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Background: The demand for certified nurse aides (CNAs) in long-term care institutions is gradually increasing. Factors such as well-being that positively influence the work of CNAs have been inadequately explored in the literature. Purpose: This study was designed to examine the relationships among social support, self-efficacy, demographics, and psychological well-being in CNAs during the recent COVID-19 pandemic and to assess the moderating role of social support on self-efficacy and well-being in this population. Methods: In this quantitative correlational study, CNAs from 24 legally registered long-term care institutions were recruited as participants. Data were collected using a demographic questionnaire, the General Self-Efficacy Scale, the Social Support Scale, and the Chinese Happiness Inventory. Partial least squares structural equation modeling was used to test the research hypotheses model. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was followed in this cross-sectional study. Results: A total of 148 CNAs were enrolled as participants. The mean age of the participants was 46.48 years. Social support and having children were identified as being significantly and positively correlated with well-being, and self-efficacy was identified as having no significant impact on well-being. Importantly, social support was found to moderate the relationship between self-efficacy and well-being. Overall, social support and having children were important predictors of well-being, with a combined explanatory power of 41.6% (Q² = .28, f 2 = 0.40). Conclusions/Implications for Practice: Self-efficacy was found to be less predictive of well-being in the presence of higher levels of social support. Being a parent was also identified as an important factor affecting the well-being of CNAs under stress. Managers of long-term care institutions should intervene to improve the CNA's social support. Also, CNAs who do not have children should pay more attention to their well-being. [ABSTRACT FROM AUTHOR]

With increasing numbers of international students entering Australian social work programs, research has focused on the challenges of teaching these students due to perceived cultural differences and language comprehension. However, limited research has examined their experiences when transitioning to practice. Semi-structured interviews were conducted with 15 international MSW graduates originating from 10 countries and residing across three Australian states. Participants' transition to practice involved similar challenges to those described in research for the broader cohort of newly qualified social workers. However, for the current cohort, initial concerns are equally focused on "fitting in", due to a learned perspective that their cultural and linguistic difference would inhibit practice. Drawing on ecological systems theory, belonging was influenced by contextual factors relating to levels of cultural diversity within workplaces; co-worker support; and participants' sense of preparedness from their education. For all participants, these feelings of difference lessened over time, with some later reflecting that their cultural difference and lived experience was beneficial to their practice. Findings suggest that the strengths of these diverse students could be more readily recognised during education and the field, for improving preparedness for practice, and inclusivity in Australian social work. Problematising international social work students and focusing on their perceived deficits can erode graduates' confidence when first transitioning to the field. The need for cross-cultural learning opportunities for educators, students, and field education agencies is highlighted for recognising the benefits of diversity and for improved preparation of early career social workers for the current professional field. Advances in training and education are needed in organisations where more culturally diverse graduates are securing employment, to ensure that international graduates are supported in early practice, and that diversity is valued in workplaces. [ABSTRACT FROM AUTHOR]

Background: Oral disorders are still a major global public health challenge, considering their perpetuating and chronic nature. Currently, there is no direct index to measure the quality of care on a population scale. Hence, we aim to propose a new index to measure the quality of care for oral disorders worldwide. Methods: We generated our database using the data from the Global Burden of Disease (GBD) study 2017. Among different variables such as prevalence, incidence, years lived with disability, and disability-adjusted life years, we utilised principal component analysis (PCA) to determine the component that bears the greatest proportion of information to generate the novel quality of care index (QCI) for oral disorders. Results: Global QCI for oral disorders gradually increased from 1990 to 2017 (from 70.5 to 74.6). No significant gender disparity was observed during this period, and the gender disparity ratio (GDR) was considered optimal in 1990 and 2017. Between 1990 and 2017, the age-standardised QCI for all oral disorders increased in all the SDI regions. The highest QCI for all oral disorders in 2017 belonged to high-middle SDI countries (=80.24), and the lowest YLDs rate was seen in the low SDI quintile. In 1990, the quality of care in European, Central Asian, and Central and South American countries was in the lowest quintiles, whereas the North American, East Asian, Middle Eastern, and some African countries had the highest quality of dental care. Maynmar (=100), Uganda (=92.5), Taiwan (=92.0), China (=92.5), and the United States (=89.2) were the five countries with the highest age-standardised QCI. Nicaragua (=41.3), Belgium (=40.2), Venezuela (=38.4), Sierra Leone (=30.5), and the Gambia (=30.3) were the five countries with the least age-standardised QCI values. Conclusion: The quality of care for all oral disorders showed an increasing trend on a global scale from 1990 to 2017. However, the QCI distribution was not homogenous among various regions. To prevent the exacerbation of imminent disparities in this regard, better attention to total tooth loss in high-income countries and prioritising primary healthcare provision in low-income countries are recommended for oral disorders. [ABSTRACT FROM AUTHOR]

Objectives: To systematically assess the prevalence of decreased intrinsic capacity in older adults, stratified by relevant factors such as country, sex, sample source, and region. Methods: We conducted a comprehensive search of PubMed, Web of Science, EMBASE, The Cochrane Library, PsychINFO, CINAHL, China Knowledge Resource Integrated Database, Wanfang Database, Weipu Database, and Chinese Biomedical Database to collect studies published on the decline of intrinsic capacity in older adults before February 24, 2023. The results of the study were analyzed using the Stata 15.0 software package, using a random-effects model to estimate the pooled detection rate of decreased intrinsic capacity in older adults. The Joanna Briggs Institute Critical Appraisal Tool was used to assess the quality of all included studies. Results: A total of 16 studies (67,881 older adults in 4 countries) were included. The results showed that the pooled detection rate of decreased intrinsic capacity in older adults was 76.1% (95% CI: 68.0%–84.2%). The 16 studies had obvious heterogeneity, and further subgroup analysis showed that the detection rate of decreased intrinsic capacity in older adults was higher in developed countries, females, and hospitals. Thirteen studies found that the pooled detection rate was 73.7% (95%: CI 64.5%–82.8%) for decreased intrinsic capacity in Chinese older adults, with higher rates in mainland China and Hong Kong than in Taiwan. Conclusions: Our study suggests that intrinsic capacity declines more rapidly in older adults. Understanding the degree of decline in the intrinsic capacity of older adults will help to provide an important basis for the formulation and development of care policies for older adults. Trial registration number: PROSPERO (CRD42023402680). [ABSTRACT FROM AUTHOR]

Objectives Past studies showed that intergenerational contact is beneficial in improving attitudes toward older people. To date, however, research on the benefits of contact with older adults focused on younger adults (intergenerational contact), overlooking the effects for older adults (contact with same-age peers). In this study, we investigated the association between contact with older adults and views of the self in old age in a domain-specific way among younger and older adults. Methods The sample (n = 2,356) comprised younger (39–55 years) and older (65–90 years) adults who participated in the aging as future study and were from China (Hong Kong and Taiwan), the Czech Republic, Germany, and the United States. We used moderated mediation models for data analysis. Results Contact with older adults was related to more positive views of the self in old age and this effect was mediated by more positive stereotypes of older people. These relations were stronger for older adults. Beneficial effects of contact with older adults emerged mostly in the domains of friends and leisure, but less in the family domain. Discussion Having interactions with other older adults may help favorably shape how younger adults and particularly older adults view their own aging, especially in relation to friends and leisure activities. From the perspective of older adults, having regular contacts with other older adults may increase the heterogeneity of exposure to different aging experiences, thus encouraging the formation of more differentiated stereotypes of older people and of their views of themselves in old age. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has changed the learning style and campus life of dental students. This study aimed to evaluate the learning attitudes and outcomes of endodontics among mainland Chinese students and non-mainland Chinese students (students from Hong Kong, Macao, and Taiwan) during the pandemic. Methods: A cross-sectional survey was conducted in November 2022 at the School of Stomatology, Jinan University, utilizing a self-report online questionnaire, including demographic characteristics and attitudes toward the endodontic course and the COVID-19 pandemic. The endodontics scores were collected from recruited students for further analysis. The collected data were analyzed using SPSS 22.0 software, with independent two-sample t-tests to compare continuous variables and chi-square tests for categorical variables. Results: A total of 215 dental students completed the survey, with 126 (58.6%) of them being non-mainland Chinese students. Compared to mainland Chinese students, non-mainland Chinese students had lower scores in both theoretical (63.6 ± 13.5 vs. 83.2 ± 8.00) and skill (88.4 ± 5.38 vs. 90.0 ± 4.91) endodontic assessments. Non-mainland Chinese students reported significantly greater impacts of the COVID-19 pandemic on their learning emotions, personal hygiene, and future career choices compared to mainland Chinese students. Conclusions: Non-mainland Chinese students had poorer academic performance in endodontics and experienced a greater impact from the COVID-19 pandemic in terms of their studies and lives. Dental educators should consider the diversity of students and take necessary measures to support their mental health and enhance learning outcomes in the post-COVID-19 era. [ABSTRACT FROM AUTHOR]

