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BackgroundInsomnia is a prevailing health problem among older adults. Tai Chi, a popular mind-body exercise practiced by older people in various oriental communities, has been shown to improve sleep. However, Tai Chi has not been directly compared to cognitive behavioral therapy for insomnia (CBT-I), which is the first-line non-pharmacological treatment for insomnia in older adults. This study aims to examine whether Tai Chi is non-inferior to CBT-I as a treatment for insomnia in older adults.MethodsThis is a single-center, assessor-blinded, non-inferiority randomized controlled trial comparing Tai Chi and CBT-I in 180 older adults aged ≥50 years with chronic insomnia according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Participants will be randomly assigned to either the Tai Chi or CBT-I group. Interventions will last for 3 months with a 12-month follow-up. The primary outcome is self-perceived insomnia severity measured by Insomnia Severity Index (ISI) at 3 months and at 15 months. The secondary outcomes include the remission rate of chronic insomnia, insomnia treatment response, subjective sleep quantity and quality, 7-day actigraphy, 7-day sleep diary, sleep medication, health-related quality of life, mental health, body balance and lower extremity function, adverse events, habitual physical activity, and dietary intake. Measurements will be conducted at baseline, 3 months, and 15 months by outcome assessors who are blinded to the group allocation.DiscussionThis will be the first non-inferiority randomized controlled trial to compare the efficacy and long-term outcomes of Tai Chi versus CBT-I for treating insomnia in older adults. This study will be of clinical importance as it supports the use of Tai Chi as an alternative non-pharmacological approach for insomnia treatment and sustainable management.

This study aims to develop and validate a strength-based instrument for assessing the academic advising needs of university students in Hong Kong using the Appreciative Advising Inventory (AAI) as a blueprint. We reviewed the content validity and cultural relevance of the AAI and developed a 37-item AAI Hong Kong Version (AAI-HK). We conducted Rasch analysis and principal component analysis. The AAI-HK has four stable and reliable factors (social competence and support; positive identity and participation; positive values; and commitment to learning and study), which represent key strengths of university students. Four AAI-HK subscales demonstrate good reliability. We found significant differences in AAI-HK scores between students who are under academic probation or not and between students who are local or nonlocal.

This study evaluates the efficacy of a school-based social cognitive intervention for children with autism. Seventy-four children and adolescents were taught visually scaffolded, theory of mind-based social skills program. Using a mixed-methods approach, children's social competence was assessed at pre-test and post-test. Compared to a waitlist control group, children in the intervention group demonstrated significantly greater gains on theory-of-mind and social skill measures. Focus groups and interviews were conducted to explore parents' views and generalization of children's social skills across settings. Children's social participation exhibited improvement in home, community, and school settings. The study findings offer promising evidence for a cost-effective program and support of the school-based social skills intervention for children with ASD in Hong Kong context.

Universities in Hong Kong implemented a new 4-year undergraduate curriculum in 2012, and many initiated academic advising programs to help students from different academic backgrounds and with various levels of preparedness to review their options and manage challenges in college. For this study, we administered a questionnaire survey to discover students' views on and expectations for academic advising. The results show an overall positive evaluation of academic advising from students, who expected academic advisors to help them understand their study options and preferred a developmental over a prescriptive approach. Students reported that discussing career issues was their greatest need for academic advising.

This study aims to examine the comparative effects of 75 min of volume-matched once-weekly and thrice-weekly high-intensity interval training (HIIT) on body adiposity in adults with central obesity. This assessor-blinded, three-arm, randomized controlled trial will recruit 315 physically inactive adults with central obesity (aged ≥18 years, body mass index ≥23, waist circumference ≥90 cm for men and ≥80 cm for women). Participants will be randomly allocated to the once-weekly HIIT, thrice-weekly HIIT or usual care control group. Participants in the HIIT groups will receive weekly exercise training sessions for 16 weeks, prescribed either once or three times weekly. Each HIIT session will consist of a supervised program of four 4-min high-intensity intervals at 85%–95% peak heart rate (HR peak) interspersed with 3-min active recovery intervals at 50%–70% HR peak. Participants in the once-weekly HIIT group will perform the 25-min HIIT bout three times with a break between each 25-min HIIT bout. The usual care control group will receive bi-weekly health education classes. The outcome assessments will be conducted at baseline, 16 weeks (post-intervention) and 32 weeks (follow-up). The primary outcome will be total body adiposity assessed by dual-energy X-ray absorptiometry (DXA). The secondary outcome measures will include markers of cardiovascular and metabolic health (body composition, cardiorespiratory fitness, blood pressure, and blood lipids), mental health, cognitive performance, health-related quality of life, sleep quality, habitual physical activity, diet, medication, adverse events and adherence to the intervention. The findings from this study are expected to consolidate the therapeutic efficacy of HIIT for the management of central obesity and inform the comparative compliance, feasibility and suitability of once-weekly and thrice-weekly HIIT as exercise strategies to manage obesity. In particular, the present study is expected to provide a novel perspective on the utility of low-frequency HIIT (i.e., once-weekly) as an effective and sustainable exercise strategy to tackle the obesity pandemic. The anticipated findings will hold substantial translational value by informing public health policies and enhancing exercise compliance in the physically inactive obese population. ClinicalTrials.gov (NCT04887454). [ABSTRACT FROM AUTHOR]

