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Face culture is a crucial facet of East Asia. The most common self‐report measure for face concern is the unidimensional Loss of Face Scale. In this study, we examined the dimensionality, factor structure, and validity of the Loss of Face Scale in two samples. Sample 1 (N = 602) consisted of 303 Taiwanese mothers and 299 U.S. mothers. Sample 2 (N = 602) was an independent sample from Sample 1, consisting of 294 Taiwanese mothers and 308 U.S. mothers. We proposed a modified 15‐item four‐dimensional factor structure to better capture the complexity of face. Four sub‐domains emerged from the results of exploratory structural equation modelling: Low‐Profile, Over‐Preparation, Harmony Seeking, and Non‐Aggression. Multigroup confirmatory factor analysis indicated configural and metric invariance but failed to establish full scalar invariance across countries. Convergent validity was supported by positive correlations with other Asian cultural values. While all four domains of face showed small to moderate correlations with depression in the U.S., only Low‐Profile was associated with depression in Taiwan, suggesting that not all aspects of face concern are non‐adaptive in East Asian contexts. Future studies should consider the multidimensional nature of face as well as how different dimensions affect mental and social well‐being across cultures. [ABSTRACT FROM AUTHOR]

This study examines how social media (SM) use is related to human responses to emerging infectious disease risks in the context of the COVID-19 pandemic via an online survey conducted in the United States and Taiwan. Results showed that SM use was related to different types of communicative responses (information seeking, interpersonal discussion, and rumor correction) directly and indirectly through cognitive and affective responses (risk perception, responsibility attribution, and negative and positive emotions). The indirect relationships between SM use and communicative responses through these cognitive and affective responses were moderated by perceived SM network structures. In particular, the mediating influence of negative emotions on communicative responses was associated with perceived SM network homogeneity, while that of positive emotions was related to perceived SM network centrality. Furthermore, responsibility attribution drove Taiwanese SM users' communicative responses, whereas the interrelated influence of positive emotions and perceived SM network centrality shaped American SM users' communicative responses. [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]

Simple Summary: Although male breast cancer (MBC) is globally rare, its incidence significantly increased from 1990 to 2017. The aim of this study was to examine variations in the trends of MBC incidence between populations in Taiwan and the USA. Analysis of related databases from the two countries showed MBC incidence in Taiwan rapidly increased in contrast to the much slower increase in the USA during the same period. Furthermore, the results of the age-period-cohort analysis demonstrated a stronger cohort effect on the MBC incidence trend in Taiwan than in the USA. The observed cohort effect in this study is similar to that of a prior investigation on female breast cancer in Taiwan, indicating the potential influence of common environmental factors in both genders, such as a high-fat diet and xenoestrogen. Although male breast cancer (MBC) is globally rare, its incidence significantly increased from 1990 to 2017. The aim of this study was to examine variations in the trends of MBC incidence between populations in Taiwan and the USA from 1980 to 2019. The Taiwan Cancer Registry database and the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute of the USA were used. The age-standardized incidence rate was calculated using the world standard population in 2000. The long-term trends of the age, time period, and birth cohort effect on MBC incidence rates were estimated using the SEER Age-Period-Cohort Web Tool. The results revealed that the incidence of MBC in both countries increased from 2010 to 2019 (Taiwan: average annual percentage change (AAPC) = 2.59%; USA: AAPC = 0.64%). The age and period effects on the incidence rates in both countries strengthened, but the cohort effect was only identified in Taiwan (Rate ratio: 4.03). The identified cohort effect in this study bears resemblance to that noted in a previous investigation on female breast cancer in Taiwan. This suggests the possible presence of common environmental factors influencing breast cancer incidence in both genders, such as a high fat diet and xenoestrogen. [ABSTRACT FROM AUTHOR]

Moral thinking and communication are critical competencies for confronting social dilemmas in a challenging world. We examined these moral competencies in 70 college students and graduates from Taiwan, the United Kingdom, and the United States. Participants were assessed through semi-structured written interviews, Facebook group discussions, and a questionnaire. In this paper, we describe the similarities and differences across cultural groupings in (1) the social issues of greatest importance to the participants; (2) the factors influencing their approaches to thinking about social issues and communicating with others; and (3) the characteristics of their moral functioning in terms of moral awareness, moral judgment, moral discourse, and moral decision-making. [ABSTRACT FROM AUTHOR]