With the growing percentage of Chinese immigrants in the U.S. population, it is crucial to understand how pre-migration factors (such as reasons for migration) are related to the adjustment of families in the host country. The present study examined reasons for migration and their associations with post-migration sociocultural factors and parenting styles in a community-based sample of Chinese American immigrant families (N = 258) living in the San Francisco Bay Area. The parents' self-reported reasons for migration included family reasons (55.1%, e.g., family reunification), betterment reasons (18.0%, e.g., better education and occupational opportunities), and both family and betterment reasons (26.9%). Those who migrated for betterment reasons reported significantly higher parental education and per capita income than the family reason group (p < 0.001) and significantly higher income than the combined reason group (p = 0.007). No significant group differences emerged in cultural orientations and parenting styles after controlling for socioeconomic factors. The findings suggested that Chinese immigrant families who migrated solely for better education and occupational opportunities had significantly higher post-migration socioeconomic status than other reason groups. These differences have relevance for programs and services for new immigrants, as families might need different types of support (e.g., socioeconomic vs. relational) depending on their motivations for migration and post-migration socioeconomic resources. [ABSTRACT FROM AUTHOR]

Objectives To identify genetic variants and polygenic risk score (PRS) relating to female gout and asymptomatic hyperuricaemia (AH) in a genome-wide association study (GWAS). Methods Gout, AH and normouricemia controls were included from Taiwan biobank and China Medical University Hospital. All participants were divided into discovery and replication cohorts for GWAS. PRS was estimated according to whether the variant exhibited a protective effect on the phenotypes or not. Each cohort was separated into two groups by the age of 50 years old. Results A total of 59 472 females were enrolled, and gout and AH occupied 1.60% and 19.59%, respectively. Six variants located in genes SLC2A9 , C5orf22 , CNTNAP2 and GLRX5 were significantly predictors of female gout in those aged ≥50. For those aged <50 years old, only the variant rs147750368 (SPANXN1) on chromosome X was found. Most variants located in genes SLC2A9 , ZNF518B , PKD2 and ABCG2 were found to be significantly related to AH in both age groups. The PRS could explain ∼0.59% to 0.89% of variance of gout in variants with protective effects, which showed 6.2 times of mean PRS in the risk variants, but only 1.2 times in the AH phenotype. Moreover, the PRS also revealed a dose-response trend between AH rates and quartile scores. Conclusion The variants in gene SLC2A9 are the major genetic factors for females associated with gout in those aged ≥50. PRS can provide a more robust prediction of the gout/AH under a homogeneous selection of variants that show effects on the traits. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to explore the contributions of phonological awareness (PA) and morphological awareness (MA) to the reading comprehension skills of Chinese-speaking children with hearing loss (HL) and examine the possible mediation effect of vocabulary knowledge on the relationships of PA and MA with their reading comprehension. Method: The participants were 28 Chinese-speaking children with HL, who were followed from Grade 1 through Grade 2. They were administered a series of tests that measured their PA and MA at the beginning of Grade 1, vocabulary knowledge at the end of Grade 1, and reading comprehension at the end of Grade 2. Results: MA significantly accounted for additional variance in reading comprehension beyond the effect of PA but not vice versa. Both PA and MA contributed uniquely to vocabulary knowledge, which completely mediated the relationships of PA and MA with reading comprehension. Conclusions: PA and MA are both essential to the development of vocabulary knowledge and reading comprehension in Chinese-speaking children with HL; however, MA seems to be more important than PA in their reading comprehension. PA and MA significantly affect children’s reading comprehension through their influence on vocabulary knowledge. This study has replicated previous evidence on the importance of PA, MA, and vocabulary knowledge in the reading comprehension of children with typical hearing, and has extended its significance to children with HL. In addition, the findings have the potential to inform educational practitioners regarding the importance of teaching essential reading skills to Chinese-speaking children with HL. [ABSTRACT FROM AUTHOR]

Background: Irritability is a common experience of depressed Chinese patients but is understudied and poorly measured. Objective: We aimed to assess psychometric properties of a new measure of irritability in Chinese cancer patients across the social and political spectrum. Methods: The Irritability Scale–Initial Version (TISi) was translated into Chinese and tested in two samples of Chinese cancer patients undergoing treatments: 52 patients in Beijing, China, between 2018 and 2019 and 65 patients in Taipei, Taiwan, in 2020. Results: The Chinese version of TISi demonstrated high internal consistency, high reliability based on the split-half method in the two samples, and satisfactory discriminant validity using the Chinese version of the 17-item Hamilton Rating Scale for Depression and the seven-item depression subscale of the Hospital Anxiety and Depression Scale in the Beijing sample. A confirmatory factor analysis produced factor loadings in both samples, which resembled a sample of American cancer patients. Three TISi items were loaded more highly on the physical instead of the original behavioral subscale in the Beijing sample. A possible influence of cultures was explained. Conclusion: The Chinese version of TISi has satisfactory psychometric properties for assessing the level of irritability in Chinese cancer patients. Future large-sample studies are needed to further determine TISi's factorial structure, test–retest reliability, sensitivity to change, and predictive validity for depression in Chinese cancer patients. [ABSTRACT FROM AUTHOR]

Importance: Handwriting legibility is the main criterion for determining whether a child has handwriting difficulties. A comprehensive assessment of handwriting legibility with sound psychometrics is essential to timely identification of handwriting difficulties and outcome measurement after handwriting interventions. Objective: To evaluate the psychometrics of the Computer-Aided Measure of Chinese Handwriting Legibility (CAM-CHL) and to investigate Chinese handwriting legibility in school-age children using the CAM-CHL. Design: Cross-sectional, repeated observation, test–retest. Setting: Elementary schools in Taiwan. Participants: We recruited 25 lower-grade children for the examination of test–retest reliability, 75 children from all grade levels, and 10 senior schoolteachers for the examination of the CAM-CHL's convergent validity and the investigation of handwriting legibility. Outcomes and Measures: Children were asked to copy a set of Chinese characters as legibly as possible. We used the CAM-CHL to assess handwriting legibility in four domains: Size, Orientation, Position, and Deformation. The schoolteachers were asked to subjectively assess the handwriting legibility using a 3-point Likert-type scale. Results: The CAM-CHL demonstrated good to excellent test–retest reliability and acceptable random measurement error in all legibility domains. The CAM-CHL had fair to moderate convergent validity with schoolteachers' perceptions. Additionally, upper-grade children had better handwriting legibility in the Size and Position domains than lower-grade children. Conclusions and Relevance: The CAM-CHL, a comprehensive and objective method of assessing Chinese handwriting legibility, has sound reliability and acceptable validity, suggesting its potential as an outcome measure for school-age children. What This Article Adds: The CAM-CHL can be used in comprehensive evaluations of Chinese handwriting legibility in school-age children. The CAM-CHL has acceptable psychometrics for use as an outcome measure. This study supports the use of the Computer-Aided Measure of Chinese Handwriting Legibility (CAM-CHL) as an outcome measure with acceptable psychometrics for the comprehensive evaluation of the handwriting legibility of school-age children. [ABSTRACT FROM AUTHOR]