Cornelia de Lange syndrome (CdLS) is a multisystem genetic disorder with distinct facies, growth failure, intellectual disability, distal limb anomalies, gastrointestinal and neurological disease. Mutations in NIPBL, encoding a cohesin regulatory protein, account for >80% of cases with typical facies. Mutations in the core cohesin complex proteins, encoded by the SMC1A, SMC3 and RAD21 genes, together account for ∼5% of subjects, often with atypical CdLS features. Recently, we identified mutations in the X-linked gene HDAC8 as the cause of a small number of CdLS cases. Here, we report a cohort of 38 individuals with an emerging spectrum of features caused by HDAC8 mutations. For several individuals, the diagnosis of CdLS was not considered prior to genomic testing. Most mutations identified are missense and de novo. Many cases are heterozygous females, each with marked skewing of X-inactivation in peripheral blood DNA. We also identified eight hemizygous males who are more severely affected. The craniofacial appearance caused by HDAC8 mutations overlaps that of typical CdLS but often displays delayed anterior fontanelle closure, ocular hypertelorism, hooding of the eyelids, a broader nose and dental anomalies, which may be useful discriminating features. HDAC8 encodes the lysine deacetylase for the cohesin subunit SMC3 and analysis of the functional consequences of the missense mutations indicates that all cause a loss of enzymatic function. These data demonstrate that loss-of-function mutations in HDAC8 cause a range of overlapping human developmental phenotypes, including a phenotypically distinct subgroup of CdLS.

Insomnia and depression are prevalent mental disorders that are often comorbid among older adults. Lifestyle intervention strategies incorporating Tai Chi or conventional exercise have been shown to alleviate symptoms of insomnia and depression. However, the comparative efficacy of these exercise modalities in individuals with both disorders has yet to be determined. Therefore, the aim of this study is to examine the efficacy of Tai Chi and conventional exercise for reducing depressive symptoms in older adults with chronic insomnia and depressive symptoms, when compared to a health education control. This study is a prospective, assessor-blinded, three-arm, parallel group, randomized controlled trial. Older adults aged ≥60 years with a diagnosis of chronic insomnia and depressive symptoms will be randomly assigned to a Tai Chi, conventional exercise or health education control condition on a 1:1:1 basis. Interventions will last for 3 months, with a 6-month follow-up period. The primary outcome is depressive symptoms, assessed using the Hospital Anxiety and Depression Scale. Secondary outcomes include subjective sleep quality, 7-day actigraphy, 7-day sleep diary, anxiety symptoms, quality of life, medication usage and physical function. All measurements will be conducted at baseline, 3 months and 9 months by outcome assessors who are blinded to group allocation. This study will compare the efficacy of Tai Chi and conventional exercise in improving depression outcomes in older adults with chronic insomnia and depressive symptoms. Our results will shed light on the clinical potential of these interventions for combating insomnia and depression in older adults. [ABSTRACT FROM AUTHOR]

This pilot study explored the efficacy of a social-cognitive intervention program for adolescents with Autism Spectrum Disorder (ASD). Seven adolescents with ASD (mean age = 12.57 years) attended a school-based 10-week program. Social Skills Improvement System Rating Scales, Goal Attainment Scaling (GAS), and Theory of Mind Inventory were administered at baseline, immediately after the program, and post 2-months. There were significant positive gains in Theory of Mind knowledge and in individualized goals (of GAS), and there were further gains after 2 months. Qualitative evaluation was conducted by a focus group interview with parents of participants. Consistent with the quantitative findings, parents observed that their children have increased knowledge of social skills, socialize more with friends, and had increase in positive social behavior. On the other hand, they perceived an even more intensive and ongoing program could further benefit their children. This study has added to the understanding of the potential impact of social skills programs run in school.