Background: Hip fractures are costly and common in older adults, but there is limited understanding of how treatment patterns and outcomes might differ between countries. Methods: We performed a retrospective serial cross‐sectional cohort study of adults aged ≥66 years hospitalized with hip fracture between 2011 and 2018 in the US, Canada, England, the Netherlands, Taiwan, and Israel using population‐representative administrative data. We examined mortality, hip fracture treatment approaches (total hip arthroplasty [THA], hemiarthroplasty [HA], internal fixation [IF], and nonoperative), and health system performance measures, including hospital length of stay (LOS), 30‐day readmission rates, and time‐to‐surgery. Results: The total number of hip fracture admissions between 2011 and 2018 ranged from 23,941 in Israel to 1,219,696 in the US. In 2018, 30‐day mortality varied from 3% (16% at 1 year) in Taiwan to 10% (27%) in the Netherlands. With regards to processes of care, the proportion of hip fractures treated with HA (range 23%–45%) and THA (0.2%–10%) differed widely across countries. For example, in 2018, THA was used to treat approximately 9% of patients in England and Israel but less than 1% in Taiwan. Overall, IF was the most common surgery performed in all countries (40%–60% of patients). IF was used in approximately 60% of patients in the US and Israel, but only 40% in England. In 2018, rates of nonoperative management ranged from 5% of patients in Taiwan to nearly 10% in England. Mean hospital LOS in 2018 ranged from 6.4 days (US) to 18.7 days (England). The 30‐day readmission rate in 2018 ranged from 8% (in Canada and the Netherlands) to nearly 18% in England. The mean days to surgery in 2018 ranged from 0.5 days (Israel) to 1.6 days (Canada). Conclusions: We observed substantial between‐country variation in mortality, surgical approaches, and health system performance measures. These findings underscore the need for further research to inform evidence‐based surgical approaches. [ABSTRACT FROM AUTHOR]

Background: Patients with serious mental illness (SMI) are more likely to have Type 2 diabetes mellitus (T2DM). However, studies that discuss the eating habits of patients with both T2DM and SMI are lacking. Purpose: This study was designed to explore the beliefs and experiences of Taiwanese patients with SMI who also have T2DM. Methods: Fieldwork for this study included 2 years of participant observation and individual interviews with 13 patients with SMI. Data from transcripts of observational field notes and interviews were transcribed verbatim and analyzed. Results: The participants described their experiences and concerns regarding dietary management during the period after receiving their T2DM diagnosis. The results of the data analysis were distinguished into three categories, including (a) increased difficulty in life, (b) positive view of dietary control, and (c) inability to abide by dietary restrictions. Conclusions: The findings suggest that healthcare professionals should work to better understand the challenges faced by patients with SMI and T2DM in implementing changes and resisting the temptation to eat unhealthy food and provide suggestions tailored to their cultural background, lifestyle, and eating characteristics. [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]

Purpose. To investigate the efficacy and safety of switching to 0.0015% tafluprost ophthalmic solution with reduced benzalkonium chloride (BAK) on primary open-angle glaucoma (POAG) patients with corneal disorders under 0.005% latanoprost treatment. Material and Methods. This was a single-arm, open-label, switching study on adult POAG patients treated with latanoprost 0.005% for more than 3 months, with corneal disorders but no dry eye therapy. All patients were switched to tafluprost 0.0015% and followed up for 3 months. The primary outcome was the change in fluorescein staining score (National Eye Institute/Industry [NEI] score) at the end of the study. Secondary outcomes included changes in intraocular pressure (IOP), tear break-up time (TBUT), hyperemia score, and other ocular and nonocular adverse events. Results. Of the 20 patients initially enrolled, 17 patients, all with POAG, completed the study. At the end of the study, the mean NEI score significantly decreased by 1.8 ± 2.2 (p < 0.01). No significant changes in IOP were observed (12.8 ± 4.6 mmHg at baseline vs. 12.3 ± 4.0 mmHg on visit 2; p = 0.470). TBUT increased by 1.2 ± 1.7 seconds (p < 0.05). The proportions of patients with no sign of hyperemia on the bulbar and palpebral conjunctiva increased from 58.5% to 64.7% at baseline (before switching to tafluprost treatment) to 94.1% and 94.1%, respectively, after switching to tafluprost treatment. Dry eye sensation scores were significantly reduced (p < 0.05), while other ocular symptom scores did not change significantly. Conclusion. Switching to tafluprost 0.0015% significantly improved fluorescein staining score, TBUT, and conjunctival hyperemia while maintaining IOP control among POAG patients with corneal disorders. [ABSTRACT FROM AUTHOR]

