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Background: The proportion of hospital deaths has declined in the past few decades, while the proportions of nursing home deaths have increased. This trend of increasing deaths in long-term care facilities underlines the importance of improving end-of-life care provisions in these settings to meet individual preferences and needs. Under these circumstances, a comprehensive understanding of end-of-life care preferences in local nursing home residents can help healthcare professionals and policymakers develop strategies to increase the advance directive completion rate and quality of care. This study aimed to explore and compare advance directive and end-of-life care preferences of nursing home residents in Hong Kong and Taiwan. Methods: A structured questionnaire was developed by the research team to investigate advance directive and end-of-life care preferences in older Chinese nursing home residents. Nursing home residents with frail or pre-frail status and over the age of 64 were invited to participate in the study, and information on demographics, functional status, advance directive experiences, and end-of-life care expectations was collected through questionnaire interviews. Results: A total of 325 eligible participants from 32 facilities completed the survey, including 238 older residents in Hong Kong and 87 in Taiwan. A significantly lower proportion of the Hong Kong residents had completed an advance directive compared with the Taiwanese (3 vs. 13%, p = 0.001). Among participants who did not have an advance directive, 46% of the Taiwanese participants said they would consider completing one in the future, compared with 20% of the Hong Kong participants (p < 0.001). A total of 79% of the Hong Kong participants and 80% of the Taiwanese participants responded that prolonging life in the given hypothetical dying scenario was "not important" (p = 0.76). Only 14% of participants in Hong Kong and 18% of participants in Taiwan reported prior occurrence of end-of-life care discussions with family members or health professionals (p = 0.37). Conclusions: This paper adds evidence in support of improving end-of-life communication and the advance directive completion rate in nursing homes in Hong Kong and Taiwan. Further research is necessary to explore cross-cultural differences in end-of-life preferences and its applications in predicting decision-making and the quality of end-of-life care. [ABSTRACT FROM AUTHOR]

Background: In China, the field of orthopedics has experienced significant growth over the past 12 years. However, the recent status of research on orthopedics among individuals in mainland China, Hong Kong, and Taiwan is unknown. In this study, we investigated characteristics and trends of orthopedics publications from these three regions. Methods: Between 2003 and 2014, all articles published in 63 orthopedics journals originating from mainland China, Hong Kong, and Taiwan were identified via Science Citation Index Expanded (SCIE) database. A survey was conducted to systematically analyze the published orthopedics articles from the three regions according to the numbers of articles, study design, impact factors (IFs), citations, most prolific authors, and institutions. Additionally, we evaluated global trends in orthopedics publications, and ranked top 10 countries in terms of the total number of published articles over 12 years and the number of published articles per year. Results: A total number of 123,317 articles were published in the 63 orthopedics journals between 2003 and 2014. The worldwide number of annually published orthopedics articles tended to increase during the study period. The total number of orthopedics publications from the three regions, especially in mainland China, increased markedly from 2003 to 2014. The annual number of orthopedics articles from mainland China increased from 6 in 2003 to 813 in 2014, Hong Kong increased from 32 in 2003 to 71 in 2014, and Taiwan increased from 68 in 2003 to 168 in 2014. For accumulated IFs and total citations of articles, mainland China ranked the first place, followed by Taiwan and Hong Kong. However, publications from Taiwan had the highest average citations per article, and publications from Hong Kong had the highest average IFs. Among the top 10 most prolific authors and institutions, 4 authors and 4 institutions were from Taiwan, 3 authors and 4 institutions were from mainland China, and 3 authors and 2 institutions were from Hong Kong. Conclusions: The quantity of articles published in international orthopedics journals from mainland China presented a remarkable upward trend during the past 12 years. Given the relative size of the populations, it should be emphasized that mainland China still has a long way to go to achieve the academic performance of Hong Kong and Taiwan. [ABSTRACT FROM AUTHOR]

Background: The psychosocial consequences of obesity are important but often underrated. The Attitudes Toward Obese Persons (ATOP) and Beliefs About Obese Persons (BAOP) scales used to measure weight-related bias have little psychometric information, especially in East Asian contexts. The objective of this study was to use rigorous statistical methods to demonstrate the psychometric properties of these two instruments in Hong Kong and Taiwanese college students.Methods: A convenience sample of 707 students was recruited from the universities in Hong Kong and Taiwan. Several competing confirmatory factor analyses (CFAs) were conducted to confirm the factorial structure of the ATOP and BAOP. The best fit models for the ATOP and BAOP were chosen for the examination of the measurement invariance across subcultures. We then compared configurable models with or without loading and/or intercept constrained before correlating the latent constructs between the best models for the ATOP and BAOP.Results: The comparison in multiple CFAs found that the model with one factor and two correlated-wording-method factors outperformed the other models for both the ATOP and BOAP. However, the internal consistency was suboptimal (ATOP: α = .56 to .80; BTOP: α = .57 to .65) and the measurement invariance was somewhat unsupported among the Hong Kong and Taiwan samples. Moreover, after controlling wording effects, the latent construct of the ATOP was moderately associated with that of BAOP (r = .356; p < .001).Conclusion: Chinese versions of the ATOP and BAOP can be treated as a unidimensional factor for use in Hong Kong and Taiwan university students. However, further refinements of both instruments may be needed before using them to capture the social attitudes and beliefs toward obesity individuals, which is expected to advance our understanding of weight-related bias in East Asian contexts. [ABSTRACT FROM AUTHOR]