychiatric care; inadequacy and unacceptability of interpreter services; reluctance of seniors and families to acknowledge mental health problems for fear of rejection and stigma; lack of appropriate professional responses; and inappropriate referral patterns.
There is a clear need for more mental health workers from ethnic backgrounds, especially appropriately trained psychiatrists, and for upgrading the mental health service capacity of frontline agencies through training and core funding. Active community education programs are necessary to counter stigma and improve knowledge of mental disorders and available services. Mainstream services require acceptable and appropriate entry points. Mental health services need to be flexible enough to serve changing populations and to include services specific to ethnic groups, such as providing comprehensive care for seniors.
The SARS outbreak in Toronto was a public health crisis. It was particularly frightening to the Chinese-Canadians, because of the origin of the deadly disease. The Chinese-Canadian community organizations launched various activities to help the Chinese-Canadians as well as other Asian-Canadian communities to fight against SARS and its social side-effects. From launching the SARS Supporting Line, distributing health promotional material, disseminating SARS related information, paying tribute to frontline health workers, and promoting local business, to fundraising for SARS related research; they played an active role in easing the public's anxiety, especially for the Chinese-Canadians in the great Toronto area. The culturally diverse population brought problems as well as solutions. Ethnic groups have expertise in almost all areas, including people with leadership skills. The Toronto Chinese community's experience in combating SARS is a good example. The Chinese-Canadian community organizations' activities during the SARS outbreak demonstrate that ethnic minority organizations can play an important role in public health, especially in a public health crisis, and beyond.
Racial and ethnic disparities in breast cancer incidence, stage at diagnosis, survival and mortality are well documented; but few studies have reported on disparities in breast cancer treatment. This paper compares the treatment received by breast cancer patients in British Columbia (BC) for three ethnic groups and three time periods. Values for breast cancer treatments received in the BC general population are provided for reference.
Information on patients, tumour characteristics and treatment was obtained from BC Cancer Registry (BCCR) and BC Cancer Agency (BCCA) records. Treatment among ethnic groups was analyzed by stage at diagnosis and time period at diagnosis. Differences among the three ethnic groups were tested using chi-square tests, Fisher exact tests and a multivariate logistic model.
There was no significant difference in overall surgery use for stage I and II disease between the ethnic groups, however there were significant differences when surgery with and without radiation were considered separately. These differences did not change significantly with time. Treatment with chemotherapy and hormone therapy did not differ among the minority groups.
The description of treatment differences is the first step to guiding interventions that reduce ethnic disparities. Specific studies need to examine reasons for the observed differences and the influence of culture and beliefs.
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Tuvans are mainly distributed in Siberia (the Republic of Tuva), Mongolia, and China. The genetic origin of Chinese Tuvans remains controversial. The Tuvans in China were classified as Mongolians in the early 1950s by the National Ethnic Affairs Commission of China, but they defined themselves as a separate group. To resolve this dispute and determine their genetic relationships with the peoples in Central Asia, we randomly selected 150 male subjects from the Tuvans in the Altai region of Xinjiang Uygur Autonomous Region in China. Fourteen Y chromosomal markers were genotyped using the RFLP method or direct sequencing. These haplogroup data were combined with public data for 15 populations in South Siberia and Central Asia. Tuvans in both China and the Republic of Tuva had the highest frequencies of haplogroups K-M9 and Q-M242. Principal component analysis demonstrated that the Tuvans in China were of a distinct cluster, separated from their neighbors, the Mongolians and Kazakhs, which finding was consistent with the Analysis of Molecular Variances. Further population tree analysis revealed that Tuvans were on a far-separated cluster from their neighbors. Based on these results, we propose that the Tuvans (in both China and the Republic of Tuva) constitute a group distinct from Mongolians and from other Central Asia populations. However, the genetic results might be the consequence of some evolutionary forces like genetic drift and founder effect, and do not necessarily reflect their ultimate origin.
To better understand the dental health care pathways of Montreal-based Chinese immigrants.