Strategy training is a promising stroke rehabilitation intervention commonly delivered in Western countries. We examined the perspectives of rehabilitation therapists who have delivered strategy training in Taiwan and the United States to understand the influence of culture on strategy training implementation. In this rapid ethnographic study, the maximum variation sampling approach was used to recruit seven therapists in Taiwan and seven therapists in the United States with experience delivering strategy training. Data was collected from multiple sources, including interviews, study documents, therapist notes, and reflective memos. Interviews with the recruited therapists in Taiwan and the United States were conducted in Mandarin and English, respectively. Data were analyzed using a constant comparative approach. The following two themes were generated: (1) differences between conventional rehabilitation and strategy training, namely that conventional rehabilitation is therapist-directed and emphasizes impairment reduction, whereas strategy training empowers clients and focuses on real-life generalization, and (2) challenges in implementing strategy training in practice, including difficulty in achieving client buy-in and disengagement. Therapists from both countries shared similar perspectives on the perceived advantages of strategy training, such as enhancing client empowerment and engagement, and the generalization of strategies. Family involvement was more prominently discussed by therapists in Taiwan than by those in the United States. Strategy training differs from conventional rehabilitation in its emphasis on clients' life participation and empowerment, generalization of strategies, and enhancement of their engagement, confidence, and problem-solving skills. Therapists may face challenges related to client buy-in and disengagement as well as difficulties in establishing a therapeutic rapport at the beginning of strategy training because clients have different expectations from those of conventional rehabilitation. Cultural differences in norms and expectations and the clinical experiences of therapists may influence the delivery of strategy training to clients. Family support may influence the success of strategy training. Thoughtful conversations to reach a mutual understanding regarding the expectations of strategy training among clients, family, and rehabilitation practitioners are necessary prior to implementing strategy 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]

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 purpose of the study was to examine whether disability acceptance, hope, and resilience mediate the relationship between functional disability and life satisfaction in people with a lived experience of an infectious viral disease (i.e., polio and postpolio syndrome [PPS]). Participants consisted of 157 individuals diagnosed with polio or PPS who were recruited from two community support organizations in Taiwan. Participants completed self-report questionnaires. Data were analyzed with a simultaneous regression analysis. The tri-mediation model indicated that disability acceptance, hope, and resilience were associated with life satisfaction, accounting for a large effect size of 46% of the variance in the life satisfaction scores. The direct effect of functional disability on life satisfaction became insignificant when the mediators were controlled for in the model. Hope, disability acceptance, and resilience were found to fully explain the association between functional disability and life satisfaction. This study demonstrated that positive psychosocial factors might help to buffer the indirect and direct negative effects of functional disability on life satisfaction. Implications of these findings for future research and clinical practice when supporting individuals with a lived experience of an infectious viral disease, including COVID-19, are discussed. [ABSTRACT FROM AUTHOR]

This cross-sectional study was designed to develop normative functional fitness standards for the Portuguese older adults, to analyze age and gender patterns of decline, to compare the fitness level of Portuguese older adults with that of older adults in other countries, and to evaluate the fitness level of Portuguese older adults relative to recently published criterion fitness standards associated with maintaining physical independence. A sample of 4,712 independent-living older adults, age 65-103 yr, was evaluated using the Senior Fitness Test battery. Age-group normative fitness scores are reported for the 10th, 25th, 50th, 75th, and 90th percentiles. Results indicate that both women and men experience age-related losses in all components of functional fitness, with their rate of decline being greater than that observed in other populations, a trend which may cause Portuguese older adults to be at greater risk for loss of independence in later years. These newly established normative standards make it possible to assess individual fitness level and provide a basis for implementing population-wide health strategies to counteract early loss of independence. [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]

