Dissertations / Theses on the topic 'Cooking, Chinese – Health aspects'

Cooking is a universal activity which all humans can relate to on some level. Historically, cooking has continued to connect people across cultures and time, simultaneously providing nutritive sustenance as well as socio- and psychological benefits. Medical and mental health practitioners only in recent years have utilized cooking in a therapeutic process, and most of those cooking activities available tend to focus on cooking from an occupational and nutrition-education stance. A gap in the literature pertaining to cooking and its therapeutic applications exists around the relational nature underlying the cooking process, especially as it pertains to couples. While marriage and family therapists have used a number of creative experiential modalities in therapy for years, such as art and music therapy, cooking has been especially underutilized in comparison, despite its therapeutic and relational applicability. Therefore, this study was conducted to offer a foundation for understanding how the interactions in a kitchen can highlight relational elements between people. Eight couples (16 participants) who have lived together for at least two years and who cook together often were interviewed in their homes. A constructivist grounded theory methodology was used for this study, and subsequent to data analysis, a three-part theory describing the relational components of couple’s cooking interactions emerged, called The Couple’s Cooking Triad. The theory is made up of Relationship Skills, Emotional Connections, and Languaging. Results from this study, organizing the complex interactions of couples in a kitchen, indicate further use by marriage and family therapists in an experiential therapeutic capacity.

Introduction: Dementia refers to impairments of memory and other cognitive functions with consequent decline in activities of daily living. Besides cognitive symptoms, demented patients can also exhibit behavioral and psychological symptoms of dementia (BPSD), which are stressors leading to family caregivers’ burden. Physical activity may give rise to benefits in cognitive function, and may reduce behavioral symptoms and caregivers’ burden. However, most previous studies were reported from Caucasian populations. There was no previous report on the relationship of physical activity in dementia patients on family caregiver’s burden in Hong Kong Chinese older adults. Objectives: The objective of this study was to investigate the associations of physical activity level with cognitive function, behavioral and psychological symptoms and caregivers’ burden in dementia patients in Hong Kong Chinese population. Method: This was a cross-sectional study. 201 dementia patients who were screened by the inclusion and exclusion criteria were recruited from the Geriatric Clinic in Queen Mary Hospital, Hong Kong, from May 2013 to August 2013. Social demographic information and comorbid diseases information were collected from all subjects. Subjects were then assessed with the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL), Physical Activity Scale for the Elderly (PASE), as well as Neuropsychiatric Inventory (NPI). Subjects’ family caregivers were assessed with Zarit Burden Interview (ZBI). Main outcome measures: The outcome measures for the cognitive function were the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). The outcome measures for BPSD and caregiver’s burden were the Neuropsychiatric Inventory (NPI) and Zarit Burden Interview (ZBI), respectively. Results: We screened a total of 239 subjects in the Geriatric Clinic of Queen Mary Hospital. 201 subjects (70 males and 131 females) were recruited. 38 participants were excluded according to the exclusion criteria. The score means (SD) of the recruited were: PASE =27.5 (23.9); ADCS-ADL=45.3 (14.5); MMSE=17.3 (5.4); MoCA=9.9 (5.3); NPI=9.5 (9.7); ZBI=33.3 (14.8). In bivariate analysis, the PASE score was significantly associated with the MMSE score (rho=0.259, p<0.001), the MoCA score (rho=0.311, p<0.001), the NPI score (rho=-0.225, p=0.001), and the ZBI score (rho=-0.253, p<0.001). In multivariate analyses, using general linear models, the PASE score was independently associated with the MMSE (F=5.57, p=0.001) and MoCA (F=7.10, p<0.001) scores, after adjusting for significant confounders in bivariate analyses (i.e. age, education and gender). The PASE was also independently associated with the NPI score (F=2.89, p=0.037). The PASE score was not an independent predictor of the ZBI score. However, the subjects’ ADCS-ADL score (F=15.65, p<0.001), and the NPI score (F=8.55, p=0.004) were independent predictors of the caregiver’s ZBI score.
published_or_final_version
Medical Sciences
Master
Master of Medical Sciences

Doctor of Philosophy
This study explores the health beliefs and preventive health behaviours of older Hong Kong Chinese people resident in Australia. Participation in physical activity was used as the case study. There were two frameworks used to shape the research. Because of their perceived influence on the health beliefs and practices of Hong Kong Chinese people, the traditional Chinese philosophies of Confucianism, Taoism, and Buddhism provided the philosophical framework. The Theory of Planned Behaviour provided a theoretical framework for understanding the target group's preventive health behaviour. Data was collected by means of in-depth interviews, participant observation and case study. Twenty-two informants were interviewed, their transcripts analysed, summarised and typologised, identifying six states of physical activity participation. Findings demonstrated that this target group possessed a holistic view of health, with food taking a special role in preventive care and self-treatment at times of illness. The Cantonese terms used to denote “physical activity” caused confusion among the target group. Most interpreted it as meaning deliberate planned body movement, strength-enhancing activities or exercise, although some did see it as including mundane daily activities and chores. Lack of time, no interest and laziness were reported as the main reasons for low participation in deliberate planned physical activity. Cultural, social and environmental determinants were the intrinsic and extrinsic factors influencing attitudes toward physical activity, as well as perceived social supports and perceived control over physical activity participation barriers. To a large extent, these interactive determinants of health were rooted in the three traditional Chinese philosophies mentioned above. The thesis concludes by arguing that rather than simply advocating activities designed for other populations, health promotion strategies and education need to create links to the traditions of this target group and also clarify their conception of physical activity.

This study critically engages with the concept of ‘recovery’ which has become a dominant discursive feature in the UK mental health policies. It asks ‘what people recover from’ through a case study of Chinese mental health service users in the UK. The dominant recovery approach under the dominant neo-liberal context tends to promote individualistic recovery strategies. It fails to address the structural inequalities that give rise to distress and mental ill health or place sufficient emphasis on the diversity of intersectional inequalities among service users that shape recovery journeys. To make visible what recovery means for ethnic minorities, Chinese mental health service users were chosen as the case study to explore how structural factors such as class, gender and ethnicity, contribute to their diverse recovery journeys. A synthesis of the Capabilities Approach and Intersectionality Analysis was developed as an alternative framework to shed light on the complex interplay of structure and agency in shaping recovery journeys. They were adapted as evaluation and analytic tools to reveal the social conditions that facilitate or hinder a meaningful recovery for Chinese mental health service users. Repeat in-depth life history interviews were carried out with twenty two Chinese people having received a psychiatric diagnosis, recruited from three cities in the England. Their recovery journeys were analysed thematically. Findings showed how the participants strove, sometimes cautiously, to retain and exercise agency to move from patienthood to personhood. Their journeys were shaped by social inequalities demonstrating that targeting social inequalities is essential for facilitating and nurturing meaningful recovery. Class, gender, ethnicity, ageism, and other forms of discrimination contributed to the diminishment or deprivation of capabilities, resulting in distress and mental ill health among the Chinese mental health service users in this study. The different ways that these inequalities intersected gave rise to the variations in what they needed to recover from and hence also the directions of their recovery journeys. The process of becoming a psychiatric patient can help develop capabilities for some but it could also result in a diminishment of other capabilities. While striving to rebuild a life they value, ableism and sanism intersect with other inequalities to constrain their life chances. While the way ‘hope’ was ‘adapted’ to limited perceived life chances and dominant ideologies of class, gender, and ethnicity could be capability diminishing and detrimental to nurturing their aspirations.

Colorectal cancer (CRC) is the second most common cancer in Hong Kong. While high-penetrance germline mutations account for up to 6% of cases, much of the variation in genetic risk may be attributable to multiple low-penetrance variants. Previous genome wide association studies (GWAS) have identified a number of CRC susceptibility alleles in Caucasian populations. Our GWAS investigated the association between genetic variants with CRC risk in the Han Chinese population in Hong Kong. In Stage I, genomic DNA samples from 455 female Chinese CRC subjects were genotyped using the Illumina 610 Quad SNP chip. Association analysis was performed on 439 cases and 771 general population female controls recruited for a study on bone mineral density. Population stratification was examined through principal components analysis using EIGENSTRAT version 2.0. From the association results, 46 SNPs (Group 1) were selected for follow-up replication (Stage II), together with 10 SNPs (Group 2) from previous GWAS studies. Genomic DNA samples from 3,571 Chinese subjects were genotyped using Sequenom MassARRAY system. Association analysis was performed on 1,505 cases and 1,452 controls. 5 SNPs (rs835378, rs2652007, rs2139273, rs2139273 and rs9286410) exceeded the genome-wide significance level in stage I, although none replicated in Stage 2, suggesting genotyping error. Results from stage II showed that the three most significant SNP were among those selected from the previous studies, yet their significance levels in Stage I were very weak . None of the SNPs selected from Stage I was significant at p<0.01 in Stage 2. Two composite scores of genetic susceptibility, one for each group of SNPs, were calculated in stage II genotype data, as the total number of high-risk alleles (according to the direction of effect in Stage I results or previous GWAS) present in an individual. Both composite scores were significantly associated with CRC risk in Stage 2 (Group 1, p=2.38 x 10-5, beta=0.046, SE=0.012; Group 2 p=1.06 x 10-7, beta=0.10, SE=0.019), suggesting that while we had insufficient power to confirm individual SNPs identified in our GWAS and the previous GWAS, these findings indicate that the SNP sets selected from Stage I results, as well as those selected from previous GWAS, contain SNPs with genuine effects on CRC risk. One SNP, rs10795668 (OR = 0.79 [CI] 95%:0.71 – 0.87 p=3.78 x 10-6), was significantly associated with CRC risk in Stage II after adjustment for multiple testing. Two further SNPs, rs6983267 and rs4939827, also achieved suggestive p-values in Stage II. All these SNPs were selected from previous GWAS in the Caucasian population, demonstrating that shared genetic factors operate for CRC in diverse populations.
published_or_final_version
Psychiatry
Master
Master of Philosophy