Mathematics learning trajectories (LTs) for students above elementary school level are widely investigated. Recently, LTs for kindergarteners have also attracted attention, but in those studies the LTs were based on Western samples, and it is unclear whether they also involved culture and gender differences. Therefore, the purposes of this study were twofold: (1) construct a counting and arithmetic LT based on an Eastern sample and (2) show its similarities and differences by gender. The constructed LT contains 13 hypothesized levels of mathematical concepts according to previous research, and 59 kindergarteners (26 boys and 33 girls) participated in this study and completed a counting and arithmetic test to examine empirically the theoretical LT. The results showed that empirically, there were eight and nine conceptual levels for boys and girls, respectively, and boys and girls mastered concepts in a similar order (basic arithmetic→basic counting→advanced counting→mediocre arithmetic→advanced arithmetic), with the first part differing from the hypothesized LT. Within this developmental progression, girls showed a different path from advanced counting to mediocre arithmetic. The findings show gender and culture differences for the LTs for kindergarteners, which contradicts most previous research based on Western samples. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore and compare stress, coping, professional identity and work locus of control of new graduate nurses among Shanghai, Hong Kong and Taipei. Background: The transition from a student to a staff nurse role is recognized as a stressful experience and can be a rough journey. Many newly graduated nurses find it challenging to cope with their new roles in their first few months. Methods: A cross‐sectional research was used in the study. This study was completed in Shanghai, Hong Kong and Taipei with newly graduated nurses working in hospitals. A total of 591 graduate nurses who had worked within 1 year in hospitals were recruited using convenient sampling. Data were collected using a structured questionnaire, including demographics, the occupational stress scale, the Chinese trait coping style questionnaire, the nurse professional identity scale and the work locus of control scale (Chinese version). Results: The newly graduated nurses in Shanghai had significantly lower (p < 0.05) work stress score (2.65 ± 0.67) compared with their counterparts in Hong Kong (2.99 ± 0.69) and Taipei (2.94 ± 0.60). Newly graduated nurses in Shanghai tended to choose positive coping to deal with stressful situations, whereas those in Hong Kong would be more likely to adopt negative attitudes (p < 0.05). The newly graduated nurses in Taipei had the lowest level of professional identity (3.25 ± 0.55, p < 0.05), and their work control tended to be external (46.13 ± 6.20). In contrast, those in Shanghai (52.75 ± 6.04) and Hong Kong (59.41 ± 7.29) tended to be controlled internally. Conclusions: The study findings revealed the differences among newly graduated nurses in Shanghai, Hong Kong and Taipei with their level of stress, coping, professional identity and work locus of control. Proper leadership, mentoring for newly graduated nurses, and emphasis on first aid nursing training, emotional management and management of stress in newly graduated nurse transition programmes were suggested. Implications for Nursing Management: By comparing the results in the three regions, we recommend that nursing managers promote the right leadership style. In addition to coaching, nursing managers can assign additional mentors to newly graduated nurses to help them supplement their clinical knowledge and skills with psychological support. These mentors can come from senior nurses or nursing managers working on less demanding tasks. In addition to the existing post transfer training programmes, new graduate nurses should also focus on emergency nursing training, emotional management training and stress management training. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

This study explores relationships between Taiwanese Sign Language (TSL) and Chinese reading comprehension with 65 deaf adults/youth (study 1: ages 14–50 years) and 27 deaf children (study 2: ages 6–13 years). Significant relationships were found between scores on two tests measuring TSL tasks. In study #1, the TSL tasks (measured by Taiwan Sign Language Comprehension Test, TSLCT) on story and syntax comprehension predicted more of the variance than vocabulary on Chinese reading comprehension. In study #2, TSL tasks measuring vocabulary (using Taiwanese Sign Language Receptive Skills Test, TSL-RST) predicted more of the variance than syntax and story comprehension on Chinese reading comprehension but were not significant. Results are interpreted utilising Cummins' Linguistic Interdependence Theory and Threshold Hypothesis. Limitations, future research and educational implications are provided. [ABSTRACT FROM AUTHOR]

Taoism and Confucianism both exited simultaneously as philosophies of living in dynastic China. Although there has been an increasing popularity in scientometric studies, religion and health (R&H) literature lacks a holistic evaluation investigating articles relevant to Taoism and Confucianism. All publications produced in Taoism and Confucianism literature and indexed in Web of Science (WoS) databases between 1975 and 2018 were included in this study. Database search on health and Taoism literature retrieved 199 documents from WoS databases. Main research areas were Psychology, Religion and Behavioral Sciences (24.121, 21.608 and 20.603, respectively). The USA ranked first with 38 papers followed China, Taiwan and the UK (n = 35, 20 and 6 documents, respectively). Hong Kong Polytechnic University from China was the most contributor institution in health and Taoism literature. A total of 448 documents were published in health and Confucianism literature between 1975 and 2018, and original articles covered 93.08% of all literature. China was leading country with 126 articles followed by the USA, South Korea and Taiwan (n = 97, 35 and 35 items, respectively). The most productive institutions were City University of Hong Kong (China), Karolinska Institute (Sweden) and University of Hong Kong (China). Researchers from developing and least developed countries should be encouraged to carry out novel scientometric studies in R&H literature. [ABSTRACT FROM AUTHOR]

The Paralympic Games is the largest sporting competition for athletes with an impairment. This competition has, however, had limited news coverage in the past particularly compared to the Olympic Games. This study analyzes newspaper coverage of the 2016 Paralympic Games by two newspapers in 11 countries (China, Iran, Japan, Malaysia, Oman, Saudi Arabia, Singapore, South Africa, South Korea, Taiwan, and the United Kingdom). The coverage period spanned 7-19 September 2016. Text and pictures were coded according to page number, content, gender, sport, and nationality of person. Media content analysis was used to extract coverage of themes. Results are presented using descriptive statistics and frequency counts. Of the 623 articles and 541 photographs analysed, a small percentage (7.3%) were on the front pages of newspapers. Most articles and photographs (78.7%) were about athletes or teams. There was more coverage of male athletes (53.2%) and local athletes (71.6%). The Paralympic Games has historically received less newspaper coverage than the Olympic Games. This study examined newspaper coverage of the 2016 Paralympic Games from 11 countries. For the 2016 Rio Paralympic Games, newspaper coverage in most countries was good, lasting nearly the whole duration, and this also included a number of front page reports. The type of coverage and number of reports differ between countries. Generally, the highest medal winning countries gave more media attention to the Games. The news reports focused primarily on their local athletes and teams. Moreover, males had more news coverage than females overall. [ABSTRACT FROM AUTHOR]

This study assessed the discrepancies between reports from parents and children concerning children's exposure to violence/pornography on mobile devices and the impact on the psychosocial adjustment of children. Data were obtained from a sample of 2,230 parent–child dyads recruited from 16 elementary schools (1,140 dyads) in Taiwan and 9 schools (1,090 dyads) in China. A self-administered questionnaire was used. The results showed that about 30 percent of children reported being exposed to violence on mobile devices. Approximately 70 percent of their parents were unaware of their child's exposure to violence on mobile devices. About 16 percent of children reported exposure to pornography on mobile devices, and 80 percent of their parents were unaware of this exposure. Multinomial logistic regression results showed that after controlling for parent and child sociodemographic variables, factors related to parental unawareness of child exposure to violence on mobile devices included a child's ownership of mobile devices, smartphone/tablet use time, a lower level of parental understanding, and a residence in China or in a rural area, whereas the parent–child relationship and a child's smartphone/tablet use time were associated with parents who were unaware of their child's exposure to pornography. Multiple regression results showed that children who were living with household poverty, had a poor parent–child relationship, spent much time using a smartphone/tablet, and with parents who were unaware of their exposure to violence/pornography on mobile devices were more likely to have emotional and behavioral problems. [ABSTRACT FROM AUTHOR]

