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Integrating theoretical perspectives with carefully grounded ethnographic analyses of everyday interaction and experience,Living Translationexamines the worlds of international translators as well as U.S. teachers and students of Chinese medicine, focusing on the transformations that occur as participants engage in a \"search for resonance\" with foreign terms and concepts. Based on a close examination of heated international debates as well as specific texts, classroom discussions, and interviews with publishers, authors, teachers, and students, Sonya Pritzker demonstrates the \"living translation\" of Chinese medicine as a process unfolding through interaction, inscription, embodied experience, and clinical practice. By documenting the stream of conversations that together constitute this process, the book thus traces the translation of Chinese medicine from text to practice with an eye towards the social, political, historical, moral, and even personal dimensions involved in the transnational production of knowledge about health, illness, and the body.

Examines the way American teachers and students of Chinese medicine search for resonance in translated texts and concepts. Traces the translation from text to practice and considers the social, political, historical, moral, and personal dimensions involved in the transnational production of knowledge about health, illness, and the body. Integrating theoretical perspectives with carefully grounded ethnographic analyses of everyday interaction and experience.

Traditional Chinese medicine (TCM) originated from the traditional medical system in the Chinese civilization, with influences from the Daoist and Chinese folk traditions in bodily cultivation and longevity techniques. In the past few decades, TCM has become one of the leading alternative medical systems in the United States. This book demonstrates the fluidity of a medical ideological system with a rich history of methodological development and internal theoretical conflicts, continuing to transform in our postmodern world where people and ideas transcend geographic, ethnic, and linguistic limitations. The unique historical trajectories and cultural dynamics of the American society are critical nutrients for the localization of TCM, while the constant traffic of travelers and immigrants foster the globalizing tendency of TCM. The practitioners in this book represent an incredible range of clinical applications, personal styles, theoretical rationalizations, and business models. What really unifies all these practitioners is not their specific practices but the goal of these practices. The shared goal is to strive for health, not just health in terms of the lack of illness but the ultimate health of achieving perfect balance in every aspect of the being of a person—physically, mentally, spiritually, and energetically.

Herbal medicine, including traditional Chinese medicine, has been used for the prevention, treatment, and cure of disorders or diseases for centuries. In addition to being used directly as therapeutic agents, medicinal plants are also important sources for pharmacological drug research and development. With the increasing consumption of herbal products intended to promote better health, it is extremely important to assure the safety and quality of herbal preparations. However, under current regulation surveillance, herbal preparations may not meet expectations in safety, quality, and efficacy. The challenge is how to assure the safety and quality of herbal products for consumers. It is the responsibility of producers to minimize hazardous contamination and additives during cultivation, harvesting, handling, processing, storage, and distribution. This article reviews the current safety obstacles that have been involved in traditional Chinese herbal medicine preparations with examples of popular herbs. Approaches to improve the safety of traditional Chinese medicine are proposed.

Meticulously researched and beautifully written, Fit to Be Citizens? demonstrates how both science and public health shaped the meaning of race in the early twentieth century. Through a careful examination of the experiences of Mexican, Japanese, and Chinese immigrants in Los Angeles, Natalia Molina illustrates the many ways local health officials used complexly constructed concerns about public health to demean, diminish, discipline, and ultimately define racial groups. She shows how the racialization of Mexican Americans was not simply a matter of legal exclusion or labor exploitation, but rather that scientific discourses and public health practices played a key role in assigning negative racial characteristics to the group. The book skillfully moves beyond the binary oppositions that usually structure works in ethnic studies by deploying comparative and relational approaches that reveal the racialization of Mexican Americans as intimately associated with the relative historical and social positions of Asian Americans, African Americans, and whites. Its rich archival grounding provides a valuable history of public health in Los Angeles, living conditions among Mexican immigrants, and the ways in which regional racial categories influence national laws and practices. Molina's compelling study advances our understanding of the complexity of racial politics, attesting that racism is not static and that different groups can occupy different places in the racial order at different times.

