Mandarin Version Research Articles

Voice Outcomes of Straw Phonation Exercises for Telephone Customer Service Staff

This study aimed to investigate the effectiveness of a straw phonation exercise program in preventing voice problems in telephone customer service staff. Prospective study. Twenty-eight participants with no obvious voice problems were placed into two groups: the experimental (n=13) and control (n=15) groups. The experimental group received voice hygiene instructions and participated in a 3-week straw phonation exercise program, while the control group only received voice hygiene instructions. The acoustic parameters and Mandarin Chinese version of the Vocal Fatigue Index (CVFI) scores were statistically analyzed before training, immediately after training, followed up one and 3 months after training. The results showed that speaking fundamental frequency (SF0), shimmer, and cepstral peak prominence (CPP) of the experimental group improved immediately after the straw phonation exercise program, and shimmer of the experimental group after training was also significantly lower than that of the control group. A higher SF0 and lower shimmer were noted in the experimental group during the follow-up phase, whereas factors 1 (voice load and fatigue) and 2 (physiological symptoms) of the CVFI did not differ significantly until the third month after training. The study results suggest that the straw phonation exercise program can help telephone service staff to establish an appropriate speaking pitch and prevent voice fatigue.

Contribution of coping style to the association between illness uncertainty and demoralisation in patients with breast cancer: a cross-sectional mediation analysis

ObjectiveDemoralisation is a common psychological issue in patients with cancer and aggravates depression, reduces the quality of life and even causes suicidal ideation. There is a lack of knowledge about...

Abstract P6-05-13: The Psychological Impacts of COVID-19 on Breast Cancer Patients in China

Abstract Background: Approximately 30% to 50% of breast cancer patients experienced mental distress prior to the advent of COVID.The delayed access to cancer treatment due to the outbreak of COVID -19 pandemic posed a unique challenge to breast cancer patients and caused a significant level of mental distress among them. In the current research, we examined the psychological impacts of COVID on breast cancer patients in China using Symptom Checklist-90-R (SCL-90-R). Method: Participants were breast cancer patients at the outpatient clinic of Xijing hospital. The study was conducted virtually, and the questionnaires were distributed via Wenjuanxing, the Chinese alternative of Qualtrics. The researchers were healthcare workers affiliated with Xijing hospital, and the survey was sent to a breast cancer patient support group which included 1399 cancer patients and 6 healthcare workers. The initial sample consisted of 199 participants who signed an informed consent form to participate in the study. The inclusion criteria were as follows: 1) diagnosed with breast cancer, 2) aged 18 years or above, and 3) had no history of cognitive impairment or previous diagnosis of psychiatric disorders. The validated Mandarin version of the SCL-90-R (Wang, 1984) was then given to the participants to evaluate their psychological status.Categorical variables were summarized as numbers and percentages; continuous variables were described as mean (M) ± standard deviation (SD). Data were analyzed using IBM SPSS Statistics Version 26. Results: Participants (N = 195) filled out the SCL-90 questionnaire in February, 2020. All participants were female breast cancer patients treated at Xijing hospital, among which 16.41%, 36.41%, 19.49%, and 28.21% had respectively received treatment for less than a year, 1-3 years, 3-5 years, and 5 years or more. 64.62% of the patients were at stage I; 0.77% were at stage II and III; 4.62% were at stage IV according to TNM classification. The molecular type of participants is as follows: 47.2% of ER+ HER2-, 31.8% of HER2+, and 21.0% of Triple negative.Participants whose treatments continued to be delayed, on average, reported an elevated general psychopathology score (M = 1.48, SD = 0.47) compared to participants whose treatments were resumed (M = 1.30, SD = 0.34), and the difference was statistically significant, t(193) = 2.96, p = .003, d = 0.44, 95%Cl [0.06, 0.30]. The one-way ANOVA revealed a marginally significant effect of length of treatment delay on general psychopathology score, F(4, 190) = 2.09, p = .08, η^2 = .04. Follow-up multiple comparison analysis showed that participants who had their treatment delayed for 3 weeks to 1 month (M = 1.70, SD = 0.70) reported significantly higher general psychopathology scores than participants whose delay in treatment was less than 1 week (M = 1.34, SD = 0.40), p = .05. General health status (p < .001) and current treatment status (p = .02) are the only two variables that were statistically associated with general psychopathology score.Poorer perceived health status and current delay in treatment were associated with higher general psychopathology score, Additionally, younger age was associated with higher interpersonal sensitivity (p = .01) and hostility (p = .006). Conclusions: We found that breast cancer patients at an advanced stage were more likely to experience psychological symptoms with longer treatment delay, and whose treatments continued to be delayed reported elevated psychological symptoms than individuals whose treatment were resumed, regardless of treatment type. Additionally, a treatment delay of more than three weeks might have exacerbated breast cancer patients’ psychological symptoms, whereas a short-term delay of less than three weeks was less likely to have a significant effect on one’s mental well-being. Table 1. Demographic Characteristics and Health Status of The Participants. Table 2A: Multiple Regression analysis for SCL-90 dimensions. Table 2B: Multiple Regression analysis for SCL-90 dimensions. Citation Format: Yijia Wang, Yuqing Yang, Changjiao Yan, Jixin Yang, Hongliang Wei, Wen Ma, Nanlin Li. The Psychological Impacts of COVID-19 on Breast Cancer Patients in China [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-13.