An ethnographic study based on 12 in-depth semi-structured qualitative interviews was conducted among low-income Chinese immigrants in Montreal, Canada, from January to June 2005. Data about their dental health care-seeking pathways, barriers to the use of professional dental health care services and attitudes to dental health care were collected and coded, and resulting themes analyzed.
Dental health care pathways include self-treatment and consulting a dentist in Canada or during a return visit to China. The pathways vary, depending on the circumstances. For dental caries and other acute dental diseases such as toothache, Chinese immigrants preferred to consult a dentist. For chronic diseases, some of them relied on self-treatment. Financial problems, and language and cultural barriers were the main factors that affected Chinese immigrants' access to dental care services in Canada.
Understanding immigrants' dental health care pathways can help dental health care providers supply culturally competent services and help policy makers devise preventive dental health care programs to suit community needs and cultural contexts.
The authors have undertaken a series of grounded theory studies to describe and explain how ethnocultural affiliation and gender influence the process that cardiac patients undergo when faced with making behavior changes associated with reducing their cardiovascular disease (CVD) risk. Data were collected through audiorecorded semistructured interviews (using an interpreter as necessary), and the authors analyzed the data using constant comparative methods. The core variable that emerged through the series of studies was "meeting the challenge." Here, the authors describe the findings from a sample of Chinese immigrants (10 men, 5 women) to Canada. The process of managing CVD risk for the Chinese immigrants was characterized by their extraordinary diligence in seeking multiple sources of information to enable them to manage their health.
The dentofacial morphology of Chinese is different from Caucasians. The purpose of this investigation was to assess the skeletal and dental changes contributing to the sagittal correction in group of consecutive Chinese children who were treated with the Herbst appliance. A comparison was made between 14 Chinese and 14 Swedish subjects who all had Herbst appliance treatment. All subjects were corrected from the Class II division 1 malocclusion to an overcorrected Class I or Class III dental relationship within a 6-8 month period. Lateral cephalograms taken before and immediately after the Herbst treatment were analysed. In general, the skeletal and dental changes during treatment were comparable between both ethnic groups. However, individual variations within the two groups were wide. It can be concluded that the Herbst appliance was equally successful in Southern Chinese children and similar treatment changes as those achieved in Swedish children could be found.
Measures of perceived health status may be vulnerable to ethnic and sociodemographic characteristics. The purpose of this study was to compare self-reported health status in Chinese and whites using 3 measures: physical and mental health status with the 5-point Likert-type scale, the EQ-5D together with a modified health index scale (0-100), and number of chronic conditions.
A cross-sectional telephone survey of Chinese and white Canadians was conducted in a large city in Alberta, Canada.
We analyzed 830 Chinese and 789 white respondents. Chinese, compared with whites, reported better health status using the EQ-5D health index (0.94 vs. 0.86) and had fewer chronic conditions surveyed (51.9% vs. 79.2% had one or more conditions). However, Chinese rated their health status fair or poor more often than whites (27.3% vs. 9.7% for physical health and 24.0% vs. 5.0% for mental health) and both groups rated similarly on the health index scale (80.0 for Chinese vs. 77.9 for white).
Health status measurements performed inconsistently across ethnic populations. The EQ-5D health index was consistent with the number of chronic conditions, whereas results from the 5-point Likert-type scale and the health index scale were not consistent with the number of chronic conditions. Perceived health status differed by the measures used and ethnicity.
ABSTRACTOBJECTIVEThis study aimed to describe the level of complementary and alternative medicine (CAM) use and the factors associated with CAM use among Chinese and white Canadians.DESIGNA cross-sectional telephone survey conducted in English, Cantonese, and Mandarin.SETTINGCalgary, Alta.PARTICIPANTSChinese and white residents of Calgary aged 18 or older.MAIN OUTCOME MEASURESRates of use of 11 CAM therapies, particularly herbal therapy, massage, chiropractic care, and acupuncture; reasons for use of CAM therapies.RESULTSSixty percent of 835 Chinese respondents (95% confidence interval [CI] 56.5% to 63.2%) and 59% of 802 white respondents (95% CI 55.1% to 62.0%) had used CAM in the past year. Chinese respondents were more likely to use herbal therapy than white respondents were (48.7% vs 33.7%, P