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The development of efficient and reliable online assessments has become increasingly important in the digital era. We developed a 10-min online word reading assessment of global English based on the existing paper-and-pencil version of our English silent word reading test. The test includes two parts, namely, random word recognition and contextual word reading. A total of 889 participants (437 children and 392 adults; 62.7% female) took part in the study. They were from various regions including mainland China, Hong Kong SAR, Macau SAR, Poland, the United States, and the Philippines. Reliability and validity analyses on various demographics samples (by age and country/region of origin) demonstrated that the WordSword Test is highly reliable and valid (e.g., the correlation of this test with other English reading measures were above.80). Education level was positively correlated with test performance, while the correlations between age and test performance were not consistent. Ninety-seven children participants also took the paper-and-pencil version of the WordSword Test. The correlation between performances on the online and paper-and-pencil versions of the test was.879, one year apart. With more children and adults taking the WordSword Test, we ultimately hope to establish norms by area, grade level, and age. [ABSTRACT FROM AUTHOR]

This paper explores the relationship between gender, academic achievement, and family functioning in a Chinese cultural background. Primary and secondary school students ( n = 1597) in Hong Kong participated in a survey questionnaire. Two competing hypotheses are derived and empirically tested based on the idea that parents are likely to have higher expectations toward their sons. First, when boys perform well academically, their parents might not feel particularly overjoyed because their sons simply achieved what they were expected to, which would not affect the parents' attitudes within the family and thus the boys' perceptions of the family. Second, when parents have such high expectations for their sons, they would feel particularly satisfied when the outcome fulfills their high expectations. The results indicated that boys did well academically to prevent their parents from potential disappointment, whereas parents were actually happier if their daughters overachieve because they have lower initial expectations. Such differences affected parents' attitudes, family functioning, and thus adolescents' view of family. The results of this study carry implications for the study of family functioning and parenting among Chinese families. In particular, parents should avoid having gender-based expectations toward their children, which could adversely affect how boys view their family. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to compare the effectiveness of directive programmes led by professionals where parents were taught specific parenting knowledge and strategies (Triple P – Positive Parenting Program) and non-directive parenting programmes in the form of mutual-aid support group as a universal prevention programme. Design/methodology/approach – This study employed a randomised controlled trial design. Participants included 92 Hong Kong Chinese parents with preschool children recruited from eight kindergartens and a local church. They were randomised into Group Triple P, non-directive group and control group. They completed measures on their perception of child behaviour problems and their parental stress before and after intervention. Findings – At post-intervention, results indicated significantly greater decrease in child disruptive behaviours among participants in the Triple P group than those in the non-directive group and control group while no significant group difference was found between the latter two groups. No significant difference was found in post-intervention parental stress level among the three groups. Originality/value – This study provides empirical evidence to demonstrate the effectiveness of a directive parenting programme vs a non-directive one. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to evaluate and compare the effectiveness of two intervention formats of the Positive Parenting Programme (Triple P) – Level 4 Group Triple P (TP) and brief parent discussion group (DI) with the waitlist control group (WL). Design/methodology/approach – Participants included 91 Chinese parents with preschool children in Hong Kong from eight preschools, who were randomised into the two intervention conditions (TP and DI) and a waitlist control group (WL). Parent participants completed measures on child behaviours and parenting stress before and after intervention. Findings – Results indicated that there was a significant decrease in post-intervention child behavioural problems in the TP group, with a medium effect size when compared to the WL group. There was a decrease in post-intervention child behaviour problems in the DI group, compared with the WL group. No significant difference was found in post-intervention child behaviour problems between the TP group and the DI group. Practical implications – The positive results in the present study support the extension of the implementation of Triple P interventions to the preschool setting in Hong Kong. The effectiveness of the brief parent discussion group in reducing parental report of child behaviour problems provides preliminary support for its potential as a universal preventive parenting intervention in the local context. Originality/value – The study was the first evaluation of the Level-4 Triple P programme in a local school context as well as the first evaluation of effectiveness of the brief parent discussion group in the local context at the time of the study. [ABSTRACT FROM AUTHOR]