Introduction: High‐quality research is the foundation of occupational therapy and physical therapy/physiotherapy. A bibliometric study on the research productivity of occupational therapy and physical therapy/physiotherapy scholars in different Western and Asian countries/regions could provide a snapshot of current research achievement in rehabilitation science. Method: On the basis of an understanding of the leading role of rehabilitation research in Western countries and a recognition of achievements made by Asian occupational therapy and physical therapy/physiotherapy scholars, the current bibliometric study examined the research productivity of occupational therapy and physical therapy/physiotherapy professors and associate professors from four Western countries (Australia, Canada, the United States and the United Kingdom) and five Asian countries/regions (Hong Kong, Japan, Taiwan, Singapore and South Korea). The h‐indices of these scholars were retrieved online and aggregated to quantify the research productivity of institutions and countries/regions. Results: Australia, Canada, Hong Kong and the United States were identified as countries/regions with higher research productivity in occupational therapy and physical therapy/physiotherapy. The institutions were ranked on the basis of the median h‐indices of their professors and associate professors; the top 20 productive institutions with occupational therapy programmes had a median h‐index of 17.5 or higher, whereas the benchmark of the top 20 institutions with physical therapy/physiotherapy programmes was 25. Conclusion: Professors and associate professors in Australia, Canada, Hong Kong and the United States are productive in occupational therapy and physical therapy/physiotherapy research. The number of faculty members and university connections are regarded as important for research achievement. Recommendations for various levels of collaboration are provided. [ABSTRACT FROM AUTHOR]

Purpose: This study examined intervention techniques used with children with autism spectrum disorder (ASD) by speechlanguage pathologists (SLPs) in the United States and Taiwan working in clinic/hospital settings. The research questions addressed intervention techniques used with children with ASD, intervention techniques used with different age groups (under and above 8 years old), and training received before using the intervention techniques. Method: The survey was distributed through the American Speech-Language-Hearing Association to selected SLPs across the United States. In Taiwan, the survey (Chinese version) was distributed through the Taiwan Speech-Language Pathologist Union, 2018, to certified SLPs. Results: Results revealed that SLPs in the United States and Taiwan used 4 common intervention techniques: Social Skill Training, Augmentative and Alternative Communication, Picture Exchange Communication System, and Social Stories. Taiwanese SLPs reported SLP preparation program training across these common intervention strategies. In the United States, SLPs reported training via SLP preparation programs, peer therapists, and self-taught. Conclusions: Most SLPs reported using established or emerging evidence-based practices as defined by the National Professional Development Center (2014) and the National Standards Report (2015). Future research should address comparison of SLP preparation programs to examine the impact of preprofessional training on use of evidence-based practices to treat ASD. [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]

We can gain a better understanding of short-term memory processes by studying different language codes and modalities. Three experiments were conducted to investigate: (a) Taiwanese Sign Language (TSL) digit spans in Chinese/TSL hearing bilinguals (n = 32); (b) American Sign Language (ASL) digit spans in English/ASL hearing bilinguals (n = 15); and (c) TSL lexical sign spans in Chinese/TSL hearing bilinguals (n = 22). Articulatory suppression conditions were manipulated to determine if participants would use a speech- or sign-based code to rehearse lists of signed items. Results from all 3 experiments showed that oral suppression significantly reduced spans while manual suppression had no effect, revealing that participants were using speech-based rehearsal to retain lists of signed items in short-term memory. In addition, sub-vocal rehearsal using Chinese facilitated higher digit spans than English even though stimuli were perceived and recalled using signs. This difference was not found for lexical sign spans. [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]