Psychometric properties of the Mandarin version of the autism diagnostic observation Schedule-Generic

The diagnosis of autism spectrum disorder (ASD), involving multiple components of clinical assessments, is challenging. The Autism Diagnostic Observation Schedule-Generic (ADOS-G), one of the standardized and validated instruments for ASD diagnostic evaluation, has been widely used in many countries. With the preparation of the Mandarin version of the ADOS-G (Mandarin-ADOS-G), this study aims to examine its psychometric properties, including reliability and validity. The sample included 554 individuals clinically diagnosed with ASD (477 males, 86.1%) and 50 typically developing (TD) individuals (29 males, 58.0%) who were assessed with different modules of the Mandarin-ADOS-G between 4.1 and 34.0 years old with a mean age of 13.0 years (Module 1, n=40; Module 2, n=46; Module 3, n=275; Module 4, n=243). We evaluated the inter-rater reliability, test-retest reliability, internal consistency, and concurrent validity with the Chinese Autism Diagnostic Interview-Revised (ADI-R) and Social Responsiveness Scale (SRS) caregiver-report and self-report forms. The discriminative validity of Mandarin-ADOS-G was also examined. The Mandarin-ADOS-G demonstrated good inter-rater reliability (agreement of ADOS classification 0.91), good test-retest reliability (intraclass correlations 0.55-0.73), and low to high good internal consistency (Cronbach's alpha 0.27-0.86). The concurrent validity showed significant correlations with ADI-R (Pearson correlations 0.22-0.37) and the SRS caregiver-report form (Pearson correlations 0.15-0.23). Moreover, all Mandarin-ADOS-G domains successfully differentiated autistic individuals from TD individuals (all p-values <0.001). The Mandarin-ADOS-G is a reliable and valid instrument for assisting the diagnosis of ASD in the Mandarin-speaking population.

The validation of a Mandarin version of the Empathy Components Questionnaire (ECQ-Chinese) in Chinese samples.

Empathy involves both empathic ability and empathic motivation. An important topic has been how to measure empathic ability and motivation simultaneously in both clinical and non-clinical samples and across different cultures. The Empathy Components Questionnaire (ECQ) is a self-report questionnaire that measures empathic ability and motivation in a questionnaire. The current study aimed to validate the Mandarin Chinese version of the ECQ (ECQ-Chinese) in three Chinese samples. In study 1, a total of 538 Chinese participants (Sample 1) completed the ECQ-Chinese via an online survey, and existing measures of empathy and related constructs which were used for criterion validity. In study 2, a total of 104 participants (Sample 2) were recruited again from sample 1 and completed the ECQ-Chinese three weeks later to investigate test-retest reliability. In study 3, a further 324 participants (Sample 3) completed the ECQ-Chinese for confirmatory factor analysis. The results showed that the ECQ-Chinese has a good internal consistency reliability, split-half reliability, and criterion validity (Study 1), and a good test-retest reliability (Study 2). Further, Study 3 found that a 22-item ECQ-Chinese consisting of five subscales had a good construct validity, convergence validity and discriminate validity, demonstrating it to be a suitable tool for the measurement of empathic ability and motivation in Chinese samples and to carry out cross-cultural studies of empathy and its components.