Introduction: Video game is an emerging technology with potential to overcome many of the current barriers to behavior change. Video game playing is now woven into the fabric of children’s life and has been developed to educate individuals in health-related areas. Story immersion refers to the experience of being fully absorbed within a story in the game and is a key factor that contributes to the mechanism of behavior change. “Escape from Diab (Diab)is a health videogame designed to lower the risk of obesity and type 2 diabetes through behavior change components that were integrated into activities within the game storyline. This thesis was designed to investigate the effect of Diab for childhood obesity prevention among Hong Kong Chinese children. Methods: A literature review was conducted. Subsequently, study one conducted the validation of the Physical Activity Questionnaire for Older Children (PAQ-C) with 469 Hong Kong Chinese children. Study two was a cross-sectional study to explore the associations of self-efficacy, motivation, preference with both self-reported and objective physical activity (PA) in 301 children. Study three consisted of two phases. Phase one conducted individual interviews with 34 Hong Kong Chinese children to gather their perceptions of Diab and to assess Diab’s acceptability and applicability. Phase two examined the effect of playing nine episodes of Diab on children’s health outcomes (i.e., motivation, self-efficacy, preference for diet and PA, and PA behavior) through a non-randomized intervention. Results: The review demonstrated the effects of interventions by using health videogames on the psychological correlates. However, limited evidence is available to draw conclusions on the games’ behavioral modification efficacy. In study one, good internal consistency and test-retest reliability suggest that the PAQ-C is an adequately reliable instrument for use among Chinese children. The significant moderate correlation between the PAQ-C score and accelerometer measured moderate-to-vigorous PA support the PAQ-C’s acceptable validity. Study two revealed the important effects of self-efficacy and autonomous motivation in predicting PA. Differences were found between the prediction of self-reported PA and objective PA, which is likely due to self-reported error variance common to the PAQ-C and psychological correlates but not common to acclerometry. Study three indicated that Diab was perceived to be an immersive game by most of participating Hong Kong Chinese children. Four themes emerged from the interviews indicated that story immersion was a perceptible component and that Diab, developed for American children, was acceptable to the Hong Kong Chinese children. The pilot intervention study found short-term benefits after completing the game. However, the effects were not sustained at follow-up testing 8-10 weeks later. Conclusion: The current thesis demonstrated the validity of PAQ-C and the important effects of self-efficacy and autonomous motivation in predicting PA, which could inform the development of efficacious interventions. Diab, a Health videogames with appealing characters and immersive stories, partially motivated children to improve their motivation, self-efficacy, and preference for diet and PA behaviors immediately after completing nine episodes of the game, however, the lasting effectiveness and mechanisms of change require more thorough investigation.

Introduction: Dementia is an age-associated neurodegenerative disorder characterized by a progressive loss of neuro-cognitive function and the emergence of a wide variety of behavioral symptoms. Alzheimer's disease (AD) is the most common types of dementia. Sleep disturbances in patients with Alzheimer's disease is common and previous studies from North America, Europe and Japan reported light therapy could improve the sleep circadian rhythm ( rest-activity) disturbances in AD. However, there was no previous Chinese study on light exposure and sleep quality nor the circadian rhythm in Chinese Alzheimer's disease patients. Objective : The objective of the present study was to investigate the association of light exposure intensity with the quality of sleep and behavioural symptoms in Chinese Alzheimer’s disease (AD) patients Method: This was a cross-sectional observational study. 203 Chinese elderly patients with Alzheimer's disease were recruited from the Memory Clinic in Queen Mary Hospital, the University of Hong Kong, from July 2014 to December 2014. Socio-demographic data and comorbid diseases information were collected from all subjects. Their sleep qualities, quantities and conditions of light exposure were recorded with a sleep logbook and light meter. Their cognitive function, disturbing behaviour, depressive mood and quality of life scales were assessed by a semi-structured questionnaire. Light exposure intensity measured by Light meter (Model SDL 400). Measure for cognitive function were the Abbreviated Mental Test (AMT), Behavioral symptoms measured by the Neuropsychiatric Inventory (NPI) and mood by Geriatric Depression Scale. (GDS-15) The association of outdoor or indoor light exposure with sleep quality and quantities were analyzed by descriptive, bivariate and multivariate analyses. Main outcome measures: The main outcome measure was the sleep quality and quantities of patient, measured by Pittsburgh Sleep Quality Index. (PSQI) Results: 203 subjects (60 males and 143 females) were recruited. 70.4 % of the studied subjects were females. Male to female ratio is 1:2.38. Mean age of them was 81.6 years. The mean (SD) scores of the recruited were: AMT = 4.5 (2.9); PSQI = 6.9 (3.4); NPI =14.4 (17.2); GDS-15= 4.3 (2.8); QOL-AD (patients) = 30.7 (4.9); QOL-AD (caregivers) = 29.5 (4.7) respectively. In bivariate analysis, the Global PSQI score was significantly associated with the morning and afternoon outdoor light exposure. (r = -0.634 and -0.466, respectively) For the total light exposure and mean light exposure, both of them showed strong significant negative correlation with Global PSQI score. (r = -0.769 and -0.769 respectively). Mean (SD) light exposure per day for morning and afternoon outdoor setting were 2372.9 lux (2564.7) and 1090.8 lux (1894.6) respectively. Mean(SD) light exposure per day was 1196.7 lux (866.1) Gender identity showed significant correlation with Global PSQI score (r = 0.034). Global PSQI score was significantly associated with the NPI total score (r = 0.261, p<0.001), the GDS-15 score (r = 0.336, p<0.001), the QOL-AD for patients (r = -0.257, p<0.001), and the QOL-AD for caregivers. (-0.313, p<0.001) In multivariate analyses, using general linear models, the Global PSQI score was highly independent associated with the total light exposure (p=0.000), and significantly associated with the NPI score and Gender (p = 0.011 and 0.021), after adjusting for potential confounders in bivariate analysis. (i.e. gender, activity of daily living status, hypertension and Chronic obstructive airway disease). Confounding factors were NPI and gender. Conclusion: In the present study, We found the intensity of natural light exposure was related to good sleep quality in older Chinese Alzheimer’s disease patients with age 65 years and above in Hong Kong as well as lesser episode of behavioural symptoms. Hence, daily outdoor light exposure is highly recommended for persons with Alzheimer’s disease.
published_or_final_version
Medicine
Master
Master of Medical Sciences