There is evidence showing that the triarchic model of grit and its dimensions (i.e., perseverance of effort, consistency of interests, and adaptability to situations) predict engagement and well-being outcomes in high school and undergraduate students during the COVID-19 pandemic outbreak. However, there has been limited research on how this model of grit relates to engagement and optimal psychological outcomes in primary school students. This research investigates the association of grit's dimensions with academic engagement in math and science as well as well-being outcomes (i.e., positive emotions, negative emotions, and flourishing) in primary school students. Participants were primary school students (Mage = 10.42; SDage = 1.26) from Hong Kong (n = 279) and Macau (n = 124). Results showed that perseverance of effort positively predicted cognitive and behavioral engagement in math as well as positive emotions even after controlling for demographic covariates (i.e., age, gender, setting, and year level), conscientiousness, and achievement goal orientations. Adaptability to situations positively predicted cognitive and social engagement in math and flourishing. Consistency of interests negatively predicted both cognitive engagement in science and negative emotions. Indeed, this study indicates that perseverance and adaptability may facilitate children's positive academic and psychological functioning during the COVID-19 pandemic outbreak. [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]

Teachers' self-efficacy is a critical predictor for successful inclusive physical education. However, little is known about preservice physical educators' self-efficacy toward teaching students with autism spectrum disorders in China. A sound instrument is necessary to measure their self-efficacy level. This validation study examined the psychometric properties of the Chinese version of the Physical Educators' Self-Efficacy Toward Including Students with Disabilities--Autism. A multisection survey form was administered to preservice physical educators in Mainland China (n = 205) and Hong Kong (n = 227). The results of confirmatory factor analysis confirmed the one-factor model of the scale in the total sample and each of the two samples. Invariance tests across the two samples supported configural and metric invariance but not scalar invariance. The scale scores showed good internal reliability and were correlated with theoretically relevant constructs (i.e., burnout and life satisfaction) in the total sample and subsamples. These findings generally support the utility of the scale for use among Chinese preservice physical educators. [ABSTRACT FROM AUTHOR]

This study compares the findings of two qualitative research studies on meanings of divorce endorsed by Chinese divorced women in Hong Kong conducted in 1998–2002 and 2016–2018, respectively. It is clearly shown that ideas about divorce have changed enormously in the past two decades. While the ideas that divorce is not acceptable and divorced women are failures were still prevalent, particularly in the divorce decision-making process, there has been a move towards a more dominant modern stance on divorce, although two powerful obstacles, the welfare of children and social stigmatisation, have persisted. [ABSTRACT FROM AUTHOR]

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Objective: Women frequently report breastfeeding problems in the early postpartum period. Women who have self-endorsed beliefs that breastfeeding benefits their babies and themselves are more likely to continue breastfeeding despite breastfeeding barriers. Maternal self-endorsed beliefs is a key component of maternal self-regulated motivation. The present study examined the association between maternal self-regulated motivation, breastfeeding duration and exclusivity in Chinese women. Methods: This was a prospective cohort study, of which we recruited participants in postnatal maternity units of publicly funded hospitals in Hong Kong. Postpartum women were asked to fill in the validated breastfeeding self-regulation questionnaire (BSRQ) before hospital discharge and their breastfeeding status was assessed by telephone follow-ups at 6 and 12 weeks postpartum. Multiple logistic regression was used to study the relationship between breastfeeding self-regulated motivation and the duration of breastfeeding at follow-up. Results: At 6 and 12 weeks postpartum, women who breastfed exclusively scored significantly higher in self-regulated motivation than those who formula-fed. The self-regulated motivation was associated with higher odds of exclusive breastfeeding at 6 weeks and any breastfeeding at 12 weeks postpartum. Conclusions for Practice: The study found that self-regulated motivation was positively related to breastfeeding duration. Maternal self-regulated motivation toward breastfeeding could be enhanced by the availability of social support and breastfeeding-friendly facilities, resulting in longer breastfeeding duration. [ABSTRACT FROM AUTHOR]

This study aimed to establish a new COVID‐19 Fear (Higher Education) scale to investigate the relationship between fear and generalised anxiety symptoms among Chinese students in mainland China, Hong Kong, and other countries. 219 Chinese university students studying in universities in mainland China (n = 76, 34.7%), Hong Kong (n = 66, 30.1%), and overseas (i.e., outside of China as international students, n = 77, 35.2%) participated in an online study from March 31, 2020 to April 4. Participants completed a newly developed COVID‐19 Fear (Higher Education) scale to measure three domains of fear including fear of infection, fear of instability and fear of insecurity related to the COVID‐19 pandemic. They also completed the Generalized Anxiety Disorder 7‐item scale (GAD‐7) on the severity of anxiety symptoms. About 9.6% of the participants could be classified as exhibiting high anxiety level according to the GAD‐7. More students studying overseas (about 15%) were classified into the high GAD group when compared to students studying in both mainland China (6.6%) and Hong Kong (6.1%). MANOVA results showed that students studying in Hong Kong and overseas had more concerns related to preventive measures related to COVID‐19 than their mainland counterparts did. We concluded that international students studying away from their home country would have higher risk to develop anxiety problems during a collective trauma such as the COVID‐19 pandemic. Education institutions should provide support services including online support groups, social media groups for mutual support to alleviate the fear and anxiety of international students. [ABSTRACT FROM AUTHOR]