• Household is an important physical activity resource in older adults' daily life. • Older adults' HPA and SWB had a positive association. • Engaging in HPA is a good approach for increasing old adults' self-rated health. • HPA is recommended for old couples to maintain marital satisfaction. • Older adults living in China and South Korea had higher HPA than others. Engaging in lifelong physical activity has multiple health benefits for older populations. Household physical activity occupies older adults' awake time, and they can be an important energy expenditure during the day. The purpose of this study was to investigate the association between older adults' household physical activity and subjective well-being in four East Asian societies. The study design was a secondary data analysis. Data were retrieved from the module of Families 2016 in the database of the East Asian Social Survey. Participants were community-dwelling older adults with a mean age of 70.30±7.50 years and who lived in China, Japan, Korea, and Taiwan. Data were collected by interviews via structured questionnaires between 2016 and 2018. Descriptive analyses, independent t -tests, and an analysis of covariance were performed for the statistical analyses. In total, there were 3,432 valid responses. Participants who lived in Taiwan had significantly lower levels of total household physical activity than those living in other societies. Older adults' household physical activity was found to significantly differ by age, educational degree, gender, religion, marital status, occupation, and whether living alone. Older adults with high levels of household physical activity had significantly higher self-rated health and marital satisfaction than those with low levels. Household physical activity has potential benefits for subjective well-being across international older adult populations. Increasing household physical activity is recommended for older married couples to maintain marital satisfaction. [ABSTRACT FROM AUTHOR]

Parent-mediated intervention is a prominent approach to supplementing service insufficiency for the population with autism spectrum disorder, yet individuals from low-resource areas are largely under-represented among participants in the global parent-mediated intervention research. This systematic review and meta-analysis is the first to inspect the overall effects and research quality of parent-mediated interventions in mainland China, Hong Kong, and Taiwan. A total of 21 parent-mediated interventions were included in systematic review, and among them, 12 randomized controlled trials representing 964 children were analyzed in meta-synthesis. Overall, results of meta-analysis showed favorable effects of parent-mediated interventions with standardized mean difference ranging from 0.63 (social competence) to 1.00 (symptom severity) and averaged 0.76 across domains. However, the results should be interpreted with caution due to poor evidence quality as assessed in GRADE ratings. In terms of methodological quality, QualSyst evaluation showed that more than half (14/21) of the included studies were below satisfactory. Identified programs lack the capacity to be further disseminated in the Chinese societies due to the absence of solid theoretical foundations, the negligence of implementation outcomes, and the inadequacy of sophisticated cultural adaptations. This review reinforces the need for promotion and improvement of parent-mediated interventions in low-resource context (PROSPERO: CRD42019138723). The ideal dosage for early intensive interventions for autism spectrum disorder has been suggested to be at least 25-hour per week to reach optimal effects. However, insufficient service use and unmet needs among families with children with autism spectrum disorder are frequently reported worldwide. Helping parents to develop strategies for interaction and management of behavior through parent training has been demonstrated to be a prominent way to supplementing service insufficiency for autism spectrum disorder, which is particularly crucial in less-resourced areas. This review included 21 parent-mediated intervention programs conducted in China, the most populated developing country. Among them, we were able to combine outcome information from 12 randomized controlled trials to increase confidence in the results. We also rated the quality of methodology and evidence for all included studies, which was taken into account in making conclusions. The included programs varied in the content, length, and delivery method of trainings. Although targeting different training outcomes, the majority of the studies aimed to help parents be more competent and responsive during interactions with their child in order to decrease symptom severity. Overall, results showed sufficient evidence that parent training did improve child outcomes as intended. However, the quality of more than half (14/21) of the included studies were below satisfactory. Identified programs lack the capacity to be further transported in the Chinese societies due to the lack of solid theoretical foundations, implementation manuals, and appropriate cultural adaptations. This review reinforces the need for promotion and improvement of parent-mediated interventions in low-resource context. [ABSTRACT FROM AUTHOR]

Objectives This study constructed an Active Aging Index (AAI) for Vietnam and compares Vietnam's AAI with those of China, Korea, Taiwan, and 28 countries in the European Union. Methods A survey of 1,105 people aged 55 or above in three provinces from the northern, central, and southern parts of Vietnam was conducted. Active aging was measured using the AAI; its 22 indicators were grouped into four domains: employment, social participation, independent/healthy/secure living, and enabling environments. Results Of the 32 countries reviewed, Vietnam ranked I Ith. It ranked high for employment (1st) and social participation (5th) but low for independent/healthy/secure living (32nd) and enabling environments (26th). Conclusion Three policy priorities were identified: maintaining a high preference-driven social and workforce participation rate among older adults; promoting medical care and healthy behaviors among older adults; and improving other poorly performing aspects of active aging, including voluntary activities, poverty risk, Internet usage, and lifelong learning. [ABSTRACT FROM AUTHOR]

With the increase in our older adult population, there is a need for dementia training for informal and formal dementia caregivers. The objective of this scoping study is to assess dementia knowledge instruments utilized in educational programs and interventions intended for formal and informal dementia caregivers. Scoping review methodology was used to search PubMed, PsycInfo, CINAHL and Web of Science with tailored database search terms. The search yielded 8101 results, with 35 studies meeting inclusion. Studies were conducted in eight countries, had varying study designs (randomized controlled trials [RCTs] = 9, non‐RCTs = 6, one‐group study design = 20) and utilized previously published (19) and author developed (16) instruments. Furthermore, the studies were internationally diverse, conducted in the United States (n = 18), Australia (n = 7), UK (n = 3), China (n = 2), Canada (n = 2), Taiwan (n = 1), Brazil (n = 1) and multi‐country (n = 1). Only two studies focused on minority populations. While author‐developed instruments may be more relevant and timesaving, studies should strive to validate instruments or use previously published instruments to help standardize findings across studies and understand better the effects of educational programs on caregiver knowledge. Geriatr Gerontol Int 2020; 20: 397–413. [ABSTRACT FROM AUTHOR]