Background: Evidence has indicated a high prevalence of physical inactivity and insufficient consumption of fruit and vegetables among Chinese college students. As college students are in a crucial transition stage from adolescent to adulthood, such unhealthy lifestyle behaviors at this stage can result in nemerous negative consequences for both individuals and society. Therefore, it is urgently necessary to promote health-enhancing physical activity (HEPA) and fruit-vegetable consumption (FVC) among Chinese college students. Interventions focused on multiple health behavior change (MHBC) have shown advantages over those targeting only a single health behavior, and have therefore gained popularity over the last decade. Despite the increasing use of Internet technology and apparent promise of web-based MHBC interventions, there have been few such interventions for HEPA and FVC among Chinese college students. In addition, within the overarching scope of web-based MHBC interventions, there are several remaining questions that need to be addressed, including the timing of MHBC intervention delivery, the high dropout rate of participants, and the psychological mechanisms behind MHBC. Purpose: The main purposes of the thesis were to (1) examine the comparative effectiveness of sequentially delivered web-based MHBC interventions for HEPA and FVC in Chinese college students from both quantitative and qualitative perspectives; (2) investigate characteristics of dropouts (using quantitative method) and the underlying reasons (using qualitative method); and (3) identify the active ingredients ("key mediators") of successful health interventions for changing single health behavior (HEPA or FVC), and examine the psychological mechanisms of MHBC (HEPA and FVC) in Chinese college students based on an integrated social-cognitive model. Method: In Study 1, two web-based MHBC interventions were developed based on the health action process approach (HAPA) model. In a randomized controlled trial (RCT), 552 eligible college students (M = 19.99 years, SD = 1.04, 58.3% female) were randomly assigned to one of three groups: HEPA-first (4 weeks of HEPA followed by 4 weeks of FVC intervention), FVC-first (4 weeks of FVC followed by 4 weeks of HEPA intervention), and a control group (8 weeks of placebo treatment unrelated to HEPA or FVC). All of the participants were asked to complete online questionnaires at four time-points: at baseline (T1, the beginning of the intervention), after 4 weeks (T2, after the first behavior intervention), after 8 weeks (T3, after the second behavior intervention), and after 12 weeks (T4, 1-month post-intervention follow-up). The questionnairs addressed health behaviors (HEPA and FVC), social- cognitive determinants of behavior change (intention, self-efficacy, planning, and social support for each behavior) and health outcomes (BMI, depression and perceived quality of life). All of the data were analyzed using IBM SPSS 25.0, applying a series of generalized linear mixed models (GLMMs) to evaluate the intervention effectiveness. The mediation analysis was performed using IBM SPSS Process, with residualized change scores and the bias-corrected bootstrap approach (5000 resamples). Following the quantitative intervention study, to further evaluate the effects of aforementioned web-based MHBC interventions and to address dropout issues from a qualitative perspective, 30 students (M = 19.53 years, SD = 0.92, 56.7% female) who had participanted in Study 1 (18 completers and 12 dropouts), were invited to attend one-to-one and face-to-face semi-structured interviews (Study 2). The interviews covered three topics: 1) students' perceptions about their changes after participating in the web-based health program, 2) students' user experience and suggestions related to the design of the intervention content and the website layout and functionality, and 3) the reasons for dropping out. The audio-recorded interview data was transcribed orthographically and organized using QSR NVivo 11. Thematic analysis was adopted to analyze the qualitative data. In addition, a two-layer integrated social-cognitive model was hypothesized in Study 3 based on the HAPA model and Carry-over and Compensatory Action Model (CCAM). With a prospective design, 322 college students (M = 19.47 years, SD = 0.99, 55.6% female) were invited to report their past HEPA and FVC behavior, HEPA and FVC intentions, and demographics at baseline. After two months, an online questionnaire survey was used to collect data on their compensatory cognitions, combined volitional predictors of behavior change (self-efficacy + planning), and current HEPA and FVC behavior. All of the data were analyzed using Mplus 8.0. The proposed model was examined using structural equation modeling (SEM) with path analysis approach. Results: (1) Both the quantitative and the qualitative data fully supported the effectiveness of the web-based MHBC interventions for HEPA and FVC behavior. In addition, the effects on social-cognitive determinants of behavior change were partially supported by the quantitative data, and fully supported by the qualitative data. For health outcomes, the quantitative data supported the intervention effects on body mass index (BMI), and the qualitative data supported the effffects on both BMI and perceived quality of life. Moreover, the two delivery sequences did not show significantly different effects on HEPA after either 8 weeks or 12 weeks, whereas the FVC-first sequence showed superior effects over the HEPA-first sequence for FVC behavior after 12 weeks. (2) In terms of dropout, more male than female students withdrew from the interventions, and the dropouts showed lower HEPA self-efficacies, lower FVC planning, and inferior BMI status than completers. The interview results indicated two themes of dropout reasons: internal reasons (e.g., participants perceiving the health interventions as less necessary and less important) and external reasons (e.g., unfavorable living surroundings and problems with the program's delivery mode, intervention content, and technology). (3) In terms of the mediators of successful interventions for changing each single health behavior, the RCT results indicated that self-efficacy and intention mediated the effectiveness of the intervention on immediate changes (after 8 weeks) in HEPA and FVC, and that intention had a mediating effect on sustained change (after 12 weeks) in both HEPA and FVC. In addition, the prospective study found that the two- layer integrated social-cognitive model proposed in this thesis successfully explained the psychological mechanisms of MHBC in Chinese college students. In particular, the first layer identified the mediating effects of the volitional predictors on the intention-behavior relation for each type of health behavior. The second layer identified a positive association between volitional predictors of HEPA and volitional predictors of FVC, as well as a mediating effect of compensatory cognition between FVC intention and HEPA behavior. Discussion and Conclusions: To the best of our knowledge, this is the first study to examine the comparative effectiveness of sequentially delivered web-based MHBC interventions on HEPA and FVC in Chinese college students, and the first to identify the psychological mechanisms of MHBC in a Chinese context. The findings provide both theoretical and practical implications for future research and the application of MHBC. Future studies should more comprehensively compare simultaneous vs. sequential designs, more systematically examine dropout and its determinants, and further explore the psychological mechanisms of MHBC, especially the transfer mechanisms between the volitional predictors of one health behavior on another

Thesis submitted in fulfillment of the requirements for the degree Master of Technology: Biomedical Technology In the Faculty of Health and Wellness Sciences At the Cape Peninsula University of Technology, 2012
Human and experimental animal studies have shown that biomarkers of oxidative damage are elevated in subjects with certain diseases or risk factors. Consequently, it is hypothesized that oxidative stress plays an important role in the pathogenesis of these diseases and that dietary intake of, or supplementation with antioxidants may be protective or be useful therapeutic targets. This study was designed to investigate the modulatory effect of Camellia sinensis (Chinese green tea), Aspalathus linearis (rooibos herbal tea) and the two commercial supplements on the antioxidant status of the liver and kidney of tert-butyl hydroperoxide (t-BHP)-induced oxidative stress male Wistar rats. Rooibos and green tea are beverages well-known for their antioxidant content. Based on the specific beverage consumed, sixty male Wistar rats were randomly assigned into six groups, i.e. fermented rooibos (FRT), unfermented rooibos (URT), Chinese green tea (CGT), rooibos supplement (RTS), Chinese green tea supplement (GTS) and control (CTL). The animals had free access to the respective beverages and standard diet for 10 weeks, while oxidative stress was induced during the last 2 weeks via intraperitoneal injection of 30 μM of t-BHP per 100 g body weight. Among all the beverage and/or supplement preparations, the commercial rooibos supplement had the highest total polyphenol content and antioxidant activity while fermented rooibos, as previously shown, had a lower antioxidant content and potency when compared to its unfermented counterpart. The ability of these beverages and/or supplements to modulate the antioxidant status in tissues was organ specific and varied according to the assessment method. When considering the liver, the intake of unfermented rooibos, Chinese green tea and the commercial rooibos supplement significantly (P<0.05) restored the t-BHP-induced reduction and increased the antioxidant status with regards to oxygen radical absorbance capacity and trolox equivalent antioxidant capacity (TEAC) levels. All the beverages and/or supplements also significantly (P<0.05) enhanced the renal antioxidant capacity as assessed by the TEAC assay. In what may be an indication of decreased oxidative stress, all the beverages were associated with a general decline in activities of the antioxidant enzymes which reached significant levels in renal superoxidase dismutase activity. Generally, the beverages did not impact significantly on lipid peroxidation (LPO) although there were differing trends in the two LPO markers assessed. While thiobarbituric acid reactive substances levels showed a declining trend in both tissues, the conjugated dienes were generally elevated. In conclusion, this study confirms Camellia sinensis and Aspalathus linearis as well as their two supplements as good sources of dietary antioxidants and results demonstrated that rooibos and green tea improved the liver and kidney antioxidant capacity of oxidative stress-induced rats. Their impact on antioxidant status in rats was shown to vary between organs and according to the method of assessment. Hence multi-method, multi-organ assessment may be a more informative approach in in vivo antioxidant studies.

This thesis examines the trans-border circulation and production of feminist knowledge through translation. More specifically, my research focuses the translation of the U.S. women’s health book, Our Bodies, Ourselves, by a Chinese feminist NGO in 1998. My dissertation studies the social, cultural and political aspects of feminist translation, and examines the relation between translation and feminist praxis. Through the lens of gender and (feminist) health politics in 1990s China, I examine how the 1998 Chinese translation conveys the book’s message about how women should relate to their bodies. Set in the context of Chinese society opening up during the late 1970s, my research outlines the emergence of gender awareness in China with the influx of translated feminist texts, especially in the realm of women’s health research. Medical discourses were then assigned a privileged position in the studies of women’s sexual and reproductive health. However, with increased communications between Chinese and foreign feminists, Chinese women scholars developed new ideas around women’s sexual and reproductive health. The Chinese translation of OBOS addresses the lack of gender awareness in local discussions about women’s health. With a multi-method study, I emphasize the social and linguistic dimensions of translating a feminist health project into post-reform China. This study is based on both interview and comparative textual analysis data. Using feminist translation theories, I examine how the Chinese translators handled the book’s presentation of women’s sexuality and reproductive health. This thesis also highlights the constraints on translating feminism from the local context. This raises questions about the power of (feminist) translation, and emphasizes the need to examine the social-political context of translation practices.