The current study examined the psychometric characteristics of the Chinese translation of the Marital Satisfaction Inventory–Revised (MSI-R) in a community sample of 117 couples from Taiwan. The Chinese MSI-R demonstrated moderate to strong internal consistency. Confirmatory factor analysis revealed similar scale factor structures in the Taiwanese and U.S. standardization samples. Mean profile comparisons between the current Taiwanese sample and the original MSI-R standardization sample revealed statistically significant but small differences on several subscales. Overall, the psychometric characteristics of the Chinese MSI-R lend support to its use with couples from diverse cultural backgrounds whose sole or preferred language is Chinese. It may also be appropriate to use the MSI-R in clinical settings for prevention or intervention efforts directed at Chinese-speaking couples. The implications of these findings for clinical and research purposes are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this mixed-methods study was to explore how seventh graders in a suburban school in the United States and sixth graders in an urban school in Taiwan developed argumentation skills and science knowledge in a project-based learning environment that incorporated a graph-oriented, computer-assisted application (GOCAA). A total of 42 students comprised the treatment condition and were engaged in a project-based learning environment that incorporated a GOCAA. Of these 42 students, 21 were located in the United States and 21 were located in Taiwan. A total of 26 students comprised the control condition and were engaged in a project-based learning environment without the GOCAA. Of these 26 students, 15 were in the United States and 11 were in Taiwan. In each country, verbal collaborative argumentation was recorded and the students' post-essays were collected. A one-way analysis of variance (ANOVA) was conducted for each measure of science knowledge about alternative energies. The results showed a significant treatment effect for the outcome of scientific explanation among U.S. students, while among Taiwanese students, a significant treatment effect on scientific facts was observed. A one-way ANOVA was additionally conducted for each measure of argumentation skills and a significant treatment effect on counterarguments and rebuttals was observed among the U.S. students, while in Taiwan, a significant treatment effect on reasoning and rebuttals was observed. A qualitative analysis was conducted to examine how the GOCAA supported students' development of argumentation skills in different countries. This study found distinct argumentation patterns between the U.S. and Taiwanese intervention teams. Additionally, a distinct gender difference in the use of evidence and division of labour was noted when the Taiwanese teams were compared with the U.S. teams, which may be explained by cultural differences. This study concluded that, in both the United States and Taiwan, a project-based learning environment incorporating a GOCAA was effective in improving students' science knowledge and developing their scientific argumentation skills. [ABSTRACT FROM AUTHOR]

Research has consistently found an association between marital distress and poor mental and physical health of couples, as well as the impact on maladaptive child outcomes. Several studies have examined the problems that couples experience in the United States, while only one study has in Taiwan. However, there is no cross-cultural research on marital problems between the West and the East to examine how cultures influence couples' perceived marital problems. This cross-cultural study of marital problems is important because couples in Taiwan and other collectivistic societies might have marital priorities that are unique to their cultural characteristics. Thus, the common marital problems in Western culture might not apply to Eastern culture. In this study, perceptions of marital problems by 213 married couples living in urban Taiwan and 715 couples in the United States were examined. Results indicated the US couples reported significantly more marital problems than did the Taiwan couples in five out of six areas: communication, intimacy/sexual relations, financial matters, division of labor, and power. On the other hand, rearing children was the biggest problem among Taiwan couples, while it was the least commonly reported problem among the US sample. Implications of these findings are discussed for increasing cultural sensitivity in the MFT field. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to retrospectively compare the frequency, distribution, and radiographic features of osteosclerosis of the jaws between Taiwanese and American cohorts using cone-beam computed tomography. Methods: Our study comprised 400 Taiwanese and 400 American subjects. A three-dimensional model was used to measure the volume and mesial-distal distance (MDD) of the osteosclerotic lesions. A cross-sectional view was used to measure the top-bottom distance (TBD), buccal-lingual distance (BLD), and whether the lesions contacted the buccal and/or lingual cortical bone or adhered to root apices. The MDD and TBD were also measured on a panoramic reformatted view, which was used to classify the side, shape, and tooth site. The axial view was evaluated to categorize the osteosclerotic lesions as homogeneous or heterogeneous. Results: There was a significant difference in the frequency of osteosclerosis between the Taiwanese and American cohorts, as well as significant differences between these two cohorts in the measurements of volume, BLD, and MDD. No significant differences between males and females were found in either cohort. In the Taiwanese cohort the highest prevalence of osteosclerotic lesions (38 %) was found in subjects aged 40-49 years, while in the American cohort the highest prevalence (36 %) was found in subjects aged 30-39 and ≥60 years. Conclusions: The findings of our study may be of valuable clinical relevance to dental practitioners, since osteosclerosis of the jaws may have a significant impact on the osseointegration of dental implants. [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]