Cross-cultural adaptation and validation of the PedsQL™ stem cell transplant module in China: A methodological and cross-sectional study.

Hematopoietic stem cell transplantation (HSCT), as a mature technology, has significantly improved the survival rate of children. However, there lack efficient scales to assess the quality of life (QoL) of children with HSCT in China, which has important implications in the care of this population. This study aimed to translate the original English Pediatric Quality of Life Inventory™ (PedsQL™) Stem Cell Transplant Module into a Chinese mandarin version, and evaluate its reliability. Children of ages 2-18 years who had received HSCT at Children's Hospital of Nanjing Medical University and Children's Hospital of Fudan University were recruited. Children or their parents were asked to fill the PedsQL™ 4.0 Generic Core Scales, PedsQL™ Stem Cell Transplant Module, and PedsQL™ Family Information Form. Feasibility was evaluated by completion rate and the percentage of missing items, reliability by the internal consistency and test-retest reliability, and validity by factor analysis and correlation analysis between the scores of total scale and each dimension. A total of 120 children (mean age 6.37, SD = 3.674) and some parents were included. A low percentage of items were missed in returned reports. Cronbach's alpha coefficient reached 0.70 in the majority of dimensions of both child self-report and parent proxy-report. Test-retest reliability was 0.685 in parents' forms and 0.765 in child's forms. Eight factors were extracted, with a cumulative contribution rate of 74.54%. The correlation between PedsQL™ 4.0 and Transplant Module was 0.748 for children self-report and 0.808 for parent proxy-report. This study provides evidence that the Chinese mandarin version of the PedsQL™ Stem Cell Transplant is feasible, reliable and valid in evaluating the QoL of Chinese children after HSCT.

Investigating and comparing the psychometric properties of the Chinese Mandarin version of social responsiveness scale-2 and its shortened version in preschool-age children with autism spectrum disorder

We aimed to investigate and compare the psychometric properties of the Chinese Mandarin Social Responsiveness Scale-2 (SRS-2) and its shortened version. The study assessed 670 children with autism spectrum disorder (ASD) aged 30-54months and 138 typical developmental (TD) children of the same age in mainland China. Our item reliability test revealed that only 36 items of the 65 items in the Chinese Mandarin SRS-2 (Preschool) met the reliability criteria. Moreover, the shortened version of SRS-2 (Preschool) with four subscales and 30 items maintained strong correlations (r=0.961) with the Chinese Mandarin SRS-2 (Preschool), and demonstrated improved psychometric performance on the 4-week test-retest reliability (intraclass correlations was 0.70), internal consistency (Cronbach's alpha 0.71-0.91), construct validity, and convergent validity with the Autism Diagnostic Observation Schedule, Autism Diagnostic Interview-Revised, and Child Behavior Checklist. Receiver operating characteristics (ROC) analyses showed excellent and comparable discriminant validity of the shortened version with an area under the curve of 0.992. Our data suggested a cutoff ≥22.5 for the shortened version, with good accuracy in screening autism symptoms (sensitivity=96.9%, specificity=94.2%). Our findings demonstrated that the shortened version of SRS-2 (Preschool) was a reliable and valid instrument for identifying preschoolers with ASD in mainland China.

Studies on Eating Disorders in Taiwan

Background: Eating disorder (ED) is a disease entity with substantial physical and psychosocial morbidity, while it has remained underdetected by clinicians in Taiwan. To improve the detection and treatment of EDs by health-care professionals in Taiwan, we reviewed ED studies in Taiwan, including epidemiology, measurements, correlates, comorbidities, and health-care use. Methods: A literature review was done using PubMed. The main inclusion criteria were studies that focused on EDs and disordered eating attitudes/behaviors and were done in Taiwan. Results: Several frequently used ED measurements had well-established Mandarin Chinese versions, and they all had sound psychometric properties. Disordered eating attitudes/behaviors have been prevalent in Taiwanese adolescents and college students, but EDs were detected at an older age compared to that in Western countries. Having a diagnosis of ED and higher ED symptom severity are associated with increased comorbidity burden. All patients with anorexia nervosa (AN) and bulimia nervosa (BN) have sought treatment for physical problems while less than half have sought treatment for mental health problems. Studies have also shown a 2–4-fold higher total costs in patients with AN/BN than individuals without EDs. Conclusion: More effort is needed to detect individuals with AN and BN at a younger age in Taiwan. Programs targeting at the influence of family, peers, and media on the body image of children/adolescents and young adults await establishment. We also need to build more educational programs to improve ED literacy in both health-care professionals and the general public for early detection and timely treatments of EDs by mental health professionals.