Explorando el lente teórico de la colonialidad del poder y la colonialidad del ser, este artículo analiza el suicidio de uno de los personajes principales en la novela de Oscar René Benítez, Inmortales (1983). Si por un lado éste podría entenderse como un acto de autonomía ante la sujeción del personaje, por otro, se argumenta que es un acto problemático en tanto legitima la muerte como amenaza y presencia constante en la vida de los sujetos racializados viviendo en la diáspora centroamericana.

Although copying and name writing skills are regarded as the indicators of handwriting development in alphabetic writing systems, there is limited information on logographs such as Chinese. Chinese characters are not only simply a combination of strokes as letters in English, but also place a great demand on visuospatial ability to maintain good proportion and alignment of these interwoven strokes. This study investigated the developmental characteristics of visuo-orthographic copying on the composition of Chinese characters, namely strokes, radicals and characters, and Chinese name writing among kindergarten children in Hong Kong. A group of 141 children from the first to third year of kindergarten education (K1 to K3) were recruited. They were asked to complete two tasks: (1) visuo-orthographic copying of common Chinese strokes, radicals, and characters; and (2) write down their Chinese name from memory. Overall, the abilities of Chinese name writing were moderately to strongly related with the abilities in copying the composition of Chinese characters. It also showed that copying radicals significantly predicted Chinese name writing ability. The results suggested that copying radicals provided a foundation so that a good spatial organization of these components within a square configuration could be achieved in the name writing task. It recommended that copying of strokes, radicals, and characters should be addressed as a whole for the Chinese handwriting development. In addition, Chinese name writing skills should also be assessed to provide a window on the understanding of the transition of copying skills into Chinese handwriting.

Visual-motor integration (VMI) is the ability to coordinate visual perception and motor skills. Although Chinese children have superior performance in VMI than U.S. norms, there is limited information regarding the performance of its basic composition of VMI in regard to visual and motor aspects. This study aimed to examine the differences in performance in VMI, visual perception (VP), and motor coordination (MC) using the Beery-Buktenica Developmental Test of Visual-Motor Integration (VMI-6) among Hong Kong Chinese kindergarten children compared to established U.S. norms. Standard scores for each age were statistically compared to the corresponding mean values for U.S. children. This comparison showed significantly higher VMI mean scores for Hong Kong Chinese children than for their age-matched peers. The following equation was derived to allow for a comparison of VMI to U.S. norms (adjusted score = 0.777 (Chinese VMI raw score)--0.796). In extending current knowledge on superior performance in VMI among Chinese children, better VP and MC skills were also observed. This phenomenon might be due to the orthographic feature of traditional Chinese characters and early formal instruction on reading and writing in Hong Kong. This study has not only pointed out the need to administer all three tests of the VMI-6 to identify the underlying causes of VMI problems but has also alerted educators and clinicians as to when to administer the tests to Chinese children in Hong Kong.

This study re-examined the Memory Assessment Scale (MAS), a brief memory test developed in Hawai'i in 1987, to assess whether it remains a valid and reliable cognitive impairment screening tool in Hawai'i. Patients suspected of having neurocognitive dysfunction were divided into 2 groups (those with and without mild cognitive impairment) based on their results on a battery of neuropsychological tests. No differences in MAS scores were found between patients with and without mild cognitive impairment. Further research with the MAS comparing patients with mild cognitive disorder to healthy controls is indicated to further examine the efficacy of this population-based test. [ABSTRACT FROM AUTHOR]