Researchers have found that the stigma associated with seeking therapy-particularly self-stigma-can inhibit the use of psychological services. Yet, most of the research on self-stigma has been conducted in the United States. This is a considerable limitation, as the role of self-stigma in the help-seeking process may vary across cultural groups. However, to examine cross-cultural variations, researchers must first develop culturally valid scales. Therefore, this study examined scale validity and reliability of the widely used Self-Stigma of Seeking Help scale (SSOSH; Vogel, Wade, & Haake, 2006) across samples from 6 different countries (England, Greece, Israel, Taiwan, Turkey, and the United States). Specifically, we used a confirmatory factor analysis framework to conduct measurement invariance analysis and latent mean comparisons of the SSOSH across the 6 sampled countries. Overall, the results suggested that the SSOSH has a similar univariate structure across countries and is sufficiently invariant across countries to be used to explore cultural differences in the way that self-stigma relates to help-seeking behavior. [ABSTRACT FROM AUTHOR]

The article discusses the effect of psychosocial factors as moderators between clinical characteristics and dyspnea in American and Taiwanese patients with heart failure. The results of the study suggest that depression and anxiety enhanced the association between clinical characteristics and dyspnea in American patients, while perceived social support affected Taiwanese patients, and that a dyspnea management plan unique to the psychosocial factors influencing the groups could relieve symptoms.

This study was designed to examine connections among father beliefs, perceptions, context, and involvement, and school-aged children's attachment and school outcomes in the U.S. and Taiwan (n = 274 father-child dyads). Fathers completed questionnaires regarding their family demographics, education-related beliefs, perceptions, and involvement, and children's school achievement. Children completed a pictorial measure of attachment and standardized socio-emotional assessments. Father involvement was related to father beliefs and perceptions and to children's attachment-related secure exploration. Children's positive and negative school outcomes were related to father beliefs, perceptions, involvement, and children's attachment. School outcomes were uniquely predicted from nationality, attachment, father-teacher relationship quality, and fathers' beliefs about teachers, motivation for involvement, perceptions of invitations for involvement, efficacy, and school-based involvement, as well as from family income and mother involvement. Results are discussed in the context of 'relationship-focused' education. [ABSTRACT FROM AUTHOR]

This paper presents a self-paced reading experiment comparing the processing of subject-extracted relative clauses (SRCs) and object-extracted relative clauses (ORCs) in supportive contexts in Chinese. It is argued that lack of a consistent pattern in the literature for the comparison between Chinese SRCs and ORCs is due to potential temporary ambiguity in these constructions in null contexts. By placing the materials in contexts biased towards a relative clause (RC) interpretation, we limit the effects of temporary ambiguity. The results of the experiment demonstrate that SRCs are read more slowly than ORCs in supportive contexts. These results provide evidence for working memory-based sentence processing theories whereby processing difficulty increases for connecting sentence elements that are further apart. Some convergent evidence that strengthens these conclusions comes from recent research on aphasic populations where a dissociation between English and Chinese RC processing has been revealed: whereas English aphasic patients have more difficulty with ORCs and Chinese aphasic patients have more difficulty with SRCs (Su, Lee, & Chung, 2007). Taken together, these results support the idea that sentence processing is constrained by working memory limitations. [ABSTRACT FROM AUTHOR]

This study surveys elementary and secondary teachers in Taiwan and compares the findings with other studies conducted in America and Japan. The objective is to explore differences among teachers in Taiwan, Japan, and the United States in terms of their knowledge of, and attitudes toward, aging and the implementation of aging education in schools. Multistage sampling was adopted, with a total of 1038 Taiwanese elementary and secondary teachers sampled. It was found that while knowledge of aging among Taiwanese teachers appears lower in comparison with American teachers, their attitudes toward aging are largely consistent with their American counterparts. In addition, Taiwanese teachers seem to offer just as little aging education in schools as their American and Japanese counterparts. Lastly, Taiwanese teacher attitudes toward aging, rather than their knowledge of aging, correlate closely to their provision of aging education in schools. Educational authorities should, therefore, offer teachers pre- and in-service education on aging or gerontology so as to equip them with the right knowledge on, and positive attitudes toward, aging. By so doing, teachers will be more likely to teach the subject of aging in schools. [ABSTRACT FROM AUTHOR]