The equivalent reduction in greenhouse gas emissions (GHGEs) by Mahayana Buddhists with vegetarian diets is quantitatively evaluated. The Buddhists in seven Mahayana-dominated countries or regions, i.e., China, Japan, Vietnam, South Korea, Taiwan, Hong Kong, and Singapore, are studied. Assessments of the vegetarian population among these Mahayana-dominated countries or regions are performed. Correlation formulas based on data from a national survey are developed to quantify the GHGEs of various dietary groups by using the meat consumption as the only required input. To demonstrate its reliability, the prediction from the formulas developed is first compared with the results of a food production-and-consumption study using a different approach. Then, the formulas are used to assess the GHGE reduction due to Mahayana Buddhists with vegetarian diets. The assessment indicates that Mahayana Buddhists with vegetarian diets account for the equivalent GHGE reduction of 48.83 million metric tons of carbon dioxide equivalent, which is a huge amount and is equal to 11.3 or 8.9% of the GHGEs from France or the UK in 2012, respectively. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate the cultural and semantic equivalence of the Activity Measure Post-Acute Care (AM-PAC) outpatient short forms after they were translated from American English to Mandarin Chinese. Method: This study was conducted with a composite sample of a group of 483 American adults (mean age 63.1 years, 42.4% males) and 553 Taiwanese adults (mean age 60.6 years, 47.2% males) who were undergoing home care or outpatient rehabilitation services. A confirmatory factor analysis tested the cultural equivalence of the AM-PAC dimensions between the US and Taiwanese samples. Semantic equivalence was tested through an item response theory-based differential item functioning (DFI) analysis. Results: Results of the confirmatory factor analysis demonstrated good model-data fit of the AM-PAC in both the US and Taiwanese samples. Significant DFI was found for six Basic Mobility items, two Daily Activity items, and four Applied Cognition items. A DFI adjusted conversion table was generated to transform the raw scores of the measure for comparisons between the two countries. Conclusions: This study provides evidence to support the conceptual equivalence of the AM-PAC when used in rehabilitation patients between American and Taiwanese cultural contexts. Some DFI items between the two groups were found, suggesting that some differences in semantic understanding of these items between cultures require cross-cultural adjustments. Cultural equivalence needs to be tested before applying a clinical measure to another context. The findings of this study supported the three activity domains that the Activity Measure Post-Acute Care measures: Basic Mobility, Daily Activity, and Applied Cognition, which are all important rehabilitation outcomes that need to be assessed and monitored across rehabilitation settings. Differential item functioning was observed between the English and Chinese versions of the Activity Measure Post-Acute Care, indicating that linguistic and cultural differences across countries need to be adjusted for before using the translated measure in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To systematically assess the prevalence of frailty, including prefrailty, stratified prevalence according to frailty criteria, gender, age, and region, and the risk factors for frailty in China. Design: We conducted a systematic literature review and meta-analysis using articles available in 8 databases including PubMed, Cochrane Library, Web of Science, CINAHL Plus, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and Weipu Database (VIP). Setting: Crosssectional and cohort data from Chinese community. Participants: Community-dwelling adults aged 65 and older. Measurements: Two authors independently extracted data based upon predefined criteria. Where data were available we conducted a meta-analysis of frailty parameters using a random-effects model. Results: We screened 915 different articles, and 14 studies (81258 participants) were ultimately included in this analysis. The prevalence of frailty and prefrailty in individual studies varied from 5.9% to 17.4% and from 26.8% to 62.8%, respectively. The pooled prevalence of frailty and prefrailty were 10% (95% CI: 8% to 12%, I2 = 97.4%, P = 0.000) and 43% (95% CI: 37% to 50%, I2 = 98.0%, P = 0.000), respectively. The pooled frailty prevalence was 8% for the Fried frailty phenotype, 12% for the frail index, and 15% for the FRAIL scale. Age-stratified meta-analyses showed the pooled prevalence of frailty to be 6%, 15%, and 25% for those aged 65–74, 75–84, and ≥85 years old, respectively. The pooled prevalence of frailty was 8% for males and 11% for females. The pooled prevalence of frailty in Mainland China, Taiwan, and Hong Kong was 12%, 8%, and 14%, respectively. The pooled frailty prevalence was 10% in urban areas and 7% in rural areas. After controlling for confounding variables, increasing age (OR = 1.28, 95% CI: 1.2 to 1.36, I2 = 98.0%, P = 0.000), being female (OR = 1.29, 95% CI: 1.16 to 1.43, I2 =92.7%, P=0.000), activities of daily living (ADL) disability (OR = 1.72, 95% CI: 1.57 to 1.90, I2 = 99.7%, P = 0.000), and having three or more chronic diseases (OR = 1.97, 95% CI: 1.78 to 2.18, I2 = 97.5%, P = 0.000) were associated with frailty. Conclusions: These findings of this review indicate an overall pooled prevalence of frailty among Chinese community-dwelling older people of 10%. Increasing age, being female, ADL disability, and having three or more chronic diseases were all risk factors for frailty. Further research will be needed to identify additional frailty risk factors in order to better treat and prevent frailty in the community. [ABSTRACT FROM AUTHOR]

Using the Global Trust Inventory, an integrated measure of trust toward 21 relationships and institutions, the structure of trust was explored in four East Asian societies (Mainland China, Japan, South Korea, and Taiwan). The Western model, in which trust is distributed among seven factors representing different branches of society, did not generalize to these East Asian societies, perhaps due to differences in culture and institutional power structures. Instead, two unique structures of trust were identified. Mainland China had a top ‐ down structure of trust (the China model), in which trust is hierarchically separated between the central government and subordinate implementing bodies. The other three democratic East Asian societies shared a hybrid structure of trust (the Democratic East Asian model) that has a degree of similarity to both the China model and the Western model. Having established two similar, but still distinct models, a cross ‐ cultural comparison was made on the proportions of trust profiles generated by latent profile analysis. Mainland China had the largest proportion of people with a high propensity to trust, followed by Japan and South Korea, and Taiwan was the least trusting. Implications of the structure of trust and this alternative approach to conducting cross ‐ cultural comparisons are discussed. [ABSTRACT FROM AUTHOR]

An understanding of symptoms in heart failure (HF) among different cultural groups has become increasingly important. The purpose of this study was to compare symptom reporting and symptom clusters in HF patients between a Western (the United States) and an Eastern Asian sample (China and Taiwan). A secondary analysis of a cross-sectional observational study was conducted. The data were obtained from a matched HF patient sample from the United States and China/Taiwan (N = 240 in each). Eight selective items related to HF symptoms from the Minnesota Living with Heart Failure Questionnaire were analyzed. Compared with the U.S. sample, HF patients from China/Taiwan reported a lower level of symptom distress. Analysis of two different regional groups did not result in the same number of clusters using latent class approach: the United States (four classes) and China/Taiwan (three classes). The study demonstrated that symptom reporting and identification of symptom clusters might be influenced by cultural factors. [ABSTRACT FROM AUTHOR]

Attitude toward women and relationship violence in Chinese societies has been shaped by a history of Confucian patriarchy. Studies suggest that this patriarchal orientation continues to influence modern-day dating behaviors and rates of relationship violence. This study examined through the lens of the intergenerational transmission of violence theory the effects of dominance and jealousy on the likelihood of physical assault and how violent socialization moderates these effects. A maximum likelihood path analysis with robust standard errors was conducted for a total of 915 individuals from Beijing, Shanghai, and Taiwan who participated in the International Dating Violence Study from 2001 to 2006. Results revealed that dominance and violent socialization were significantly associated with assault victimization and perpetration. Violent socialization also significantly amplified the associations between dominance and both minor and severe assault victimization. Jealousy, however, was only associated with severe assault perpetration. Clinical implications and further research directions are discussed. [ABSTRACT FROM AUTHOR]

The current study examined the associations between basic auditory perception, speech prosodic processing, and vocabulary development in Chinese kindergartners, specifically, whether early basic auditory perception may be related to linguistic prosodic processing in Chinese Mandarin vocabulary acquisition. A series of language, auditory, and linguistic prosodic tests were given to 100 preschool children who had not yet learned how to read Chinese characters. The results suggested that lexical tone sensitivity and intonation production were significantly correlated with children's general vocabulary abilities. In particular, tone awareness was associated with comprehensive language development, whereas intonation production was associated with both comprehensive and expressive language development. Regression analyses revealed that tone sensitivity accounted for 36% of the unique variance in vocabulary development, whereas intonation production accounted for 6% of the variance in vocabulary development. Moreover, auditory frequency discrimination was significantly correlated with lexical tone sensitivity, syllable duration discrimination, and intonation production in Mandarin Chinese. Also it provided significant contributions to tone sensitivity and intonation production. Auditory frequency discrimination may indirectly affect early vocabulary development through Chinese speech prosody. [ABSTRACT FROM AUTHOR]

Antitobacco advertisement components, including types of messages and advertising appeals, have not been evaluated among multinational groups. This study identified and compared the content of antismoking video ads across three countries. We reviewed 86 antismoking video advertisements for the following information: severity of the consequences of smoking, types of risks, appeals to audiences' self-efficacy, benefits of not smoking, targeted social-ecological level and types of message appeal used. Two researchers independently coded each advertisement with an average inter-coder reliability of 0.79. Analyses showed a variety of focuses: smoking related health risks (86%), severe consequences of smoking (54.7%), self-efficacy beliefs (40.7%) and benefits of not smoking (84.9%). Compared to the United States and Taiwanese ads, Chinese ads were more likely to target at the community level (10% versus 23.3% versus 47.2%). Additionally, 55% of the United States ads used the fear approach, whereas 61.1% of Chinese ads used the social approach. Taiwanese ads were evenly distributed among both approaches. In conclusion, the countries used different targeting strategies and approaches during message delivery. Although China's neighboring country, Taiwan, has many similar cultural aspects, including the same language, they are greatly influenced by US antitobacco campaigns. As a result, Taiwan's tobacco campaigns appear to have similar components to both China and the United States. Further research is warranted to understand the reasons for each method and to examine the effectiveness of the ads in reducing smoking rates. [ABSTRACT FROM AUTHOR]