Objectives: Most of the fine-motor assessment tools used in Hong Kong have been designed in Western countries, so there is a need to develop a standardized assessment which is relevant to the culture and daily living tasks of the local (that is, Chinese) population. This study aimed to (1) develop a fine-motor assessment tool (the Hong Kong Preschool Fine-Motor Developmental Assessment [HK-PFMDA]) for use with young children in a Chinese population and (2) examine the HK-PFMDA's psychometric properties. Method: The HK-PFMDA was developed by a group of occupational therapists specializing in the area of developmental disabilities in Hong Kong. A panel of 21 experts reviewed the content validity of the instrument. Rasch item analysis was used to examine the model fit of items against the rating scale model, and to explore the dimensionality of the test. Intra- and interrater reliability, convergent validity, and criterion-related validity were examined. The participants included 783 children without disabilities, 45 with autistic spectrum disorder, and 35 with developmental delay. Results: The Rasch analysis suggested that the 87-item HK-PFMDA had a unidimensional structure, as the items explained most (91.6%) of the variance. The HK-PFMDA demonstrated excellent intra- (ICC = 0.99) and interrater reliability (ICC = 0.99), and internal consistency ([alpha] ranging from 0.83 to 0.92). In terms of validity, the HK-PFMDA had significant positive correlations with both age and the convergent measures of the Peabody Developmental Motor Scales (PDMS-2). Conclusion: A set of normative data for local children aged from birth to 6 years was established. The HK-PFMDA has shown excellent psychometric properties and is suitable for clinical application by occupational therapists in the assessment of fine-motor skills development of young children in Chinese populations. (Contains 2 tables and 1 figure.)

Social problem solving is the cognitive-affective-behavioral process by which people attempt to resolve real-life problems in a social environment, and is of key importance in the management of emotions and well-being. This paper reviews a series of studies on social problem solving conducted by the authors. First, we developed and validated the Chinese version of the Social Problem-Solving Inventory Revised (C-SPSI-R) which demonstrated very good psychometric properties. Second, we identified the scope of stressful social situations faced by young adults and their self-efficacy in facing such situations (N = 179). Young adults were generally confident about their basic social skills but found it much more stressful to relate to family members, handle conflicts, handle negative behaviors from others, self-disclose to others, and to express love. Third, in two separate studies, we found that social problem solving was closely linked to measures of depression (n = 200), anxiety (n = 235), and family well-being (N = 1462). Measures of anxiety and depression were found to be significantly related to aspects of social problem solving in expected directions and expected strength. In another study, higher parental social problem solving behavior and lower avoidance behavior were found to be related to indicators of family well-being, including better overall family functioning, and fewer parent-adolescent conflicts.

This study compared the patterns of sensory processing among children with autism spectrum disorder (ASD), attention deficit and hyperactivity disorder (ADHD), and children without disabilities. Parents reported on the frequency of sensory processing issues by completing the Chinese Sensory Profile (CSP). Children with disabilities (ASD or ADHD) exhibited significantly more sensory processing issues than children without disabilities. The results of GLM and discriminant analyses showed that the CSP effectively differentiated between children with and without developmental disabilities. But it failed to identify major differences in sensory processing issues between children with either ASD or ADHD. Sensory processing issues could be one of many criteria that characterize and differentiate the features of children with different developmental disabilities. Although no significant gender differences in sensory processing issues appeared, age was a significant cofounding factor in evaluating sensory processing. Children without disabilities showed some small decreases in sensory processing issues as they aged from 6 to 12 years old. Children with ASD showed some decrease in sensory processing issues over the span of their childhood, while children with ADHD showed a significant increase in auditory processing issues as well as small increases in many aspects of sensory processing. (Contains 5 tables.)

Objective: This article describes the development and initial validation of the 90-item Chinese Positive Youth Development Scale (CPYDS), which contains items related to 15 aspects of positive youth development. Method: Adolescents with well adjustment ( N = 162) and poor adjustment (N = 160) responded to the CPYDS. Results: The findings showed that the CPYDS measures possess acceptable internal consistency and were able to discriminate the two groups. Although the CPYDS measures were positively related to thriving, life satisfaction, and perceived academic achievement, they were negatively related to substance abuse, delinquency, and behavioral intention to engage in problem behavior. Conclusions: The CPYDS can be used as a global measure of positive youth development in Chinese adolescents, but its dimensionality and subscales should be further examined. (Contains 4 tables.)

This paper reports evidence on the factor structure, reliability, and validity of the Chinese Family Assessment Instrument (C-FAI), an instrument developed to assess family functioning in Chinese populations. A convenience sample of 1,462 adolescents from junior secondary schools completed the C-FAI and measures of parent-adolescent conflict. Exploratory and confirmatory factor analyses showed that five factors were abstracted from the scale, a finding which was similar to those reported in previous validation studies. Results also showed that the C-FAI was internally consistent and its scores were moderately correlated with measures of conflict with parents, providing support for the convergent validity of the measure. Finally, females perceived family functioning to be better than did males and age was linearly related to perceived family dysfunction. In conjunction with the previous findings, the present study suggests that the C-FAI can be used to objectively assess family functioning in Chinese adolescents.