Purpose: A deluge of fake news and misinformation about the coronavirus disease 2019 (COVID‐19) on the Internet poses challenges for the public in their search for reliable and relevant health information for taking protective measures, especially among people with chronic diseases (PWCD). This study aimed to (a) understand the satisfaction level of the online information related to COVID‐19 in people with and without chronic diseases; (b) explore information‐searching behavior and digital health literacy in PWCD; and (3) identify the possible predictors of information satisfaction among PWCD. Methods: This was a multicity, cross‐sectional study using an online survey with a convenience sample of people who (a) were 15 years of age or older and (b) had access to the Internet in mainland China, Hong Kong, and Macau. Findings: Four thousand four hundred and seventy‐two subjects completed the survey, of whom less than 50% felt satisfied with the online information. About 20% of respondents (n = 882) were diagnosed with at least one chronic disease and reported a lower level of information satisfaction (p =.003) than the people without chronic diseases. The majority of the PWCD obtained their online health information from social media. Higher digital health literacy (adjusted odds ratio [OR] = 5.07), higher frequency of searches regarding symptoms of COVID‐19 (adjusted OR = 2.07), higher perceived importance of quickly learning from the information searched (adjusted OR = 1.63), and lower frequency of searches on the topic of dealing with psychological stress (adjusted OR = 0.54) were found to be predictors of information satisfaction among PWCD. Conclusions: The majority of PWCD sought online information related to COVID‐19 from social media, and their level of information satisfaction was significantly lower than among people without chronic diseases. Digital health literacy is a strong and significant predictor of information satisfaction. Clinical Relevance: To support PWCD, we not only have to provide them with clear and accurate information, but also promote their digital health literacy so that they may seek, understand, and appraise health information from the Internet to make appropriate health‐related judgments and decisions. [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]

Most studies of stalking are conducted with samples from individualist cultures. Little is known about the phenomenon within collectivist cultures. The present study is arguably the first stalking study conducted in Hong Kong. Specifically, this study investigates a large sample of Asian college students' (N = 2,496) perceptions of stalking behavior, potential reasons for stalking, and coping strategies that may be employed by stalking victims. Associations between these variables and gender and culture (Hong Kong vs. Mainland China) were also explored. Gender was more strongly associated with perceptions of stalking behavior than was culture. Gender was less strongly associated with perceptions concerning motivations for stalking and the effectiveness of coping strategies that may be employed by stalking victims than was culture. Effect sizes for all associations with culture were small, perhaps due to a high degree of similarity between the two cultures examined. The findings are generally supportive of similar results produced by previous work conducted within individualistic Western cultures, suggesting that stalking and the way that it is perceived may be universal in nature. This study concludes with the argument that legislation against stalking needs to be extended to non-Western countries, such as Hong Kong and Mainland China, as antistalking laws are relatively scarce outside Western industrialized countries. [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]

Relatively little is known about the experiences of Chinese widows, especially those living outside China. This qualitative study examines the experiences of eight Chinese or Hong Kong-born widows living in the UK. Using a semistructured approach to interviewing, participants were asked about their lives before, during, and after their spousal bereavement. Five major themes emerged: (1) complexity of marital lives; (2) experiences around the time of the death including fate; (3) loneliness and isolation; (4) the challenges of practical tasks; and finally, (5) current life. The implications of the findings for social policy and practice are briefly discussed. [ABSTRACT FROM AUTHOR]