Chiu Yuk Lan.
"December 2004."
Thesis (Ph.D.)--Chinese University of Hong Kong, 2004.
Includes bibliographical references (p. 160-185)
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Mode of access: World Wide Web.
Abstracts in English and Chinese.

自十九世紀末期，中式餐館已成為悉尼食味景觀 ( foodscape) 的一部分。近年中餐廳所提供的菜式，更由以廣東菜為主流，演變為一系列不同的地方風味，如上海菜、四川菜及北京菜等。中菜的全球化不能簡單定義為中國移民將自己的家鄉菜帶到移居地的一個過程。本文旨在闡述移民身份的餐館東主以及廚師怎樣在燒菜和營運餐館的過程中，改變了悉尼的食味景觀。一向以來，移民總是運用他們的民族文化資源謀生，使自己及家人有更佳的生活，而餐館正正為他們提供了適切的場地。本文亦審視中國新移民怎樣通過經營餐館，從而改變了當地西方人對中餐的觀念；即從中國菜即是廣東菜，演變為包括其他中國地方的風味菜。在這演變的過程中，餐館東主和廚師們都要不斷面對一個議題：怎樣與不同類形的顧客對何謂地道中國菜的觀念達至共識。較年輕的餐館東主通常會懂得因應社會上的話題以及利用對悉尼西方人的喜好的認識，為餐館營造時尚的格調來吸引他們。經過訓練的廚師以他們的專業成功移民澳洲，而僱用他們的餐館則以他們的專業作為餐館水準的保證。本文通過闡述上述人士改變悉尼的食味景觀的過程，展示人類學所提供的那種由下而上的角度如何為屬於宏觀層次的食物研究，如餐館東主對食味景觀的影響，作出貢獻。
Chinese restaurants have been a part of the Sydney foodscape since the late nineteenth century. Recently, Chinese food in Sydney has changed from being Cantonese based to including a range of regional cuisines such as Shanghainese, Sichuanese and Beijing cuisines. The globalisation of Chinese cuisine is not simply the process of Chinese migrants bringing their cuisines with them to a new place. This study sheds light on how migrant restaurant owners and chefs have transformed the Sydney foodscape by cooking in and running their restaurants. Migrants have long used their ethnic resources to make a living and create better lives for themselves and their families. Restaurants are a means for them to achieve these aims. This study also examines how new Chinese migrants run restaurants that have changed notions of Chinese food in Sydney from being mainly based on Cantonese cuisine to including other regional Chinese cuisines. Throughout this process, restaurant owners and chefs have had to negotiate different ideas of authentic Chinese food held by different customers. Younger restaurant owners use their knowledge of public discourse and preferences of Caucasians in Sydney to create stylised spaces to appeal to Caucasian customers. Professionally trained chefs use their training as vehicles for migration and the restaurants that hire them use their professional training to maintain their standards. By illustrating how these individuals have changed the Sydney foodscape, this study shows how anthropology can contribute to food studies by providing a ground up perspective of how individuals such as restaurant owners can have an impact on macro level issues such as changing foodscapes.
Detailed summary in vernacular field only.
Pang, Leo.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2012.
Includes bibliographical references (leaves 155-163).
Abstracts also in Chinese.
Abstract --- p.i
論文摘要 --- p.ii
Acknowledgements --- p.iii
List of Figures --- p.vii
Chapter Chapter 1 --- Introduction --- p.1
The Globalisation of Chinese Food --- p.4
Chinese Migration and Restaurants --- p.15
Methodology --- p.21
Thesis Organisation --- p.26
Chapter Chapter 2 --- Chinese Migration and Chinese Restaurants in Sydney: Historical Background --- p.29
Pre-Gold Rush Migration: The Need for Labour --- p.31
New Gold Mountain: The Gold Rush Era --- p.35
The End of the Gold Rush and the Move towards a White Australia --- p.37
The end of the White Australia Policy and Multiculturalism --- p.43
Chinese and their Restaurants in Australia --- p.47
Conclusion --- p.51
Chapter Chapter 3 --- Changing their Lives and Changing the Foodscape: Chinese Migrants and Their Restaurants in Sydney --- p.54
Untrained cooks --- p.58
Professional Chef-Migrants --- p.64
Younger and More Corporate Owners --- p.72
Location, Location: Where to Open Restaurants and Aspirations for their Children --- p.75
Conclusion --- p.80
Chapter Chapter 4 --- To Compromise or Not To Compromise: Chinese Restaurant Menus in Sydney --- p.85
Reproducing Chinese Food in Sydney --- p.89
Local Favourites --- p.91
Authenticity and Cultural Reproduction --- p.94
Pleasing the Locals: Modifying Dishes and Adding Dishes to Menus --- p.102
Conclusion --- p.107
Chapter Chapter 5 --- Restaurant Chains and the Expansion of Chinese Restaurants in Sydney --- p.112
From Ethnoburbs to the Suburbs: Chinese Restaurants in New Locations --- p.116
Corporatisation: Increasing Professionalism --- p.119
Décor and Presentation: Creating a New Image for Chinese Food --- p.123
Conclusion --- p.134
Chapter Chapter 6 --- Conclusion --- p.138
Negotiating Multiple Authenticities --- p.145
Making and Staging Authenticity --- p.147
Changing Tastes and Foodscapes: The Future of Chinese Food in Sydney --- p.150
Bibliography --- p.155
Chapter Appendix 1 --- : Restaurants Visited and Interviewed --- p.164
Chapter Appendix 2 --- : List of Restaurant Owners and Staff Interviewed --- p.166
Chapter Appendix 3 --- : Glossary --- p.167

Yang Zheyu.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (leaves 46-52).
Abstracts in English and Chinese.
Chapter 1 --- Introduction --- p.3
Chapter 2 --- Literature Review --- p.9
Chapter 2.1 --- Conceptual foundations and empirical implications --- p.9
Chapter 2.2 --- Evidence of the direct casual effect of schooling on health --- p.11
Chapter 2.3 --- Explanations of the schooling-health correlation --- p.16
Chapter 2.4 --- Literature review on twins data --- p.25
Chapter 3 --- Empirical Specification --- p.29
Chapter 3.1 --- Omitted Variable Bias (Selection Effect) --- p.29
Chapter 3.1.1 --- Ordinary Least Squares (OLS) Model --- p.29
Chapter 3.1.2 --- Fixed-Effect (FE) Model --- p.30
Chapter 3.1.3 --- Generalized Least Squares (GLS) Model --- p.31
Chapter 3.2 --- Measurement Error --- p.32
Chapter 4 --- Data --- p.34
Chapter 5 --- Empirical Results --- p.37
Chapter 5.1 --- Allocative Efficiency Hypothesis Test --- p.37
Chapter 5.2 --- Productive Efficiency Hypothesis Test --- p.39
Chapter 5.3 --- Returns to health --- p.44
Chapter 6 --- Conclusions --- p.45
Chapter 7 --- Bibliography --- p.46
Table 1: Summary of the evidence for correlation between education and SRH amongst different groups of individuals --- p.53
Table 2: Descriptive Statistics --- p.54
Table 3: Correlation between Health Indicators --- p.55
Table 4.1: The Impact of Education on Physical Exercise Participation --- p.56
Table 4.2: The Impact of Education on Smoking Consumption --- p.57
Table 4.3: The Impact of Education on Alcohol Consumption --- p.58
Table 5.1: OLS and FE Estimation of the Impact of Education on SRH --- p.59
Table 5.2: IV Estimation of the Impact of Education on SRH --- p.60
Table 5.3: GLS Estimation of the Impact of Education on SRH --- p.61
Table 6.1: OLS and FE Estimation of the Impact of Education on BMI. --- p.62
Table 6.2: IV Estimation of the Impact of Education on BMI --- p.63
Table 7.1: OLS and FE Estimation of the Impact of Education on Symptom Occurrence --- p.64
Table 7.2: IV Estimation of the Impact of Education on Symptom Occurrence --- p.65
Table 8: Probit Estimation of the Impact of Education on Symptom Occurrence --- p.66
Table 9: Ordered Logit Estimation of the Impact of Education on SRH. --- p.67
Table 10.1: OLS and FE Estimation of the Impact of Education Level on SRH --- p.68
Table 10.2: IV Estimation of the Impact of Education Level on SRH --- p.69
Table 11.1: OLS and FE Estimation of the Impact of Education Level on Symptom Occurrence --- p.70
Table 11.2: IV Estimation of the Impact of Education Level on Symptom Occurrence --- p.71
Table 12: OLS and FE Estimation of the Returns to SRH --- p.72