Purpose: The author compared monosyllabic Mandarin lexical tones produced by 3-year-old Mandarin-speaking children growing up in Taiwan and in the United States. Method: Following the procedures in Wong, Schwartz, and Jenkins (2005), the author collected monosyllabic tone productions from 3-year-old Mandarin-speaking children in Taiwan and low-pass filtered them to eliminate lexical information but retain tone information. Five Mandarin-speaking adults residing in Taiwan categorized these filtered tones and those produced by the Mandarin-speaking children growing up in the United States, the latter of which was reported in Wong et al. (2005). Agreements on tone categorization by judges residing in Taiwan and in the United States were evaluated. Tone accuracy of children growing up in Taiwan and the United States were examined and compared. Results: The Mandarin-speaking judges residing in the United States and in Taiwan showed high agreements on tone categorization. None of the 4 tones produced by the Mandarin-speaking children growing up in the United States and in Taiwan was adultlike. Children in Taiwan made more errors in Tone 2 and Tone 4 than did Mandarin-speaking children growing up in the United States. Accuracy rates of Tone 1 and Tone 3 were comparable in the 2 groups of children. Conclusion: Mandarin tone acquisition is a protracted process. Three-year-old Mandarin-speaking children growing up in Taiwan and the United States show similar developmental patterns and have not yet produced monosyllabic tones with adultlike accuracy. [ABSTRACT FROM AUTHOR]

Abstract: We evaluated the association between two aspects of social relationships and six inflammatory markers in Taiwan and the U.S. These two countries share similar levels of current life expectancy, but exhibit important differences in social structure. The data comprised population based samples from Taiwan (aged 53+; n =962) and the U.S. (aged 35–86; n =990) collected between 2003 and 2009. Circulating levels of interleukin-6 (IL-6), C-reactive protein (CRP), fibrinogen, and soluble forms of intercellular adhesion molecule 1, E-selectin, and IL-6 receptor (sIL-6R) were measured in fasting blood samples. A social integration score was based on marital status, contact with family and friends, church attendance, and other social participation. A perceived social support index was based on questions regarding the availability of care and support from family and friends. Linear regression models tested the association between these two measures and each inflammatory marker controlling for sociodemographic characteristics, obesity, medication use, and baseline health status. After adjusting for potential confounders, social integration had a significant but weak inverse association with CRP in Taiwan. Perceived social support was significant in two of 12 models, and the coefficient was positive (i.e., higher support was associated with higher CRP and sIL-6R in the U.S.). We found no evidence that the coefficients for social relationship measures varied by sex or age. Our results yielded limited evidence of a weak association between two dimensions of social relationships and six inflammatory markers in Taiwan and the U.S. Given that the literature suggests a strong link between social relationships and mortality, and that inflammation plays an important role in the leading causes of death, we had expected to find consistent and moderately strong associations between social relationships and inflammatory markers. The small effect sizes and lack of robustness across markers were surprising. [Copyright &y& Elsevier]

Summary: Arzoxifene increased bone mineral density and decreased bone turnover to a significantly greater extent than raloxifene. The hot flush incidence was lower with arzoxifene than raloxifene. Introduction: To assess the effect of arzoxifene versus raloxifene on change in lumbar spine (LS) bone mineral density (BMD) in postmenopausal women with osteoporosis. Methods: In this 12-month study (NEXT trial), participants were randomly assigned to arzoxifene 20 mg/day ( N = 158) or raloxifene 60 mg/day ( N = 162). All received daily calcium and vitamin D. Change in LS BMD was assessed by DXA. Secondary objectives included assessment of femoral neck (FN) and total hip BMD, serum bone turnover markers, and safety. Results: Treatment groups were similar at baseline (mean age 63 years, mean LS BMD T-score −2.9). At 12 months, the increase in LS BMD with arzoxifene was greater than with raloxifene (+2.75% vs. +1.66%), as was FN and total hip BMD ( P < 0.05). For LS and FN, this effect was also evident at 6 months. Arzoxifene reduced bone turnover to a greater extent than raloxifene at 3, 6, and 12 months ( P < 0.05). The proportion of women reporting ≥1 adverse event did not differ between treatment groups, nor did vaginal bleeding. No cases of endometrial polyps, hyperplasia, or cancer were reported. Nasopharyngitis and bronchitis were reported more frequently with arzoxifene versus raloxifene (10.1% vs. 2.5%, and 5.1% vs. 0%, respectively) and new/worsening hot flushes were reported less frequently with arzoxifene (7.0% vs. 16.7%) ( P < 0.05). Conclusions: Arzoxifene increased BMD and suppressed bone turnover to a greater extent than raloxifene and resulted in a lower incidence of new/worsening hot flushes. Based on subsequent findings from a fracture outcome study, this difference did not translate into improved fracture efficacy. [ABSTRACT FROM AUTHOR]