Abstract: Background: Researchers have found breastfeeding disparities between immigrant and native‐born women in many countries. However, most studies on immigration and breastfeeding practices have been in Western countries. The aim of this study was to examine the effect of length of time since immigration on the breastfeeding practices of Mainland Chinese immigrants living in Hong Kong. Methods: We recruited 2704 mother‐infant pairs from the postnatal wards of four public hospitals in Hong Kong. We examined the effect of migration status on the duration of any and exclusive breastfeeding. Results: Breastfeeding duration was progressively shorter as the time since immigration increased. When compared with mothers who had lived in Hong Kong for <5 years, Hong Kong‐born participants had a 30% higher risk of stopping any breastfeeding (hazard ratio [HR] 1.34 [95% confidence interval {CI} 1.10‐1.63]) and exclusive breastfeeding (HR 1.33 [95% CI 1.11‐1.58]). In both Hong Kong‐born and immigrant participants, breastfeeding cessation was associated with return to work postpartum and the husband's preference for infant formula or mixed feeding. Intention to exclusively breastfeed and to breastfeed for >6 months, and previous breastfeeding experience substantially reduced the risk of breastfeeding cessation for both Hong Kong‐born and immigrant participants. Conclusions: Health care professionals should consider immigration history in their assessment of pregnant women and provide culturally adapted breastfeeding support and encouragement to this population. [ABSTRACT FROM AUTHOR]

Background Individuals with ID are often withheld information about the death of their loved ones as it has often been thought that they do not understand death or cannot grieve. This grief exacerbates the stress of individuals with ID as they often encounter secondary losses such as transitioning to a care facility. The aim of this study is to investigate men and women with ID understanding death concepts and to what extent . Method Adopting a stratified random sampling method, 156 Chinese people with ID were invited to join the study. One hundred and ten participants were interviewed using simple death related vignettes expanding upon and replicating a published study carried out in Ireland. The understanding of the five death concepts: causality, irreversibility, nonfunctionality, universality and inevitability was examined. The correlates of demographics, bereavement experiences and comprehension were explored. Results The majority of the participants did understand concepts such as death is irreversible and that the deceased no longer function. One third of the participants understood causality and the universality of death. One fifth understood the inevitability of death. Previous bereavement experiences were correlated with higher understanding. Communication and community skills were correlated with all concepts of death except universality. Conclusion The results indicate that individuals with ID do have a partial to full understanding of the concepts of death. The culture of Hong Kong is one that considers death to be a taboo or unlucky subject. Therefore, the results mirror the the lack of understanding of universality and inevitability concepts as it is forbidden to speak of these concepts. An open and honest environment is encouraged to educate individuals with ID about death and bereavement. [ABSTRACT FROM AUTHOR]

This study’s purpose was to develop a temporal and cultural definition of volunteering in China. Using a comparative mixed-methods approach,N1 = 218 Chinese students in Hong Kong were surveyed about their perceptions of volunteering. These quantitative data were compared cross-culturally with a sample of adults in the United States who used the same instrument calledWho is a Volunteer? Subsequently,N2 = 40 of these same students voluntarily participated in a series of focus groups, to further explore more in-depth their opinions about volunteering. The main quantitative results revealed that at the extreme ends of the volunteer scale, both the U.S. and Chinese samples could readily distinguish what volunteering was or was not. The more nuanced empirical differences on the scale (24% of the 21 items) were explained either by unique cultural differences, or the longer and more prominent history that volunteering has had in North America versus China. Main qualitative findings revealed additional between-group cultural differences exemplified by (1) a more family-centric and collectivist Chinese culture versus a more individualistic American culture, (2) a role blurring about volunteer activities versus paid work activities, and (3) that both organizational and cultural context must be seriously considered when defining volunteerism. This study adds to the growing definitional literature on this transformational concept and represents the largest comparative empirical investigation on this subject from East Asia. [ABSTRACT FROM PUBLISHER]

Infertility is estimated to affect 10–15% of couples in industrialized countries and many of them are under tremendous stress. Stress can lead to poor quality of life and sexual dysfunction in general, but little is known about their prevalence in infertile women. We, therefore, conducted this cross-sectional survey in two primary care subfertility clinics between August 2012 and April 2013. A total of 159 women completed two validated Chinese questionnaires: Female Sexual Function Index and core Fertility Quality of Life. The overall Female Sexual Function Index score (mean ± SD) of the whole group was 24.99 ± 4.22. Using the urban Chinese cut-off, the prevalence of female sexual dysfunction, low desire, arousal disorder, lubrication disorder, orgasmic disorder and sexual pain were 32.5%, 15.7%, 19.3%, 22.3%, 33.1% and 15.1%. The core Fertility Quality of Life score of the whole group was 59.76 ± 13.59 and the subgroup of infertile women with sexual dysfunction (n = 50) had significantly lower mean core Fertility Quality of Life score than those without sexual dysfunction (n = 109) (55.03 versus 61.88) (p = 0.005). Among the subscales, the relational score had the strongest correlation with sexual dysfunction. Infertile women with sexual dysfunction had significantly worse quality of life especially in the relational aspect. [ABSTRACT FROM AUTHOR]