In this thesis, return to health is also estimated. We examine the effects of height on hourly wage, monthly earnings, working hours, and education level. Our results show that height has different causal impacts on women and men. Women benefit from height: taller women earn more, work less, and have more leisure time. However, taller men are more likely to land a job and work longer, largely because they are better endowed. Moreover, the positive effect of height on hourly wage for women is larger than that for men. In general, the findings have contributed new evidence to existing literature that estimates the return to health.
This thesis mainly investigates the intergenerational transmission of socioeconomic status. Specifically, it estimates the effects of family income and parental education on the health status and educational attainment of the next generation using unique twins data collected from urban China. By using twins strategy, we can largely control for unobservables, which may cause biases in estimations. Our results show that the positive correlations of family income and maternal education with child health are largely due to unobserved endowment and family background. However, family income and paternal education do have a positive effect on child education. Overall, our findings suggest that increasing family income and parental schooling do not help in improving child health. However, to reduce the educational gap of the next generation, redistributing income would prove beneficial. The design of government policies is dependent on the policy targets.
Xiong, Yanyan.
Advisers: Hongbin Li; Junsen Zhang.
Source: Dissertation Abstracts International, Volume: 70-06, Section: A, page: 2176.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2008.
Includes bibliographical references.
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest dissertations and theses, [201-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

In this study, an integrated model was proposed to examine the impact of emotional labor on quality of work life and psychological health among Chinese employees. Compared to other emotional labor models, this model considered the influence of perceived service culture as an antecedent of perceived organizational emotion control (i.e., display rules and performance monitoring). Apart from surface acting and deep acting, it also incorporated an alternative emotional regulation strategy, namely authentic self, to cope with the organizational emotion control. The integrated model included emotional expressivity as an individual factor that might influence the emotional regulation process. Two studies were conducted to examine the validity of the model. In Study 1, 486 Chinese service employees, including call center representatives, retail shop managers, human service workers, and local registered nurses were recruited. Path analysis was used to examine if the integrated model fit the cross-sectional data and results showed satisfactory model fit. A series of hierarchal regression analyses were conducted to examine the moderating effect of emotional expressivity. Instead of the hypothesized moderating effect, there were significant main effects of emotional expressivity on emotional regulation strategies. Considering the significant association between these variables, the integrated model was further revised by incorporating the emotional expressivity as an individual factor of emotional regulation strategies. Multi-sample path model analyses showed that the model was equally applicable in both gender groups for job and health outcomes. Result of the cross-sectional model showed that perceived service culture was directly related to both perceived display rules and performance monitoring. While perceived performance monitoring and authentic self were associated with surface acting, perceived display rule was in turn related to deep acting. Emotional expressivity was related to authentic self. Quality of work life was associated with surface acting and deep acting. This model could also be applied to understand psychological distress.
Study 2 was conducted to provide additional support to the integrated model, including an emotional expressivity training program and a longitudinal validation on the emotional regulation strategies model. In the emotional expressivity training program, 155 participants who had completed the questionnaire survey in Study 1 were recruited. Among them, 131 participants had joined a half-day emotional expressivity training program while 24 participants were assigned into the control group. The objective of the program was to enhance participants' positive expressivity and reduce negative expressivity and impulse strength. Results showed that the training was effective in maintaining participants' authentic self. In particular, authentic self did not change across time among training group. However, authentic self in the control group decreased significantly 3 months after the training program (T2) when it was compared to the pre-training period. In the longitudinal validation study, a longitudinal model was devised to measure changes on emotional expressivity at T1 and T2 and its relations to emotional regulation strategies among the training group (n = 131). The significant associations between perception of service culture, organizational emotion control, and emotional regulation strategies in Study 1 were also found in Study 2. Quality of work life at T2 was related to surface acting at T2 and quality of work life at TI. The longitudinal model was also applied to predict psychological distress. Deep acting, surface acting, and emotional expressivity at T2 as well as psychological distress at TI were significantly related to psychological distress at T2. Limitations, suggestions for future research, and practical implication to organizations are discussed in Chapter 6.
Cheung Yue Lok.
"July 2006."
Adviser: Catherine S. K. Tang.
Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1970.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2006.
Includes bibliographical references (p. 172-189).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstracts in English and Chinese.
School code: 1307.

The purpose of this study was to explore the relationships among adult attachment, acculturation, and psychological well-being in Chinese/ Taiwanese immigrants. Specifically, the present study examined how adult attachment predicted psychological well-being and how acculturation moderated the relationship between adult attachment and psychological well-being. Adult attachment was measured by two dimensions, attachment anxiety and attachment avoidance. Acculturation was measured by two domains, behavioral aspect and psychological aspect of acculturation. Bivariate correlation analyses on attachment anxiety, attachment avoidance and psychological well-being were conducted. The results suggested that both attachment anxiety and attachment avoidance were significantly negatively associated with psychological well-being. In addition, hierarchical multiple regression analyses were performed where attachment anxiety and attachment avoidance were entered as predictor variables; acculturation towards Chinese orientation, acculturation towards American orientation and Asian cultural values as moderating variables; psychological well-being as the outcome variable. The results indicated that acculturation towards American orientation moderated the relationship between attachment anxiety and psychological well-being and the relationship between attachment avoidance and psychological well-being. The findings and discussions, limitations, implications for future research, clinical practice and training were addressed.

Xu Liying.
"April 2004."
Thesis (Ph.D.)--Chinese University of Hong Kong, 2004.
Includes bibliographical references (p. 159-175)
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Mode of access: World Wide Web.
Abstracts in English and Chinese.