Dignity and Related Factors in Patients with Cancer: A Cross-Sectional Study

Dignity is a basic human right that is related to psychological distress factors in patients with cancer such as depression and demoralization. Hence, the dignity issue is of great importance to healthcare professionals. The present study aimed to advise healthcare professionals regarding the related distress factors of dignity in patients with cancer by investigating its relationship with patients' demographics, disease characteristics, and psychological distress. This was a cross-sectional study design. A convenience sample of 267 patients with cancer from a medical center was recruited into this study. Each patient completed demographics and disease characteristics questionnaires, the Patient Dignity Inventory Mandarin Version, the Demoralization Scale Mandarin Version (DS-MV), and the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed with SPSS 22.0 software. Dignity was significantly correlated with age, demoralization, and depression. Cancer patients aged 65 or above were more likely to have a lower sense of dignity. In the present study, the sensitivity and specificity of the Patient Dignity Inventory Mandarin Version for demoralization (DS-MV≥30) were 84.8% and 79.1% and for depression (PHQ-9≥10) were 73.8% and 70.9% in patients with cancer with an aggregate score of 35 or above. Dignity is significantly correlated with personal demographic characteristics and psychological distress in patients with cancer. The results provide reference data for healthcare professionals to understand and enable dignity in patients with cancer and aid in the development of methods that promote their dignity.

Incidence and risk factors of falls in older adults after discharge: A prospective study

ObjectivesThis study aimed to determine the incidence of falls and risk factors associated with falling in discharged older adults. MethodsA prospective study was conducted on older adults who had been issued a discharge order in a Class A tertiary hospital in Chongqing, China, from May 2019 to August 2020. The risk of falling, depression, frailty, and daily activities were evaluated at discharge using the mandarin version of the fall risk self-assessment scale, Patient Health Questionnaire-9 (PHQ-9), FRAIL scale, and Barthel Index, respectively. The cumulative incidence function estimated the cumulative incidence of falls in older adults after discharge. And the risk factors of falls were explored using the sub-distribution hazard function in the competing risk model. ResultsIn a total of 1,077 participants, the total cumulative incidence of falls at 1, 6 and 12 months after discharge was 4.45%, 9.03%, and 10.80%, respectively. The cumulative incidence of falls in older adults with depression (26.19%, 49.93%, and 58.53%, respectively) and those with physical frailty (21.59%, 41.67%, and 48.73%, respectively) was much higher than that in those without depression and physical frailty (P < 0.05). Depression, physical frailty, Barthel Index, length of hospital stay, re-hospitalization, being cared for by others, and the self-assessed risk of falling were directly associated with falls. ConclusionsThe incidence of falls among older adults discharged from the hospital has a cumulative effect with the lengthening of the discharge time. It is affected by several factors, especially depression and frailty. We should develop targeted intervention strategies to reduce falls for this group.

Post-Stroke Activity Engagement in Community Dwellers: Association with Illness Perceptions and Perceived Environment

<h3>Research Objectives</h3> To test the hypothesis that post-stroke individuals' activity engagement is associated with their perceptions of stroke, as well as their perceptions of their physical and social environment. <h3>Design</h3> This study used a cross-sectional design. <h3>Setting</h3> Various rehabilitation settings in Beijing, China, including 4 hospital-based rehabilitation outpatient clinics, 2 rehabilitation centers, and 2 community rehabilitation health stations. <h3>Participants</h3> A convince sample of 202 dyads of Chinese community-dwellers with stroke and their caregivers participated in this study. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> We used: the Assessment of Life Habits, Mandarin version, to assess activity engagement; the Stroke-Specific Illness Perceptions Questionnaire–Revised to assess stroke individuals' and caregivers' illness perceptions; and the Social Support Survey and abbreviated Neighborhood Environment Walkability Scale to assess stroke individuals' perceived social and physical environment. <h3>Results</h3> In our participating samples, stroke individuals with positive illness perceptions performed better in their personal level activity engagement, and those who believed their neighborhoods positively support their daily lives performed better in their societal level activity engagement, after controlling for demographic and performance skill factors. <h3>Conclusions</h3> Post-stroke activity engagement is associated not only with stroke individuals' performance skills but also with their perceptions of stroke, and how they perceive their physical environment. The findings of this study may assist clinicians' decision making when developing comprehensive, targeted interventions for improving activity engagement and maximizing recovery after stroke. <h3>Author(s) Disclosures</h3> The authors declare that there is no conflict of interest.