Childhood internalizing problems such as anxiety and depression can have serious personal, familial and societal repercussions, including drug and alcohol abuse, delinquency, unplanned pregnancy, and even suicide. There is little research on mindfulness interventions for children with clinical levels of internalizing problems, and school-based mindfulness research with children has focused on non-clinical groups. We employed a two-stage screening and intervention procedure to evaluate an in-school mindfulness-based cognitive intervention for Hong Kong children with subclinical internalizing difficulties. Ninety-three fourth to sixth graders were screened, and twenty students (age 9-13, median age 10) highest among their peers on internalizing problems, but lowest on externalizing problems, participated in a 9-week group mindfulness-based intervention. We employed a two-phase open trial design, with random assignment to an immediate intervention group or wait-list control group. In single-trial analysis, one-tailed dependent sample t-tests showed significant decreases in both worry and in symptoms of panic disorder, obsessive compulsive disorder, generalized anxiety and overall internalizing problems. In a randomized controlled trial analysis, the immediate intervention group evidenced larger but nonsignificant reductions on almost all measures. Eighty-five percent of the participants rated the program as helpful, and 65-80 % reported improvement in handling emotions and interpersonal relationships at post-treatment, with some treatment gains maintained at 3-month follow-up. These preliminary findings have encouraging implications for implementing time-limited school-based mindfulness interventions targeting elevated childhood internalizing difficulties. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed at assessing the differences in prevalence rates of common health behavior among adolescents in the five Chinese cities and the influential factors at the contextual and individual levels. Method: We compared the standardized rates of three lifestyle behaviors (sedentary, dietary, and physical activity) and three addictive behaviors (cigarette smoking, alcohol consumption, and participation in gambling) among a sample of 13,950 adolescents. The sample was randomly selected from five cities, including Hong Kong, Macau, Taipei, Zhuhai, and Wuhan. Population size, GDP per capita, and literacy at the city level as well as parental monitoring and school performance at the student's level were assessed. Multi-level mixed effect models were used to examine the interaction of individual level factors with study sites. Results: The six health behaviors differed significantly across sites with the highest rates of alcohol consumption in Hong Kong (39.5 %), of cigarette smoking in Macau (9.8 %), and of gambling in Taipei (37.1 %) and Hong Kong (35.9 %). The city-level measures were associated with only a few behavioral measures. Relative to Hong Kong, parental monitoring had stronger association with the three addictive behaviors in the other sites. Conclusion: Findings suggest that although the study sites share similar Chinese culture, students in the five cities differed from each other with regard to levels of health behaviors. Relative to the broad socioeconomic development, differences in parental monitoring played a significant role in explaining the observed difference. [ABSTRACT FROM AUTHOR]

BACKGROUND: The objective of this study is to evaluate the effects of the Multi-disciplinary Orthopaedics Rehabilitation Empowerment (MORE) Program on reducing chronic disability among injured workers and improving efficiency of work rehabilitation process. METHODS:A cohort of patients with workplace injuries in the lower back were recruited from orthopaedics clinics and assigned to either MORE group (n = 139) or control group (n = 106). Patients in MORE group received an early MRI screening and a coordinated multi-disciplinary management, while patients in the control group received conventional care. Outcome variables are time to return-to-work (RTW) from date of injury, waiting time for MRI screening and time to medical assessment board (MAB). RESULTS: Patients in the MORE Program had significantly shorter duration for RTW (MORE: 6.1 months, Control: 12.8 months, p < 0.01), and more RTW cases (n = 64, 46.0%) compared to Control group (n = 29, 27.4%). The MORE group also had much shorter waiting time for MRI scans (91.85 vs. 309.2 days, p <0.001) and MAB referral after MRI scans (97.2 vs. 178.9 days, p = 0.001) compared to Control group. CONCLUSIONS: The MORE Program which emphasizes early intervention and early MRI screening, is shown to be effective in shortening sick leave and improving RTW outcomes of injured workers. [ABSTRACT FROM AUTHOR]