Objectives. We evaluated the causes, hearing, and speech performance before and after cochlear implant reimplantation in Mandarin-speaking users. Methods. In total, 589 patients who underwent cochlear implantation in our medical center between 1999 and 2014 were reviewed retrospectively. Data related to demographics, etiologies, implant-related information, complications, and hearing and speech performance were collected. Results. In total, 22 (3.74%) cases were found to have major complications. Infection (n=12) and hard failure of the device (n=8) were the most common major complications. Among them, 13 were reimplanted in our hospital. The mean scores of the Categorical Auditory Performance (CAP) and the Speech Intelligibility Rating (SIR) obtained before and after reimplantation were 5.5 versus 5.8 and 3.7 versus 4.3, respectively. The SIR score after reimplantation was significantly better than preoperation. Conclusions. Cochlear implantation is a safe procedure with low rates of postsurgical revisions and device failures. The Mandarin-speaking patients in this study who received reimplantation had restored auditory performance and speech intelligibility after surgery. Device soft failure was rare in our series, calling attention to Mandarin-speaking CI users requiring revision of their implants due to undesirable symptoms or decreasing performance of uncertain cause. [ABSTRACT FROM AUTHOR]

Demographic, socioeconomic, and urbanization level variations in Parkinson’s disease (PD) are rarely investigated, especially in Asia. This study describes an eight-year trend in PD incidence and prevalence in Taiwan as well as assessing the effects of sociodemographics and urbanization on the incidence and prevalence of PD. The data analyzed were acquired from the Taiwan National Health Insurance Research Database (NHIRD) entries between 2002 and 2009. The calendar year, sex, and age-specific rates were standardized, and the effects of the sociodemographics and urbanization on PD were assessed using Poisson regression analysis. PD incidence and prevalence showed a significantly increasing trend, with a greater magnitude noted for prevalence than for incidence (87.3% versus 9.2%). The PD incidence and prevalence increased with age and were slightly higher in men than in women. The people who were not under the labor force (i.e., dependents) or with lower monthly incomes were at significantly increased adjusted incidence rate ratio (1.50–1.56) and adjusted prevalence rate ratio (1.66–1.71) of PD. Moreover, significantly higher PD incidence and prevalence were noted in areas with lesser urbanization. This information emphasizes the need for preventive and clinical care strategies targeting the segment of Taiwanese population that exhibited a greater incidence and prevalence of PD. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the pattern of Traditional Chinese Medicine (TCM) usage for urolithiasis patients in Taiwan and to determine the most common Chinese herbal products used for urolithiasis. Design: Retrospective review of urolithiasis patients treated with TCM treatment. Settings/Location: One million randomly selected samples in the Taiwanese National Health Insurance Research Database between 1997 and 2008. Patients: Eighty-two thousand five hundred and fifty-one newly diagnosed urolithiasis patients. Outcome measures: The correlation between TCM treatment, demographic factors, or medical conditions. Results: A total of 62.6% of urolithiasis patients use TCM treatment. A younger age, female gender, polypharmacy, multiple comorbidities, and stone in the lower urinary tract result in a greater tendency to use TCM, after adjusting for demographic factors. Jia-Wei-Xiao-Yao-San Extract Powder and Ji-Sheng-Shen-Qi-Wan Extract Powder are the most frequently prescribed Chinese medicine formulae. Conclusion: This is the first study to examine the use of and the prescription pattern for TCM in urolithiasis patients using a random, national population-based sample. More than 62% of urolithiasis patients use TCM, and patients with polypharmacy, multiple comorbidities, and stone in the ureter are more likely to use TCM. The most frequently prescribed Chinese medicine formulae were Jia-Wei-Xiao-Yao-San Extract Powder and Ji-Sheng-Shen-Qi-Wan Extract Powder, which were reported to retard the progression of renal failure and alleviate flank pain or tenderness. [ABSTRACT FROM AUTHOR]

Discrimination plays an important role in the development of ethnic minority adolescents. However, previous studies have often adopted a unidirectional model examining the influence of discrimination on adolescent development, thus leaving the potential reciprocal relationship between them understudied. Moreover, there is a dearth of studies on Chinese Americans in the discrimination literature. Therefore, this study aimed to examine the reciprocal relationships between discrimination and two measures of adolescent outcomes (i.e., ethnic affect and depressive symptoms) from early adolescence to emerging adulthood in Chinese Americans. Participants were 444 adolescents (54 % female), followed at four-year intervals, beginning at 7th or 8th grade ( M = 13.03) in 2002, for a total of three waves. An examination of cross-lagged autoregressive models revealed two major findings. First, in contrast to the rejection-identification model, perceived discrimination at early adolescence negatively related to ethnic affect at middle adolescence. Conversely, ethnic affect at early adolescence also negatively related to discrimination at middle adolescence. These results held the same direction but became insignificant from middle adolescence to emerging adulthood. Second, perceived discrimination positively related to depressive symptoms across the studied developmental periods, and depressive symptoms positively related to perceived discrimination from middle adolescence to emerging adulthood. The strength of these longitudinal relationships did not change significantly across developmental periods or gender. These findings highlight the bidirectional relationship between perceived discrimination and adolescent outcomes; they also demonstrate the value of studying the discrimination experiences of Chinese Americans. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this study was to investigate whether there were gender-specific depressive symptom profiles or gender-specific patterns of psychotropic agent usage in Asian patients with depression. Method: Clinical data from the Research on Asian Psychotropic Prescription Patterns for Antidepressant study (1171 depressed patients) were used to determine gender differences by analysis of covariates for continuous variables and by logistic regression analysis for discrete variables. In addition, a binary logistic regression model was fitted to identify independent clinical correlates of the gender-specific pattern on psychotropic drug usage. Results: Men were more likely than women to have loss of interest (adjusted odds ratio = 1.379, p = 0.009), fatigue (adjusted odds ratio = 1.298, p = 0.033) and concurrent substance abuse (adjusted odds ratio = 3.793, p = 0.008), but gender differences in other symptom profiles and clinical features were not significant. Men were also more likely than women to be prescribed adjunctive therapy with a second-generation antipsychotic (adjusted odds ratio = 1.320, p = 0.044). However, men were less likely than women to have suicidal thoughts/acts (adjusted odds ratio = 0.724, p = 0.028). Binary logistic regression models revealed that lower age (odds ratio = 0.986, p = 0.027) and current hospitalization (odds ratio = 3.348, p < 0.0001) were independent clinical correlates of use of second-generation antipsychotics as adjunctive therapy for treating depressed Asian men. Conclusion: Unique gender-specific symptom profiles and gender-specific patterns of psychotropic drug usage can be identified in Asian patients with depression. Hence, ethnic and cultural influences on the gender preponderance of depression should be considered in the clinical psychiatry of Asian patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prescription pattern of antidepressants in patients with medical co-morbidity from major psychiatric centres in Asia. Methods: The Research on Asian Psychotropic Prescription Pattern for Antidepressants (REAP-AD 2013) collected data from 42 psychiatric centres in 10 Asian countries and regions. Antidepressant prescriptions of 2320 patients with various psychiatric disorders were evaluated. Of these, 370 patients who had specified medical co-morbidities formed the study cohort. Results: Escitalopram (20%) and mirtazapine (20%) were the most commonly prescribed antidepressants in patients with medical co-morbidity followed by sertraline (16%), trazodone (15%), and paroxetine (12%). Overall, more than half (52%; 247/476) of prescriptions comprised selective serotonin reuptake inhibitors. Slightly less than two-thirds (63%; n = 233) of patients received at least 1 selective serotonin reuptake inhibitor. In addition, 79% of patients were prescribed only 1 antidepressant. The mean number of antidepressants used per patient was 1.25 (standard deviation, 0.56). There were subtle differences in the most preferred antidepressant across medical illnesses such as diabetes mellitus, liver dysfunction, acid peptic disease, and cerebrovascular disease. Differences were also seen in prescription patterns across different countries. Conclusion: Although selective serotonin reuptake inhibitors formed the bulk of antidepressant prescriptions in the presence of medical co-morbidity, mirtazapine was also commonly used in the presence of medical co-morbidities. Specified medical morbidities do influence the selection of antidepressants. [ABSTRACT FROM AUTHOR]