Background Climate variation has affected diverse physical and biological systems worldwide. Population health is one of the most important impacts of climate variation. Although the impact of climate variation on infectious diseases has been of significant concern recently, the relationship between climate variation and infectious diseases, including vector-borne diseases and enteric infections, needs greater clarification. Australia is grappling with developing politically acceptable responses to global warming. In China, few studies have been conducted to examine the effect of climate variation, including global warming, on population health. As residents of developing countries may suffer more from climate change compared with people living in more developed countries, this thesis has significance for both countries. Aims This study aims to contribute to a better understanding of the impact of climate variation on population health, and to provide scientific evidence for policy makers, researchers, public health practitioners and local communities in the development of public health strategies at an early stage, in order to prevent or reduce future risks associated with ongoing climate change. The objectives of this study include: (1) to quantify the association between climate variation and selected vectorborne diseases and enteric infections in different climatic regions in Australia and China; (2) to project the future burden of selected vector-borne diseases and enteric infections based on climate change scenarios in different climatic regions in Australia and China. Methods This ecological study has two components. The first uses time-series analyses to quantify the relationship between meteorological variables and infectious diseases, whereas the second projects the burden of selected infectious diseases using future climate and population scenarios. Temperate and subtropical climatic zones in both Australia and China were selected as the primary study areas, and a study of an Australian tropical region was also conducted. Study of Australia’s temperate zones was conducted in Adelaide, South Australia, as well as the Murray River region in that State. The study of China’s temperate zone was carried out in Jinan, Shandong Province. Subtropical studies were conducted in Baoan, Guangdong Province, China, and Brisbane in Queensland, whilst research for the tropics centred on Townsville, also in Queensland, Australia. The selected infectious diseases - one vector-borne disease and one enteric infection in each country - are Ross River Virus (RRV) infection and salmonellosis in Australia, and malaria and bacillary dysentery in China. Study periods vary from eight to sixteen years (depending upon the availability of data). Climate data, infectious disease surveillance data and demographic data were collected from local authorities. Data analyses conducted in the ecological studies include Spearman correlation analysis, time-series adjusted Poisson regression and the Seasonal Autoregressive Integrated Moving Average (SARIMA) model with consideration of lag effects, seasonality, long-term trends, and autocorrelation, on a weekly or monthly basis depending on data availability, and Hockey Sticky model to detect potential threshold temperatures. In the burden of disease component, analyses include the calculation of an indicator of the burden of disease - Years Lost due to Disabilities (YLDs) - and use scenario-based models to project YLDs for the selected diseases in 2030 and 2050 in Australia and 2020 and 2050 in China respectively. The projections consider both different scenarios of projected temperature and future population change. Results Relationship between climate variation and selected infectious diseases In all the study regions in Australia, maximum temperature, minimum temperature, rainfall and humidity are all significantly related to the number of RRV infections, with lag effects varying from 0 to 3 months. Additionally, high tides in the two seaside regions with tropical (Townsville) or subtropical (Brisbane) climates, and river flow in the temperate region (Murray River region), are related to the number of cases without any lag effects. A potential 1°C increase in maximum or minimum temperature may cause 4%~23% extra cases of RRV infection in the temperate region, 5~8% in the subtropical region, and 6%~15% in the tropical region. Maximum temperature, minimum temperature, humidity and air pressure are significantly related to malaria cases in the temperate city Jinan and subtropical city Baoan in China, with a lag effect range of 0 to 1 month. An association between rainfall and malaria cases was not detected in either region. A potential 1°C increase in maximum or minimum temperature may lead to 4%~15% extra malaria cases in the temperate region, and 12%-18% in the tropical region in China. Maximum temperature, minimum temperature, rainfall and humidity are all significantly related to the number of salmonellosis cases in the three study cities in Australia, with lag effects varying from 0 to 1 month. A potential 1°C increase in maximum or minimum temperature may cause 6%~19% extra salmonellosis cases in the temperate region (Adelaide), 5%~10% in the subtropical region (Brisbane), and 4%~15% in the tropical region (Townsville). The thresholds for the effects of maximum and minimum temperatures are 20ºC and 12ºC respectively in Adelaide. No threshold temperatures are detected in Townsville and Brisbane. Maximum temperature, minimum temperature, humidity, air pressure and rainfall are significantly related to bacillary dysentery cases in the temperate city Jinan and subtropical city Baoan in China, with the lag effect range of 0 to 2 months. A potential 1°C increase in maximum or minimum temperature may cause 7%~15% extra bacillary dysentery cases in the temperate region and 10% ~ 19% in the subtropical region in China. The thresholds for the effects of maximum and minimum temperatures on bacillary dysentery are 17ºC and 8ºC respectively in Jinan. No threshold temperatures are detected in Baoan. Projection of YLDs from target diseases In Australia, considering both climatic and population scenarios, if other factors remain constant, compared with the YLDs observed in 2000, the YLDs for salmonellosis might increase by up to 48% by 2030, and nearly double by 2050 in South Australia, while the YLDs might double by 2030 and increase by up to 143% by 2050 in Brisbane, Queensland. The YLDs for RRV infection might increase by up to 66% by 2030, and nearly double by 2050 in South Australia. They might increase by up to 61% by 2030 and double by 2050 in Brisbane, Queensland. In China, considering both climatic and population scenarios, if other factors remain constant, compared with the YLDs observed in 2000, the YLDs for bacillary dysentery might double by 2020 and triple by 2050 in both Jinan and Baoan. The YLDs for malaria might increase by up to 108% by 2020 and nearly triple by 2050 in Jinan, the temperate city, and increase by up to 144% by 2020 and nearly triple by 2050 in Baoan, the subtropical city. Conclusions 1. Both maximum and minimum temperatures are important in the transmission of vector-borne diseases in various climatic regions in both Australia and China. River flow or high tides may also play an important role in the transmission of such diseases. 2. Both maximum and minimum temperatures play an important role in the transmission of enteric infections in various climatic regions in both Australia and China, with a threshold temperature detected in the temperate regions but not in subtropical and tropical regions. 3. The effects of rainfall and relative humidity on selected infectious diseases vary in different study areas in Australia and China. 4. The burden of temperature-related infectious diseases may greatly increase in the future if there is no effective preventive intervention. Public health implications 1. Implication for health practice • Public health practitioners, together with relevant government organisations, should monitor trends in infectious diseases, as well as other relevant indexes, such as vectors, pathogens, and water and food safety. They should advise policy makers of the potential risks associated with climate change and develop public health strategies to prevent and reduce the impact of infectious disease associated with such change. • Doctors and other clinical practitioners should be prepared and supported in the provision of health care for any expected extra cases associated with climate variation and should play an important role in relevant health education on climate change. • Community participation is of significance to adapt to and mitigate the risk of climate change on population health. Community involvement helps to deliver programmes which more accurately target local needs. Therefore, community should be involved in the partnerships of climate change as early as possible. • Relevant education programs on the potential health impact of climate change should be conducted by government at all levels for different stakeholders, including industries, governments, communities, clinicians and researchers. • Advocacy for adapting to and mitigating climate change should be a longstanding public health activity. 2. Implication for researchers • The main task for researchers is to identify the independent contribution made by key climatic variables and whether there are exposure thresholds for infectious disease transmission. Further studies should include various infectious diseases in different climatic regions. • Developing countries and rural regions are more vulnerable to the impact of climate change so more research should be conducted for people living in those regions. • Studies using summary measures that combine prevalence of disease, quality of life and life expectancy, such as Disability Adjusted Life Years (DALYs), to assess the burden of disease due to climate change is necessary to assist in decision making. • More research should be conducted on the assessment of adaptive strategies and mitigation to future climate change. 3. Implication for policies • Public and preventive health strategies that consider local climatic conditions and their impact on vector and food borne diseases are important in reducing such impact due to climate change in the future. • The extra health burden that may be caused by future climate change may have a great impact on the currently overloaded public health system in both developed and developing countries. Long-term planning about health resource allocation, infrastructure establishment, and relevant response mechanisms should be developed at relevant government levels. • Effective prevention and intervention strategies will be possible only if the efforts of relevant sectors, including governments, communities, industries, research institutions, clinical professionals and individuals, have coordinated responses. • International and regional collaborations are necessary to address this global issue. In addition, strategies of an international dimension should be translated into regional and local actions. This is extremely important to developing countries such as China and India. • Sustainable development policies with consideration given to reducing green house gases and environmental degradation need immediate action which will benefit future generations. Health priorities should include the prevention of climate change.
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Thesis(Ph.D.)-- School of Population Health and Clinical Practice, 2007