Background. Patients with schizophrenia have intact ability to experience emotion, but empirical evidence suggests that they fail to translate emotional salience into effortful behaviour. Previous research in patients with chronic schizophrenia suggests that working memory is important in integrating emotion and behaviour. This study aimed to examine avolition and anhedonia in patients with first-episode schizophrenia and clarify the role of working memory in emotion- behaviour coupling. Method. We recruited 72 participants with first-episode schizophrenia and 61 healthy controls, and used a validated emotion-inducing behavioural paradigm to measure participants' affective experiences and how experienced emotion coupled with behaviour. Participants were given the opportunity to expend effort to increase or decrease their exposure to emotion-inducing photographs. Participants with schizophrenia having poor working memory were compared with those with intact working memory in their liking and emotion-behaviour coupling. Results. Patients with first-episode schizophrenia experienced intact 'in-the-moment' emotion, but their emotion was less predictive of the effort expended, compared with controls. The emotion-behaviour coupling was significantly weaker in patients with schizophrenia with poor working memory than in those with intact working memory. However, compared with controls, patients with intact working also showed substantial emotion-behaviour decoupling. Conclusions. Our findings provide strong evidence for emotion-behaviour decoupling in first-episode schizophrenia. Although working memory deficits contribute to defective translation of liking into effortful behaviour, schizophrenia alone affects emotion-behaviour coupling. Conclusions. Our findings provide strong evidence for emotion-behaviour decoupling in first-episode schizophrenia. Although working memory deficits contribute to defective translation of liking into effortful behaviour, schizophrenia alone affects emotion-behaviour coupling. [ABSTRACT FROM AUTHOR]

Immigrants, especially the first-generation, were thought to have different knowledge, attitudes and practice (KAP) with antibiotics. Doctors often perceived extra pressure from them to prescribe antibiotics. To test these perceptions, we studied the difference in KAP with antibiotics between the recent-immigrants from mainland China and the local-born of Hong Kong-places with significantly different healthcare and socio-economic systems. Focus groups (including one specific group of recent-immigrants) with 56 participants and territory-wide telephone questionnaire survey with 2,471 randomly selected respondents. Recent-immigrants shared similar KAP with the local-born. After adjustment for age, sex and education, the main significant difference was the new-immigrants' behaviour of acquiring antibiotics without prescription and keeping the leftover. They, like the local-born, preferred doctors who prescribed antibiotics cautiously. Immigration status could be the surrogate for age, sex and education in the KAP with antibiotics. For antibiotic use, health education and patient care could be similar between the recent-immigrants and the local-born. [ABSTRACT FROM AUTHOR]

Background An increasing number of people with intellectual disabilities (ID) are at risk of developing age-related disorders such as dementia because of a dramatic increase in life expectancy in this population in the recent years. There is no validated dementia screening instrument for Chinese people with ID. The Dementia Screening Questionnaire for Individuals with Intellectual Disabilities (DSQIID) was reported to be a valid, user-friendly, easy-to-use observer-rated instrument. It was developed in the UK and has good psychometric properties. Validation of a Chinese version of the DSQIID will facilitate its application among the Chinese population. Method The DSQIID was translated into the Chinese version (DSQIID-CV). By purposive sampling, service users with ID aged 40 years or over were recruited through two large centres serving adults with ID in Hong Kong. Carers who had taken care of the participants continuously for the past 6 months were invited to complete the DSQIID-CV. All participants were examined by qualified psychiatrists to determine the presence or absence of dementia. Results Two hundred people with ID whose age ranged between 40 and 73 years (mean 51 years, SD = 7.34 years) were recruited to the study. A clinical diagnosis of dementia was established in 13 participants. An overall total score of 22 as a screening cut-off provided the optimum levels of specificity (0.995) and sensitivity (0.923). The DSQIID-CV showed good internal consistency (alpha = 0.945) for all its 53 items, and excellent test-retest reliability (0.978, n = 46) and inter-rater reliability (1.000, n = 47). Exploratory factor analysis resulted in a four-factor solution explaining 45% of the total variance. Conclusions The DSQIID-CV is shown to have robust psychometric properties. It is the first valid and reliable dementia screening instrument for Chinese adults with ID. [ABSTRACT FROM AUTHOR]