Purpose: The objective of these studies was to evaluate the pharmacokinetic profile, safety, and tolerability of mirabegron, a β3-adrenoceptor agonist for the treatment of overactive bladder, including food effects (low- or high-fat meals) and sex, in healthy East Asian subjects. Methods: In total, 5 pharmacokinetic studies of mirabegron were conducted in healthy East Asian subjects. Food effects were assessed in 3 randomized, single-dose studies in young Japanese male subjects (study 1), male and female subjects (study 2), and young Taiwanese male and female subjects (study 3). In the other 2 single- and multiple-dose studies in young Chinese male and female subjects (study 4 and study 5), mirabegron was administered as a single dose under fasted conditions. After the washout period, mirabegron was administered once daily under fed conditions for 8 days. Pharmacokinetic parameters were determined using noncompartmental methods. Safety and tolerability assessments included physical examinations, vital signs, 12-lead ECG, clinical laboratory tests (biochemistry, hematology, and urinaly-sis), and adverse event monitoring. Findings: After administration of single oral doses of mirabegron, exposure under fed conditions was lower than under fasted conditions in Japanese and Taiwanese subjects. In Japanese subjects, a greater reduction in mirabegron Cmax and AUC0-∞ was observed after a low-fat meal compared with a high-fat meal. In Chinese subjects, Cmax was reached at approximately 4.0 hours after single oral doses. Mirabegron accumulated 2- to 3-fold on once-daily dosing of multiple-dose relative to single-dose data. Steady state was reached within 7 days. After administration of mirabegron, mean values for Cmax and AUC in female subjects were higher than those in male subjects. Mirabegron was well tolerated in Japanese, Taiwanese, and Chinese subjects. Implications: Our studies confirm the higher exposure levels of mirabegron in female compared with male East Asian subjects as found earlier in Western subjects. Furthermore, the effects of food on the pharmacokinetic profiles appeared to be similar among the 3 populations tested in our studies. The findings suggest that there are no significant pharmacokinetic differences among the Japanese, Taiwanese, and Chinese populations. [ABSTRACT FROM AUTHOR]

This study documents the indirect effects of social and environmental variables as mediated by immigrant stress and physical health. Using data from a large dual frame sample of first generation mandarin speaking Chinese immigrants in metropolitan Los Angeles counties with the largest groups of Chinese immigrants, this study uses a path analytic approach to trace how predictors are related to depressive symptoms and to measure direct and indirect influences of variables. Although bivariate analyses suggested that many predictors were associated with depressive symptoms, multivariate path analysis revealed a more complex structure of mediated associations. In the multivariate path analysis only reports of physical health and immigrant stress were directly related to depressive symptoms ( P < 0.05), while acculturation, time in the US, income, US citizenship, and distance of persons on whom one could rely were related to stress (but not to physical health status) and only to depressive symptoms as mediated by stress. Age and educational attainment were related to health status (and to stress as mediated by physical health) and to depressive symptoms as mediated by both health and stress. These variables were also unrelated directly to health status and to depressive symptoms. Associations were evaluated using statistical significance, P < 0.05. This study demonstrates the significance of stress and health as mediators of variables in the larger context of the physical environment and suggests that the mechanisms linking ecological characteristics of immigrants to depressive symptoms may be stress and physical health among immigrants. [ABSTRACT FROM AUTHOR]

Objective.The aims of this study were to (1) assess physical activity and weight status differences and (2) explore the direction and shape of subjective social status (SSS) association with physical activity and weight status within four Asian countries. Methods. Cross section data of adult respondents fromthe nationally representative East Asian Social Survey were used for analyses. Logistic regression stratified by gender was conducted for the first aim, and simple and quadratic logistic regression models were used for the second. Results. SSS was significantly associated with odds of weekly or daily physical activity across all countries and genders, except for South Korean and Japanese females. Quadratic models provided significantly better fit for Chinese males (LR (d.f. = 1) = 6.51, P value < .05) and females (LR (d.f. = 1) = 7.36, P value < .01), South Korean males (LR (d.f. = 1) = 4.40, P value < .05), and Taiwanese females (LR (d.f. = 1) = 4.87, P value < .05). Conclusions.This study provides a comparable cross Asian country measure of moderate-to-vigorous physical activity and new findings that a connection exists between SSS and physical activity. Differences of class distinction help explain the different shaped SSS relationships. [ABSTRACT FROM AUTHOR]

In this cross-sectional study of 61 immigrant mothers and their 6- to 24-month-old children in Taiwan, we examined the structure of relationships among maternal depressive symptoms, quality of the child-rearing home environment, and child development using a partial least squares approach. Maternal depressive symptoms as measured by the Edinburgh Postnatal Depression Scale had a direct and negative effect on the quality of the home environment as measured by the IT-HOME, which in turn had a direct and positive effect on child development as measured by the Comprehensive Developmental Inventory for Infants and Toddlers. Maternal depressive symptoms did not directly affect child development, suggesting that the quality of the home environment mediated the relationship between maternal depressive symptoms and child development. © 2013 Wiley Periodicals, Inc. Res Nurs Health 36: 603-611, 2013 [ABSTRACT FROM AUTHOR]

Based on Markus and Kitayama's (1991) theory, this study was conducted to examine whether the association between emotional suppression and interpersonal harmony would be moderated by cultural group (i.e., Chinese and European Americans) and an Asian cultural value (i.e., emotional self-control). A total of 451 college students (205 Chinese and 246 European Americans) participated in this study. As expected, results indicated that the association between emotional suppression and interpersonal harmony was significantly positive for Chinese but not significant for European Americans. Similarly, when emotional self-control was examined as a moderator, the results still confirmed our hypotheses. That is, the association between emotional suppression and interpersonal harmony was significantly positive for those with stronger endorsement of emotional self-control but not for those with weaker endorsement of emotional self-control. Furthermore, we examined whether the above results could be replicated when forbearance (a construct similar to suppression) and distress disclosure (a construct opposite to suppression) were examined. The results showed the same pattern for forbearance and distress disclosure when cultural group or emotional self-control served as the moderator. The convergence of findings increased the robustness of our results. Finally, our data suggest that individuals from Eastern, interdependent cultures (e.g., Chinese) tend to value emotional suppression to preserve interpersonal harmony; individuals from Western, independent cultures may or may not necessarily suppress their emotions for this purpose. A comprehensive understanding of the different meanings of a specific strategy (i.e., emotional suppression) in different cultural contexts is important to promote effective cross-cultural counseling. [ABSTRACT FROM AUTHOR]