• Nested pattern of latent bullying victimization profiles emerges across six regions. • Latent profile analysis identifies similarities in victimization experiences by region. • The more severe victimization experience, the lower sense of school belonging. • Buffering effect of parental interest acts only in the Taiwanese subsample. Bullying victimization has a negative relationship with adolescents' sense of school belonging, which is an important contributor to their adaptive development. Based on the ecological systems perspective—which suggests that multiple systems in adolescence including the family and school are interconnected—experiences at home are linked with experiences at school. Thus the current study examined the relationship among bullying victimization, sense of school belonging, and parental support. Self-reported data of students from five Northeast Asian regions (Beijing-Shanghai-Jiangsu-Guangdong China, Hong Kong, Japan, South Korea, Taiwan) and the United States from the 2015 Programme for International Student Assessment, an international cross-sectional survey, was used. First, latent profile analysis was conducted to identify subgroups of adolescents who differ in their experiences of bullying victimization. Second, multivariate regression analysis was used to examine the association between victimization profiles and sense of school belonging, and to investigate the moderating role of parental support in this relationship. There were more similarities in subgroups of victimization than differences across the six regions. The association between latent risk profiles and sense of school belonging varied across the different regions. The buffering effect of parental support on the relationship between victimization profiles and sense of school belonging was supported only by the data from Taiwanese adolescents. Despite regional similarities and differences, a common finding emerged: membership to any subgroup of victimization lowered adolescents' sense of school belonging, when compared to membership to the very low group. Implications for intervention design for victimized adolescents are discussed. [ABSTRACT FROM AUTHOR]

Question In patients with intracerebral hemorrhage and systolic blood pressure (SBP) ≥ 180 mm Hg, does intensive lowering of SBP to < 140 mm Hg, beginning within 4.5 hours of symptom onset, reduce death or disability more than standard SBP lowering? Methods Design Randomized controlled trial (Antihypertensive Treatment of Acute Cerebral Hemorrhage II [ATACH-2] trial). ClinicalTrials.gov NCT01176565. Allocation Concealed.* Blinding Blinded* (adjudicators of safety outcomes). Follow-up period 3 months. Setting 110 clinical centers in the USA, Japan, China, Taiwan, South Korea, and Germany. Patients 1000 adults ≥ 18 years of age (mean age 62 y, 62% men) who had spontaneous supratentorial intracerebral hemorrhage (ICH), ≥ 1 SBP reading ≥ 180 mm Hg (mean 200.6 mm Hg), and Glasgow Coma Scale scores ≥ 5 on emergency department arrival. Exclusion criteria included inability to initiate treatment with 4.5 hours of symptom onset, intraparenchymal hematoma ≥ 60 cm3 on initial computed tomograpy, or reduction of SBP to < 140 mm Hg before randomization. Intervention Lowering and maintenance of hourly minimum SBP to 110 to 139 mm Hg (intensive) (n = 500) or to 140 to 179 mm Hg (standard) (n = 500) for 24 hours after randomization. To achieve SBP targets, IV nicardipine was initially used, followed by other treatments as needed. Outcomes Death or moderately severe or severe disability (modified Rankin Scale [mRS] score 4 to 6) at 3 months. Secondary outcomes included serious adverse events at 3 months, hematoma expansion ≥ 33% at 24 hours, and neurologic deterioration at 24 hours. 1042 patients were needed to detect a 10% absolute reduction in the primary outcome, assuming a 60% event rate in the standard group (90% power, 2-sided α = 0.05). Patient follow-up 96% for primary outcome (intention-to-treat analysis). Main results Enrollment was stopped for futility. 88% of the intensive-lowering group and 99% of the standard-lowering group achieved the target SBP within 2 hours of randomization (P < 0.001). The main results are in the Table. Conclusion In patients with intracerebral hemorrhage and systolic blood pressure (SBP) ≥ 180 mm Hg, intensive lowering of SBP levels to < 140 mm Hg did not reduce death or disability more than standard lowering. [ABSTRACT FROM AUTHOR]