Background It is important to integrate adolescent health domains into pre-service nursing education in order to enhance undergraduate nursing students' competencies in promoting adolescent health. Aim To determine the effectiveness of a structured adolescent health summer programme for Chinese undergraduate nursing students. Methods A quasi-experimental design was used to evaluate differences in the Chinese undergraduate nursing students' perceived competency in promoting adolescent health. A stand-alone adolescent health course was implemented as an intervention with pre- and post-tests of a 2-week intensive summer programme in 2010. The questionnaire included demographics, adolescent health competency checklist and programme evaluation. Descriptive statistics with the Wilcoxon signed-ranks test and the Mann- Whitney U-test were used for data analysis. Results Of the 113 nursing students, seniors perceived higher adolescent health competence mean scores than the juniors in the post-test phase. Majority of nursing students revealed the increasing awareness of the importance in promoting healthy lifestyle behaviours and psychosocial well-being after attending the summer programme. They agreed that nurses do have a role to play. Limitations This 2-week summer programme may only have short-term impacts on students' perception. Conclusions A stand-alone adolescent health summer programme can prepare nursing students to respond to the health issues of adolescents by enhancing their competence in health need assessment and service delivery. Implications for nursing and health policy Nurses serve in a leadership role for health policies and programmes. In nursing education, it is important for students to understand how to put in place policies to resolve adolescent health issues. [ABSTRACT FROM AUTHOR]

How would religion and a life event carrying an existential threat (LEET) jointly impact a person's life goals of becoming wealthy and successful in one's career? Goal reprioritisation, socioemotional selectivity, and gerotranscendence theories predict a shift away from material goals following a LEET, independent of the effect of religion. However, terror management theory (TMT) predicts that the effect of death thoughts depends on one's prevailing cultural values. As religion can be regarded as a culture, it is possible that Christians' and non-believers' material life goals would be differentially altered by LEET. Data from 1259 young Chinese adults reveal no main effect of LEET, but a strong effect of religion. Moreover, there was an interaction effect between LEET and religion on material life goals: LEET weakened material goals for Christians but not for non-believers. These findings suggest that TMT is more suitable than the other theories for predicting life goal changes. [ABSTRACT FROM PUBLISHER]

Aims and objectives To assess the effects of motivational interviewing for obese children and telephone consultation for parents to promote weight loss in obese children. Background Childhood obesity is a worldwide health problem that leads to serious metabolic and physiological consequences. An effective intervention to manage obesity is essential. Motivational interviewing is designed to resolve ambivalence, enhance intrinsic motivation and promote confidence in a person's ability to make behaviour changes. It has shown promise in the adult obesity literature as effecting positive health behaviour changes. Motivational interviewing has also been proposed as an effective method for improving the weight loss of obese children. Design A pre-post quasi-experimental design with repeated measures was used. Methods The study was conducted in four primary schools over an 11-month period in 2010-2011. Obese children ( n = 185) were screened from 791 school children studying the equivalent to UK grades 5 and 6 and were divided into three groups: motivational interviewing, motivational interviewing+ and a control group. The motivational interviewing group ( n = 70) children were provided with motivational interviewing counselling; the motivational interviewing+ group ( n = 66) children were provided with motivational interviewing counselling while telephone consultation was provided for their parents; and the control group did not receive any intervention ( n = 49). Results Children in both the motivational interviewing and motivational interviewing+ groups showed significant improvement in their weight-related behaviour and obesity-related anthropometric measures from the baseline to the end of the 14-week intervention, while the control group had significant deterioration in their anthropometric measures. Conclusion Motivational interviewing appears to be a promising intervention for promoting weight loss in obese children. Motivational interviewing counselling may be extended to obese children of different age groups. Relevance to clinical practice This study indicates that motivational interviewing is a useful method for improving behaviour changes in eating, physical activity and weight loss for obese children, suggesting the benefits of such intervention. [ABSTRACT FROM AUTHOR]

Objective To assess the perceived effectiveness of cigarette health warnings in China, compared with picture and text-only warnings from other countries. Method 1169 individuals (adult smokers, adult nonsmokers and youth) from four Chinese cities (Beijing, Shanghai, Kunming and Yinchuan) viewed 10 health warnings on cigarette packages, which included (a) the current Chinese text warnings covering 30% of the front/back of the pack (introduced October 2008); (b) the former Chinese text warning located on the side of the pack; (c) four picture warnings covering 50% of the front/back of the pack from Canada (lung cancer), Singapore (mouth disease), Hong Kong (gangrene) and European Union (clogged arteries); and (d) the same four warnings without the picture. Participants rated and ranked the 10 warnings on dimensions including how effective each would be in motivating smokers to quit and in convincing youth not to start smoking. Results Both Chinese warnings were consistently rated as least effective, with the new Chinese warning rated only slightly higher than the old warning. The picture warnings were consistently ranked or rated as most effective, with the text-only versions in the middle. Results were consistent across subject group, city and sex. Conclusions (1) Picture warnings are rated as much more effective than the same warnings without pictures. (2) The revised health warnings in China, introduced in October 2008, are only marginally more effective than the previous warning and far less effective than even text warnings from other countries. These results, coupled with population-based evaluation studies, suggest that pictorial warnings would significantly increase the impact of health warnings in China. [ABSTRACT FROM PUBLISHER]