Acupuncture has become popular and widely practiced in many countries around the world. Despite the large amount of acupuncture-related literature that has been published, broader trends in the prevalence and scope of acupuncture research remain underexplored. The current study quantitatively analyzes trends in acupuncture research publications in the past 20 years. A bibliometric approach was used to search PubMed for all acupuncture-related research articles including clinical and animal studies. Inclusion criteria were articles published between 1995 and 2014 with sufficient information for bibliometric analyses. Rates and patterns of acupuncture publication within the 20 year observational period were estimated, and compared with broader publication rates in biomedicine. Identified eligible publications were further analyzed with respect to study type/design, clinical condition addressed, country of origin, and journal impact factor. A total of 13,320 acupuncture-related publications were identified using our search strategy and eligibility criteria. Regression analyses indicated an exponential growth in publications over the past two decades, with a mean annual growth rate of 10.7%. This compares to a mean annual growth rate of 4.5% in biomedicine. A striking trend was an observed increase in the proportion of randomized clinical trials (RCTs), from 7.4% in 1995 to 20.3% in 2014, exceeding the 4.5% proportional growth of RCTs in biomedicine. Over the 20 year period, pain was consistently the most common focus of acupuncture research (37.9% of publications). Other top rankings with respect to medical focus were arthritis, neoplasms/cancer, pregnancy or labor, mood disorders, stroke, nausea/vomiting, sleep, and paralysis/palsy. Acupuncture research was conducted in 60 countries, with the top 3 contributors being China (47.4%), United States (17.5%), and United Kingdom (8.2%). Retrieved articles were published mostly in complementary and alternative medicine (CAM) journals with impact factors ranging between 0.7 and 2.8 in the top 20 journals, followed by journals specializing in neuroscience, pain, anesthesia/analgesia, internal medicine and comprehensive fields. Acupuncture research has grown markedly in the past two decades, with a 2-fold higher growth rate than for biomedical research overall. Both the increases in the proportion of RCTs and the impact factor of journals support that the quality of published research has improved. While pain was a consistently dominant research focus, other topics gained more attention during this time period. These findings provide a context for analyzing strengths and gaps in the current state of acupuncture research, and for informing a comprehensive strategy for further advancing the field.

National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of education, and total fertility rates. This frontier allowed us to better quantify the maximum levels of personal health-care access and quality achieved across the development spectrum, and pinpoint geographies where gaps between observed and potential levels have narrowed or widened over time. Between 1990 and 2015, nearly all countries and territories saw their HAQ Index values improve; nonetheless, the difference between the highest and lowest observed HAQ Index was larger in 2015 than in 1990, ranging from 28·6 to 94·6. Of 195 geographies, 167 had statistically significant increases in HAQ Index levels since 1990, with South Korea, Turkey, Peru, China, and the Maldives recording among the largest gains by 2015. Performance on the HAQ Index and individual causes showed distinct patterns by region and level of development, yet substantial heterogeneities emerged for several causes, including cancers in highest-SDI countries; chronic kidney disease, diabetes, diarrhoeal diseases, and lower respiratory infections among middle-SDI countries; and measles and tetanus among lowest-SDI countries. While the global HAQ Index average rose from 40·7 (95% uncertainty interval, 39·0–42·8) in 1990 to 53·7 (52·2–55·4) in 2015, far less progress occurred in narrowing the gap between observed HAQ Index values and maximum levels achieved; at the global level, the difference between the observed and frontier HAQ Index only decreased from 21·2 in 1990 to 20·1 in 2015. If every country and territory had achieved the highest observed HAQ Index by their corresponding level of SDI, the global average would have been 73·8 in 2015. Several countries, particularly in eastern and western sub-Saharan Africa, reached HAQ Index values similar to or beyond their development levels, whereas others, namely in southern sub-Saharan Africa, the Middle East, and south Asia, lagged behind what geographies of similar development attained between 1990 and 2015. This novel extension of the GBD Study shows the untapped potential for personal health-care access and quality improvement across the development spectrum. Amid substantive advances in personal health care at the national level, heterogeneous patterns for individual causes in given countries or territories suggest that few places have consistently achieved optimal health-care access and quality across health-system functions and therapeutic areas. This is especially evident in middle-SDI countries, many of which have recently undergone or are currently experiencing epidemiological transitions. The HAQ Index, if paired with other measures of health-system characteristics such as intervention coverage, could provide a robust avenue for tracking progress on universal health coverage and identifying local priorities for strengthening personal health-care quality and access throughout the world. Bill & Melinda Gates Foundation.

There is growing recognition that the ultimate success of China's ambitious health reform (enacted in 2009) and higher education reform (1998) depends on well educated health professionals who have the clinical, ethical, and human competencies necessary for the provision of quality services. In this Review, we describe and analyse graduate education of doctors in China by discussing the country's health workforce and their clinical residency education. China has launched a new system called the 5 + 3 (5 year undergraduate and 3 year residency [standardised residency training]), which aims to set national quality standards. To improve understanding for the Chinese model, we present a comparative perspective with systems from the UK and USA. To succeed, the 5 + 3 model will need to overcome major challenges of accreditation and certification, alternative education pathways, and China's unique degree and credentialing system. We conclude by reviewing the challenges of clinical competencies in China, especially the complementarity of specialist training and general practitioner training, which are essential for the quality and equity of China's health-care system.