該前瞻性研究對香港中國裔孕婦的25羥基維生素D（25（OH）D）的水平及其影響因素進行調查，并對25（OH）D與甲狀旁腺激素（PTH）、孕期肌肉酸痛、不良妊娠結局、孕期及産後骨質流失，以及嬰兒的骨骼發育等關係進行探索，力求建立適用于香港的中國孕婦的25（OH）D正常值。
共有237名單胎妊娠婦女以及62名多胎妊娠的婦女在2010年8月至2011年11月間參加本研究中的隊列研究，分別在參加研究時（<20 孕周）、24-28孕周、31-36孕周以及産後6-11周進行抽血測量血清25（OH）D以及PTH水平，同時填寫一份包括對每月攝取含維生素D的食物以及營養補充劑頻度、接受日照情況及喜好、以及肌肉不適等情況的問卷，并在24-28孕周進行75克口服葡萄糖耐量試驗。參與隊列研究的單胎孕婦在20周前、31-36孕周以及産後隨訪時接受用定量超聲測量非優勢手的橈骨遠端以及中指近掌指骨的骨質超聲速率（SoS）。在産後複查時，對其嬰兒左側腓骨中部的骨質SoS進行測量。記錄婦女各次檢查時的體重、抽血月份紫外線輻射強度的歷史記錄、以及妊娠結局。另外募集一批孕婦參加病例對照研究，比較患早產（PTB）、子癇前期（PET）、妊娠糖尿病 （GDM）以及胎兒生長受限（FGR）併發癥的婦女與對照組 （體重指數以及抽血時紫外線強度配對）的血清25（OH）D水平。
孕婦在孕期的平均25（OH）D水平在44.7 ± 12.6 至48.9 ± 17.1 nmol/l範圍，25（OH）D水平與體重指數、維生素D營養補充劑、抽血時紫外線強度以及個人對陽光的喜好情況有關，而與胎兒數量、孕次、孕周以及終止妊娠無關。
單胎妊娠的孕婦三個孕期的血清25（OH）D與PTH水平均負相關，但在多胎妊娠中，二者無明顯相關性。PTH在孕期以及産後的變化相對不受25（OH）D影響。孕婦25（OH）D的水平與孕婦肌肉酸痛癥狀、産後恢復、孕期及產褥期骨質流失以及嬰兒骨質無關。患早期PTB（< 34孕周）、PET或FGR的孕婦的血清25（OH）D比對照組低，但GDM患者的25（OH）D水平與對照組無差別。血清25（OH）D低於34.3 nmol/l者的早期早產以及子癇前期的風險增高，低於50 nmol/l者發生胎兒生長受限的風險增高。服用維生素D補充劑情況可能影響25（OH）D與FGR的關係。
總而言之，血清25（OH）D水平不足以全面完全反映孕期維生素D的情況，對預測不良妊娠結局的作用有限。
This prospective study explored the maternal serum level of 25(OH)D in Chinese pregnant women in Hong Kong and the factors affecting 25(OH)D level. It also explored the correlation between maternal 25(OH)D with PTH level, maternal musculoskeletal complaints, adverse pregnancy outcome, maternal bone turnover during pregnancy and postpartum, and the bone development of the offspring, aiming to explore and establish a normal range of 25(OH)D level in pregnancy for the Hong Kong Chinese women.
A total of 237 women with singleton pregnancy and 62 women with multiple pregnancies were recruited for the cohort study from August, 2010 to November, 2011. Maternal blood samplings for 25(OH)D and PTH measurements were performed at recruitment, 24-28 weeks, 31-36 weeks of gestation, and 6-11 weeks postpartum respectively. A questionnaire which included the monthly dietary and supplement intake of vitamin D, questions about sunlight exposure, and musculoskeletal complaints was administered on each visit. A 75g oral glucose tolerance test (OGTT) was performed on cohort cases at 24-28 weeks of gestation. Measurements of the speed of sound (SoS) at the distal one third of the maternal radius and the proximal phalanx of the third finger of the non-dominant side were performed with quantitative ultrasonography (QUS) measurement during the visits at the first and third trimesters, and postnatal period. The SoS at the left mid-shaft tibia of the offspring was determined during the postnatal visit. Maternal characteristics, ultraviolet radiation (UVR) intensity at blood sampling, and pregnancy outcome, were also recorded. Cases with pregnancy complications were recruited for case-control studies, and maternal 25(OH)D level was examined with respect to preterm birth (PTB), preeclampsia (PET), gestational diabetes (GDM), and fetal growth restriction (FGR, birthweight below the 10th percentile of the customized estimated birthweight). The controls were matched for booking body mass index (BMI) and UVR intensity at blood sampling.
The mean 25(OH)D level in ranged from 44.7 ± 12.6 to 48.9 ± 17.1 nmol/l in the three trimesters, and was related to BMI, vitamin D supplementation, UVR intensity at blood sampling, and the acceptance of sunlight exposure, but not the number of fetus, parity, gestational age, or the completion of pregnancy.
Inverse correlation between PTH and 25(OH)D were observed in singleton, but not in multiple, pregnancy. The change in maternal PTH level is found to be relatively independent from that of 25(OH)D. There was no correlation between maternal 25(OH)D level with musculoskeletal complaints, postnatal recovery, bone turnover during and after pregnancy, or the bone density of the offspring. Maternal 25(OH)D level was lower in women with early PTB ( < 34 weeks), PET, and FGR, but not for GDM. A maternal 25(OH)D level of lower than 34.3nmol/l and 50 nmol/l was associated with increased risk of early PTB, PET, and FGR respectively. But the correlation between maternal 25(OH)D level with FGR might be affected by supplementation.
In conclusion, serum level of 25(OH)D is insufficient in reflecting maternal vitamin D status and metabolism in pregnancy, and is of limited use in predicting adverse pregnancy outcome.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Detailed summary in vernacular field only.
Hu, Zhiyang.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2013.
Includes bibliographical references (leaves 201-223).
Abstracts and appendixes also in Chinese.
Thesis dedication --- p.i
Acknowledgments --- p.ii
Abstract --- p.v
Abstract (Chinese) --- p.viii
List of Abbreviation --- p.x
Table of contents --- p.xiii
List of Figures --- p.xxii
List of Tables --- p.xxiv
Chapter Chapter 1: --- Literature Review --- p.1
Chapter 1.1 --- The synthesis and metabolism of vitamin D --- p.3
Chapter 1.1.1 --- The synthesis of vitamin D --- p.3
Chapter 1.1.2 --- The metabolism of vitamin D --- p.4
Chapter 1.1.3 --- Vitamin D binding protein --- p.10
Chapter 1.1.4 --- Factors related to 25(OH)D level --- p.11
Chapter 1.2 --- Function of vitamin D --- p.13
Chapter 1.2.1 --- Mechanism of vitamin D function --- p.13
Chapter 1.2.2 --- Classic function --- p.14
Chapter 1.2.3 --- Non-classic function --- p.16
Chapter 1.2.3.1 --- Immune system --- p.17
Chapter 1.2.3.2 --- Cardiovascular system --- p.18
Chapter 1.2.3.3 --- Cell proliferation and differentiation --- p.18
Chapter 1.2.3.4 --- Neurological system --- p.19
Chapter 1.2.3.5 --- Reproductive system --- p.20
Chapter 1.2.3.6 --- Fetal development --- p.21
Chapter 1.3 --- The definition of vitamin D deficiency --- p.21
Chapter 1.4 --- Vitamin D status and pregnancy --- p.24
Chapter 1.4.1 --- Alteration in vitamin D metabolism during pregnancy --- p.24
Chapter 1.4.2 --- Factors affecting maternal serum level of 25(OH)D --- p.25
Chapter 1.4.3 --- Vitamin D and bone resorption during pregnancy and lactation --- p.27
Chapter 1.4.3.1 --- Alteration of calcium metabolism, bone absorption and the role of vitamin D --- p.27
Chapter 1.4.3.2 --- Measurement of bone density in pregnant women and babies --- p.33
Chapter 1.4.4 --- Current studies on maternal vitamin D status and pregnancy outcome --- p.35
Chapter 1.4.4.1 --- Birthweight --- p.35
Chapter 1.4.4.2 --- Infection --- p.37
Chapter 1.4.4.3 --- Preterm delivery --- p.39
Chapter 1.4.4.4 --- Diabetes (DM) and gestational diabetes (GDM) --- p.39
Chapter 1.4.4.5 --- Hypertension and preeclampsia --- p.41
Chapter 1.4.4.6 --- Multiple pregnancy, muscular symptoms --- p.42
Chapter 1.4.4.7 --- Vitamin D supplementation and pregnancy outcome --- p.44
Chapter 1.5 --- Defining vitamin D deficiency in pregnancy --- p.45
Chapter 1.6 --- Objective of the study --- p.46
Chapter Chapter 2: --- Study design and methods --- p.48
Chapter 2.1 --- Case recruitment and study design --- p.48
Chapter 2.1.1 --- Longitudinal singleton study --- p.49
Chapter 2.1.2 --- Cross-sectional study --- p.50
Chapter 2.1.2.1 --- Preterm birth (PTB) --- p.51
Chapter 2.1.2.2 --- Preeclampsia (PET) --- p.51
Chapter 2.1.2.3 --- Gestational diabetes (GDM) --- p.52
Chapter 2.1.3 --- Multiple pregnancy study --- p.52
Chapter 2.2 --- Measurements --- p.53
Chapter 2.2.1 --- Hormonal analysis of serum levels of 25(OH)D and PTH --- p.53
Chapter 2.2.2 --- Calculation of monthly intake of vitamin D from diet --- p.55
Chapter 2.2.3 --- SoS measurements --- p.56
Chapter 2.2.4 --- Ultraviolet radiation strength assessment --- p.59
Chapter 2.3 --- Statistical analysis --- p.60
Chapter Chapter 3 --- Longitudinal Study on the Level of and Factors Affecting Vitamin D in Singleton Pregnancy --- p.62
Chapter 3.1 --- Introduction --- p.62
Chapter 3.2 --- Material and method --- p.63
Chapter 3.3 --- Statistics --- p.64
Chapter 3.4 --- Results --- p.65
Chapter 3.4.1 --- Demographic data of the subjects --- p.65
Chapter 3.4.2 --- Maternal levels of 25(OH)D and PTH, and the factors affecting their levels --- p.66
Chapter 3.4.2.1 --- Distribution of 25(OH)D level and PTH level in the four visits --- p.66
Chapter 3.4.2.2 --- Dietary intake of vitamin D and supplementation --- p.69
Chapter 3.4.2.3 --- Seasonality and sunlight exposure --- p.73
Chapter 3.4.2.4 --- Parity --- p.76
Chapter 3.4.3 --- Changes of maternal levels of 25(OH)D and PTH in pregnancy --- p.78
Chapter 3.4.4 --- Independent factors related to maternal 25(OH)D level in pregnancy --- p.79
Chapter 3.4.5 --- Maternal and fetal 25(OH)D level at delivery --- p.80
Chapter 3.4.6 --- Muscular symptoms and other complaints in pregnancy, pregnancy outcome, and their relationships with maternal 25(OH)D level --- p.81
Chapter 3.4.7 --- Postnatal recovery and factors related to postnatal level of 25(OH)D and PTH --- p.86
Chapter 3.4.7.1 --- Postnatal symptoms and relationship with 25(OH)D and PTH --- p.86
Chapter 3.4.7.2 --- The postnatal level of 25(OH)D and PTH in women with different feeding mode --- p.88
Chapter 3.4.7.3 --- Independent factors related to postnatal 25(OH)D and PTH level --- p.89
Chapter 3.4.7.4 --- Factors related to the change of 25(OH)D and PTH after delivery --- p.90
Chapter 3.4.8 --- Correlation between 25(OH)D with PTH in pregnancy and postnatal period --- p.91
Chapter 3.5 --- Discussion --- p.92
Chapter 3.5.1 --- 25(OH)D level in Chinese pregnant women --- p.92
Chapter 3.5.2 --- Factors related to maternal 25(OH)D level --- p.93
Chapter 3.5.2.1 --- Dietary and supplementation --- p.93
Chapter 3.5.2.2 --- Seasonality and outdoor activity --- p.96
Chapter 3.5.2.3 --- Gestational age --- p.98
Chapter 3.5.2.4 --- Age and parity --- p.98
Chapter 3.5.3 --- Relationship of 25(OH)D level in the cord blood with maternal 25(OH)D level --- p.99
Chapter 3.5.4 --- 25(OH)D level and muscular complains in pregnancy --- p.100
Chapter 3.5.5. --- Postnatal recovery and 25(OH)D level --- p.101
Chapter 3.5.6 --- PTH level in pregnancy and postnatal period --- p.101
Chapter 3.6 --- Conclusion --- p.102
Chapter Chapter 4 --- Longitudinal Study on the Relationship between Maternal 25(OH)D level with Changes of Maternal Bone Density in Pregnancy and Lactation, and Factors Affecting Bone Density of newborn Infants --- p.105
Chapter 4.1 --- Introduction --- p.105
Chapter 4.2 --- Material and method --- p.106
Chapter 4.3 --- Statistics --- p.108
Chapter 4.4 --- Results --- p.108
Chapter 4.4.1 --- Demographic data --- p.108
Chapter 4.4.2 --- Maternal bone density and the changes in pregnancy and postnatal recovery --- p.109
Chapter 4.4.2.1 --- Maternal bone density in the first trimester and related factors --- p.109
Chapter 4.4.2.2 --- Maternal bone density in the three visits --- p.109
Chapter 4.4.2.3 --- The change in maternal bone density in the three visits --- p.110
Chapter 4.4.2.4 --- Diversity in the change of bone density in pregnant women --- p.112
Chapter 4.4.3 --- Factors related to the changes in bone density --- p.114
Chapter 4.4.3.1 --- Changes between the first and the third trimesters --- p.114
Chapter 4.4.3.2 --- Change between the third trimester and postnatal visits --- p.116
Chapter 4.4.4 --- The bone density in infants and related factors --- p.120
Chapter 4.5 --- Discussion --- p.122
Chapter 4.5.1 --- Maternal bone density changes in pregnancy and postnatal period --- p.122
Chapter 4.5.2 --- Factors related to the maternal bone density changes in pregnancy and postnatal period --- p.124
Chapter 4.5.2.1 --- Initial bone density, parity, and BMI --- p.125
Chapter 4.5.2.2 --- 25(OH)D and PTH level --- p.126
Chapter 4.5.2.3 --- Supplement --- p.127
Chapter 4.5.2.4 --- Lactation --- p.128
Chapter 4.5.2.5 --- Height --- p.129
Chapter 4.5.3 --- Factors related to bone density of the infant. --- p.130
Chapter 4.5.3.1 --- Maternal 25(OH)D level --- p.130
Chapter 4.5.3.2 --- Gestational age and birthweight --- p.131
Chapter 4.5.3.3 --- Maternal bone density change --- p.131
Chapter 4.5.3.4 --- The gender of the offspring and feeding method --- p.132
Chapter 4.6 --- Conclusion --- p.133
Chapter Chapter 5 --- Maternal 25(OH)D Level in Multiple Pregnancy --- p.134
Chapter 5.1 --- Introduction --- p.134
Chapter 5.2 --- Material and method --- p.135
Chapter 5.3 --- Statistics --- p.136
Chapter 5.4 --- Results --- p.137
Chapter 5.4.1 --- Demographic data of the subjects --- p.137
Chapter 5.4.2 --- The level of 25(OH)D in multiple pregnancy and singleton pregnancy --- p.137
Chapter 5.4.3 --- Supplementation in multiple pregnancy --- p.140
Chapter 5.4.4 --- The change of maternal 25(OH)D and PTH levels in the three trimesters --- p.141
Chapter 5.4.5 --- 25(OH)D level in cord blood and its correlation with 25(OH)D level of the sibling --- p.143
Chapter 5.4.6 --- Correlation between 25(OH) with PTH in pregnancy --- p.143
Chapter 5.5 --- Discussion --- p.144
Chapter 5.5.1 --- 25(OH)D level in multiple pregnancy and singleton pregnancy --- p.144
Chapter 5.5.2 --- Supplementation in multiple pregnancy --- p.146
Chapter 5.5.3 --- Changes of maternal levels of 25(OH)D and PTH in the three trimesters in multiple pregnancy --- p.146
Chapter 5.5.4 --- The PTH/25(OH) correlation --- p.147
Chapter 5.6 --- Conclusion --- p.148
Chapter Chapter 6 --- Maternal level of 25(OH)D in complicated pregnancy --- p.150
Chapter 6.1 --- Introduction --- p.150
Chapter 6.2 --- Method --- p.153
Chapter 6.2.1 --- Preterm birth --- p.155
Chapter 6.2.2 --- Preeclampsia --- p.155
Chapter 6.2.3 --- Gestational diabetes --- p.156
Chapter 6.2.4 --- Fetal growth restriction --- p.157
Chapter 6.2.5 --- The association between 25(OH)D level with pregnancy complication --- p.158
Chapter 6.3 --- Statistics --- p.159
Chapter 6.4 --- Results --- p.160
Chapter 6.4.1 --- Setting of the cutoff values of hypovitaminosis D --- p.160
Chapter 6.4.2 --- Preterm birth --- p.160
Chapter 6.4.3 --- Preeclampsia --- p.164
Chapter 6.4.4 --- Gestational diabetes --- p.168
Chapter 6.4.4.1 --- Case-control study --- p.168
Chapter 6.4.4.2 --- Factors affecting OGTT results --- p.170
Chapter 6.4.5 --- Fetal growth restriction --- p.173
Chapter 6.5 --- Discussion --- p.179
Chapter 6.5.1 --- Adjustment for confounders for case-control study --- p.179
Chapter 6.5.2 --- PTB and 25(OH)D level --- p.181
Chapter 6.5.3 --- PET and 25(OH)D level --- p.182
Chapter 6.5.4 --- GDM and 25(OH)D level --- p.186
Chapter 6.5.5 --- FGR and 25(OH)D level --- p.189
Chapter 6.5.6 --- Defining vitamin D deficiency in pregnancy --- p.192
Chapter 6.6 --- Conclusion --- p.195
Chapter Chapter 7 --- Summary --- p.196
References --- p.201
Chapter Appendix 1 --- Antenatal questionnaire (English/Chinese) --- p.224
Chapter Appendix 2 --- Postnatal questionnaire (English/Chinese) --- p.238