This study evaluated the dimensionality of the construct of social problem solving and examined the relationships between social problem solving and empathy, emotional well-being and family well-being in a sample of secondary school students in Hong Kong (N = 1462). The participants completed measures of social problem solving (the 25-item short form of the Chinese version of the Social Problem-Solving Inventory: C-SPSI-R), empathy (the Chinese Interpersonal Reactivity Scale), emotional well-being (the Chinese Vengeance Scale) and family well-being (the Chinese Family Assessment Instrument and the Conflict Behaviour Questionnaire). Regarding the dimensionality of the C-SPSI, confirmatory factor analysis showed that the scale has a stable five-factor structure (RMSEA = 0.05) and that the related subscales were reliable (with ranging from 0.65 to 0.81). Participants with higher levels of social problem solving had higher levels of empathy and lower personal distress in applying empathy, which suggested that these personal competencies were inter-related. Higher levels of social problem solving were also related to better emotional well-being (less tendency to take revenge) and better family quality of life (better family functioning and fewer parent-adolescent conflicts).

Objectives: Psychometric properties of the Chinese version of the Interpersonal Reactivity Index (C-IRI) for the assessment of empathy in Chinese people were examined. Method: The Interpersonal Reactivity Index (IRI) was translated to Chinese, and an expert panel reviewed its content validity and cultural relevance. The translated instrument (C-IRI) was administered to 189 junior high school students and 391 university students. Results: Confirmatory factor analyses revealed a stable hierarchical three-factor structure that was consistent with structure of the English IRI, but the cognitive and emotional aspects of empathy were combined to form a new factor. The subscales of the C-IRI demonstrated acceptable to good internal consistency and test-retest reliability. Some evidence for the construct validity of the measure was also found. Conclusions: The C-IRI possessed acceptable psychometric properties in Chinese adolescent samples. The present findings suggest that the cognitive and emotional aspects of empathy are not differentiated in Chinese adolescents. (Contains 1 figure and 3 tables.)

Examines the effects of trait intrinsic and extrinsic motivations, measured by the Work Preference Inventory, on creativity and academic performance. In an experimental creative writing task, intrinsic motivation correlated with creativity. In a follow-up study, intrinsic motivation correlated negatively with year-1 GPA, whereas extrinsic motivation correlated positively. Findings suggest that our college environment discourages intrinsic motivation and creativity. (Contains 30 references and 6 tables.) (Author)

Background: Sleep problems are a health issue worldwide. Based on the Person-Environment-Occupation-Performance model, we developed an occupation-based sleep programme to promote awareness of sleep hygiene factors, promote an environment conductive to sleep, and restructure participation in daytime activities with a focus on occupational balance. Method: This study uses a non-equivalent group design to evaluate the effectiveness of an occupation-based sleep intervention among community-dwelling adults with insomnia, when compared with a treatment-as-usual (TAU) group which focused on sleep hygiene, and relaxation. Results: When compared with the TAU group (n = 20), the intervention group (n = 22) had significant improvement in sleep duration, occupational balance, and reduction in mood symptoms at both post treatment and 1-month follow up. Conclusion: The results demonstrated that an occupation-based programme is an effective treatment for insomnia disorder and demonstrated the role which occupational therapy could play in primary health care service. [ABSTRACT FROM AUTHOR]

There is a national trend towards regionalizing complex hepatopancreaticobiliary (HPB) surgeries to high-volume institutions. Due to geographic and socioeconomic constraints, however, many patients in the United States continue to undergo HPB surgery at local community hospitals. This study evaluated complex HPB surgeries performed by a single surgeon at a low-volume community hospital from May 2007 to June 2021. A retrospective review of medical records (n=163) was done to collect data on patient demographics and outcomes. Surgical outcomes of HPB procedures were compared to published data from high-volume centers. Overall mortality within 30 days of the procedure was 1% (n=1). Using Clavien-Dindo classification, the major complication rate was 10%, including 8% grade III and 2% grade IV complications. Reoperation (2%) and readmission (3%) were rare in this population. Median length of stay was 7 days and median estimated blood loss was 500 milliliters. Surgical outcomes from the community hospital were comparable to high-volume centers. For pancreatic cancer patients treated at the community hospital, Kaplan-Meier curves revealed comparable 5-year survival time to national data. Complex HPB procedures can be safely performed at a lowvolume hospital in Hawai'i with outcomes comparable to large tertiary centers. [ABSTRACT FROM AUTHOR]