Language brokering, whereby children of immigrants provide informal translation and interpretation for others, is considered commonplace. However, the research evidence remains inconsistent concerning how language brokering relates to the psychological health of child language brokers and their relationships with their parents. Furthermore, few studies have examined the familial context as an explanation source. This study evaluated the moderating effects of adolescents' support of family obligation values and their perceptions of parental psychological control on relationships between language brokering frequency and both adolescent psychological health and parent-child relationship quality. Adolescents from 182 immigrant Chinese families residing in Canada (average age 15 years, 52% females) reported the frequency with which they translated or interpreted various materials for their parents. More frequent language brokering was associated with poorer psychological health for adolescents who held strong family obligation values or who perceived parents as highly psychologically controlling. More frequent language brokering was also associated with more parent-child conflict. Contrary to some past findings, language brokering frequency was not significantly positively associated with self-esteem or with parent-child congruence (i.e., levels of understanding and satisfaction with parent-child relationships). The findings are discussed in relation to their support for theories of parent-child role reversals or independent-interdependent scripts in language brokering. [ABSTRACT FROM AUTHOR]

Purpose: This study investigates the impact of intertalker variations on the process of mapping acoustic variations on tone categories in two different tone languages. Method: Pitch stimuli manipulated from four voice ranges were presented in isolation through a blocked-talker design. Listeners were instructed to identify the stimuli that they heard as lexical tones in their native language. Results: Tone identification of Mandarin listeners exhibited relatively stable normalization regardless of the voice, whereas tone identification of Cantonese listeners was unstable and susceptible to the influence of intertalker variations. In the case of Cantonese listeners, intertalker variations had a larger effect on the perception of F[sub 0] height dimension than of F[sub 0] slope dimension. Conclusion: The comparison between Cantonese and Mandarin listeners' performances reveals an interaction of intertalker variations and the types of tone contrasts in each language. For Cantonese tones, which depend heavily on F[sub 0] height distinctions, intertalker variations result in F[sub 0] overlapping and, consequently, ambiguities among them in isolated tone perception. For Mandarin tones, which are distinctive in terms of their F[sub 0] contours, the differences in F[sub 0] contours alone seem sufficient to elicit reliable tone identification. Intertalker variations therefore have relatively limited effect on Mandarin tone perception. [ABSTRACT FROM AUTHOR]

While a large amount of research has been conducted in the West on domestic violence related issues, only a small number of studies have focused specifically on Chinese societies. Using survey data collected from Beijing, Hong Kong, and Taipei, this study compares college students' preferences for traditional and proactive police intervention into domestic violence and assesses the determinants of such preferences in the three Chinese societies. The findings indicate that Hong Kong students showed the highest level of support for traditional police response, followed by students in Beijing and Taipei, while students in Taipei displayed the strongest preference for proactive police response, followed by students in Hong Kong and Beijing. College students' preferences for traditional police response were shaped mainly by their locality, whereas their preferences for proactive police intervention were influenced chiefly by their attitudes toward violence and gender roles. Directions for future research are discussed. [ABSTRACT FROM AUTHOR]

This article aims to address female sex workers at high risk for contracting HIV in China by recommending evidence-based socio-structural interventions and policies at the national level that have yielded effective outcomes in other countries. National governments such as the Philippines and Hong Kong have utilized the Social Hygiene Clinic (SHC) model. A similar national policy can be highly effective in China. Evidence-based research study results indicate significant reductions in STI and consistent condom use among female sex workers in both China and the Philippines. Consistent condom use in both countries continues to be significantly associated with interpersonal- and venue-level factors. Individuals who had higher appointment-keeping ratios in the Philippines had higher rates of consistent condom use (OR = 2.7, 95% CI = 1.6-3.7) and significantly lower rates of STI (OR = 0.43, 95% CI = 0.26-0.57). By beginning with provinces, which already have a good relationship between establishment venues and the local Health Department, China can develop city ordinances and establishment regulations that begin to require regular examinations of female sex workers and entertainers in the local STI clinic. [ABSTRACT FROM AUTHOR]