Liong Chan-ching Mario.
Thesis (M.Phil.)--Chinese University of Hong Kong, 2002.
Includes bibliographical references (leaves 72-79).
Abstracts in English and Chinese.
Abstract --- p.i
Acknowledgement --- p.iv
Table of Contents --- p.v
List of Tables --- p.vii
List of Figures --- p.ix
Chapter Chapter One --- Introduction --- p.1
Chapter Chapter Two --- Literature Review --- p.3
Mental Health Deterioration in Unemployment Process
Is Unemployment Status Responsible for the Mental Health Deterioration
Masculine Gender Role Worsens Mental Health During Unemployment
Chapter Chapter Three --- Objectives and Hypotheses --- p.9
Objective and Significance of the Present Study
Variables and Factors in the Study
Hypotheses
Chapter Chapter Four --- Methodology --- p.12
Participants
Procedures
Questionnaire
Chapter Chapter Five --- Results --- p.20
Operationalizaing Socio-economic Status and Financial Responsibility
Exploratory Factor Analysis on Gender Role Conflict Scale
Psychological Variables
Internal Consistencies of the Scales Used
"Intercorrelations Among Demographic Variables, Psychological Variables, and Psychological Distress"
Hierarchical Multiple Regression
Chapter Chapter Six --- Discussion --- p.63
Gender Role Conflict in Action
Limitations and Further Studies
Implications and Suggestions
Conclusion
Bibliography --- p.72
Appendix Questionnaire Used in the Present Study --- p.80

Fong, Hildy Felicia.
Thesis (Ph.D.)--Chinese University of Hong Kong, 2011.
Includes bibliographical references (leaves 221-234).
Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web.
Abstract and appendix also in Chinese.

Numerous dietary factors have been shown to influence the fatty acid profiles (FAP) in breast milk from lactating women. However, few studies have evaluated the effect of trace minerals on milk FAP. Consequently, the purpose of this study was to determine the effect of selenium status on the FAP in breast milk. Subjects were lactating women from three different regions in China; Xichang (n=21), an area where selenium intakes are among the lowest in the world, Beijing (n=20), where there are adequate selenium intakes, and Enshi (n=19), where selenium intakes are among the highest in the world. Plasma and milk samples were obtained from women at birth of their baby and within 10 months postpartum and analyzed for selenium content, glutathione peroxidase (Gpx) activity and FAP. Plasma and breast milk selenium levels were significantly lower in the Xichang women and significantly higher in the Enshi women when compared to Beijing women. Despite the fact that the highest level of plasma selenium was measured in the samples from Enshi, the Gpx activity was greatest in the samples from Beijing; there was no effect of time of sampling on these samples. In breast milk, on the other hand, all the samples obtained at birth had similar activity of Gpx. The samples taken later, however, followed the same trend as plasma with the samples obtained from the women in Beijing having the highest activity. FAP indicated a significant difference in the amount of unsaturated fatty acids in both the plasma and milk for the Beijing women, when compared to the women from Xichang and Enshi. In particular, there were higher levels of linoleic acid, 18:2(n-6), in the plasma and milk of the women whose selenium intake was adequate.
Graduation date: 1997