Background: Total or red meat intake has been shown to be associated with a higher risk of mortality in Western populations, but little is known of the risks in Asian populations. Objective: We examined temporal trends in meat consumption and associations between meat intake and all-cause and cause-specific mortality in Asia. Design: We used ecological data from the United Nations to compare country-specific meat consumption. Separately, 8 Asian prospective cohort studies in Bangladesh, China, Japan, Korea, and Taiwan consisting of 112,310 men and 184,411 women were followed for 6.6 to 15.6 y with 24,283 all-cause, 9558 cancer, and 6373 cardiovascular disease (CVD) deaths. We estimated the study-specific HRs and 95% CIs by using a Cox regression model and pooled them by using a random-effects model. Results: Red meat consumption was substantially lower in the Asian countries than in the United States. Fish and seafood consumption was higher in Japan and Korea than in the United States. Our pooled analysis found no association between intake of total meat (red meat, poultry, and fish/seafood) and risks of all-cause, CVD, or cancer mortality among men and women; HRs (95% CIs) for all-cause mortality from a comparison of the highest with the lowest quartile were 1.02 (0.91, 1.15) in men and 0.93 (0.86, 1.01) in women. Conclusions: Ecological data indicate an increase in meat intake in Asian countries; however, our pooled analysis did not provide evidence of a higher risk of mortality for total meat intake and provided evidence of an inverse association with red meat, poultry, and fish/seafood. Red meat intake was inversely associated with CVD mortality in men and with cancer mortality in women in Asian countries. [ABSTRACT FROM AUTHOR]

Knowledge about aging and the attitudes toward older people were surveyed in undergraduate students (total number of subjects sampled is 1402) in four countries (Japan, China, Taiwan, and Vietnam) in eastern cultures and in two countries (United States and United Kingdom) in western cultures. All participants completed two questionnaires, FAQ1 (for knowledge) and ASD (for attitudes) in their own languages. It was found that within the undergraduate students sampled: (a) the level of knowledge about aging in the western countries is significantly higher than that in the eastern countries, and (b) attitudes toward aging are more positive in the western countries compared to the eastern countries. The data suggest that, within the limits of the sampling: (a) the tradition of respecting older adults in eastern cultures may have weakened gradually, and (b) the modernization theory that assumes industrialization devalues aging populations appears to be supported in eastern countries but not in western countries. An alternative non-linear theory is discussed for the relationship between modernization and the societal views on aging. Educational promotion of knowledge about aging is emphasized for the formation of positive attitudes toward older adults. [ABSTRACT FROM AUTHOR]

This study explores factors that influence problem-solving coping style across cultures. There was no significant difference in applying problem solving across U.S., Taiwanese, and Chinese samples. The effective predictors of problem solving in the U.S. and Chinese samples were self-efficacy and trait resilience, respectively. In the Taiwanese sample, predictors were self-efficacy and trait resilience. Trait resilience was found to mediate the effect of self-efficacy on problem solving in the Taiwanese and Chinese samples. Practical implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Although metabolic syndrome (MetS) has been reported to be associated with cognitive decline and dementia, little was known about late-life MetS and cognitive decline among older old population. The main purpose of this study was to evaluate the role of MetS and cognitive decline among men aged 75 and over in Taiwan. Methods: This is a prospective cohort study which recruited men aged 75 years and older with intact cognitive function living in the Banciao Veterans Home, a retirement community for veterans in northern Taiwan. All participants received complete history taking, physical examinations, global cognitive tests and laboratory tests. Cognitive status was re-evaluated one year after enrollment to evaluate the role of MetS to cognitive decline in this study population. Results: Overall, 338 people participated in the study and 62 of them were excluded due to low baseline MMSE score, and the remaining 276 people (mean age: 82.4±4.2 years) were enrolled for study. The prevalence of MetS and annual cognitive decline were 22.5% and 15.6%, respectively. During the follow-up period, 9 (3.3%) participants died, 229(83.0%) complete the study. Subjects with cognitive decline were older and had lower serum levels of serum total cholesterol. Multivariate logistic regression showed that older age (OR:1.13, 95% C.I.: 1.01-1.25, P=0.026) and central obesity (OR: 4.19, 95% CI: 1.26-13.91, P=0.019) were independent risk factors for cognitive decline; and MetS defined by Adult Treatment Panel III was a protective factor (OR: 0.20, 95% CI: 0.04-0.94, P=0.041). The protective effect of MetS remained the same when MetS was defined by the criteria of International Diabetes Federation. Conclusions: Age and central obesity were significant risk factors of cognitive decline, but late-life MetS, however defined, had protective effect on cognitive function. Further investigation is needed to clarify the possible mechanism of MetS and cognitive function in older adults. [ABSTRACT FROM AUTHOR]

With the expansion of the practice of marriage and family therapy outside of the U.S. and Western Europe, it important to gain a better understanding of family interaction and processes in other cultures and countries. Several studies have examined the problems that couples experience in the United States, but little is understood about problems that couples in Asia experience. In this study, perceptions of relationship problems experienced by 213 married couples living in urban Taiwan were examined. Results indicated that raising children and communication were the two problems most frequently reported by both husbands and wives. Among eight relationship problem areas, the only gender difference was in the area of communication, with wives significantly more likely to report it as a problem. An examination of within-dyad agreement indicated that couples generally had high consensus regarding relationship problems. Implications of this research for culturally-sensitive MFT practice are discussed. [ABSTRACT FROM AUTHOR]

This cohort study assessed the structural relationships among social support, acculturation, and postpartum depressive symptoms experienced by marriage-based immigrant mothers in Taiwan. Data were collected at 1 and 6 months postpartum from 203 immigrant mothers married to Taiwanese men in Taipei, Taiwan. The structural equation modeling results showed that social support and postpartum depression were directly and negatively related. Higher social support and lower depression at 1 month postpartum were related to a positive social attitude (i.e., accepting attitude toward mainstream society). Social attitude was a moderator of the relationship between depression at 1 month and social support at 6 months postpartum, where a positive social attitude decreased the negative effect of depression at 1 month on social support at 6 months. Social support in the early postpartum period not only directly decreased postpartum depression, but also indirectly decreased postpartum depression through improving social attitude. [ABSTRACT FROM AUTHOR]

Background: Many studies have indicated that most immigrant women come from underdeveloped countries, and this can have negative effects on their lives, children's adaptation to school, and medical care utilization. However, there is insufficient literature about differences in infant caretaking, pre-postpartum health care, and health outcome between immigrant and native Taiwanese populations. The aim of this study was to investigate the differences between Southern Asia immigrants and Taiwanese women in their access to medical care, postnatal growth, and infant care throughout the first six months postpartum. Methods: Comparative and descriptive designs were applied. Immigrant women were eligible if they visited three suburban settings of the Outpatient Department of Obstetrics and Gynecology and the Outpatient Department of Pediatrics in Northern Taiwan during the period up to six months postpartum. Results: Immigrant women appeared to have a lower frequency of antenatal examinations and obtained less health information from health care providers. However, they did not differ significantly from native Taiwanese women in maternal body size, postnatal growth curves, exclusive breastfeeding rates or vaccination awareness at the 6th month postpartum. Conclusions: Learning strengths from cultural differences between immigrant and native women and closing the gaps in health inequality are important issues. Despite the limitation of small sample size, the present findings can be used as references to help health care providers to develop further health policies in Taiwan. [ABSTRACT FROM AUTHOR]

Two studies examined topic avoidance in Chinese and Taiwanese opposite-sex friendships and romantic relationships. Five areas of topic avoidance emerged through analytic induction and cluster analysis: negative appraisal, relational issues, sexual issues, politics, and personal experience. Partner protection, negative relational impact, and self inefficacy emerged as the most common reasons for avoidance. Results revealed that friends, relative to romantic partners, engaged in higher levels of topic avoidance. Taiwanese participants, moreover, avoided discussing politics to a greater extent than did mainland Chinese participants. Lacking closeness was the main reason behind avoidance of political discussion. Topic avoidance was also linked to relationship quality, as relational satisfaction negatively predicted relational issue avoidance and topic avoidance breadth (i.e. the number of topics regularly avoided in the relationship). The authors explain these and other findings based on Chinese cultural codes and historically-embedded concepts that shape interpersonal interaction. [ABSTRACT FROM AUTHOR]