The impact of untreated hearing loss on depression, anxiety, stress, and loneliness in tonal language-speaking older adults in China.

Age-related hearing loss, mental health conditions, and loneliness commonly affect older adults. This study aimed to determine whether untreated hearing loss is independently associated with depression, anxiety, stress, and loneliness in tonal language-speaking older adults in China. Observational, cross-sectional study. 293 older adults (111 males, M = 70.33 ± 4.90 years; 182 females, M = 69.02 ± 4.08 years) were recruited. All participants completed a pure tone audiometric hearing assessment, and provided information on living arrangements, marital status, leisure activities, tobacco and alcohol use, and medical history. The Mandarin version of the De Jong Gierveld Loneliness Scale was used to measure loneliness, and the Mandarin version of the 21-item Depression Anxiety Stress Scale (DASS-21) was used to assess a range of symptoms common to depression, stress, and anxiety of the participants. The analysis focused on determining the predictors of depression, anxiety, and stress, and the predictors of measures of loneliness. Multiple stepwise regression analyses revealed that the emotional loneliness (β = 0.303, p < 0.001) and living status (β = 0.110, p = 0.048) significantly predicted DASS depression scores; emotional loneliness (β = 0.276, p < 0.001) and a history of vascular disease (β = 0.148, p = 0.009) were significantly related to DASS anxiety scores; emotional loneliness (β = 0.341, p < 0.001) and a history of vascular disease (β = 0.129, p = 0.019) significantly predicted DASS stress scores. Furthermore, multiple stepwise regression analyses showed that DASS stress scores (β = 0.333, p < 0.001), education years (β = -0.126, p = 0.020), marriage status (β = 0.122, p = 0.024), and a history of vascular disease (β = 0.111, p = 0.044) significantly predicted emotional loneliness; four-frequency average hearing loss (β = 0.149, p = 0.010) and DASS stress scores (β = 0.123, p = 0.034) significantly predicted social loneliness scale; and four-frequency average hearing loss (β = 0.167, p = 0.003) and DASS stress scores (β = 0.279, p < 0.001) also significantly predicted overall loneliness. There were no significant associations with high-frequency hearing loss. This study revealed that loneliness has a significant relationship both with hearing loss and aspects of mental health in an older adult Mandarin-speaking population. However, mental health was not significantly associated with hearing loss in this population.

Minimal clinically important difference for the Mandarin version of the Tinnitus Questionnaire determined via anchor-based and distribution-based methods

BackgroundThe previous study showed that the Mandarin Tinnitus Questionnaire (MTQ) has satisfactory reliability and validity. We have also completed the classification of the severity of tinnitus based on MTQ scores. In clinical studies, efficacy is often judged by whether results are statistically significant; however, statistical significance does not necessarily equate to clinical significance, whereas the minimum clinically important difference (MCID) of the scale does. In the following project, we will explore the MCID of the MTQ.MethodsWe recruited participants aged 18 years and above who sought treatment for primary or secondary tinnitus at the Otorhinolaryngology Department of the Hearing Center of West China Hospital, Sichuan University from September 2020 to September 2021. The participants had to undergo the following four assessments of tinnitus severity: doctor evaluation, self-report, the MTQ, and the visual analog scale (VAS), all at baseline and at the follow-up. The MCIDs of the MTQ were established via anchor-based and distribution-based methods. The anchor method used the VAS and self-reported clinical impression as anchors and defined the treatment effectiveness by mean/median and receiver operating characteristic (ROC) curve, while methods of effect size (ES), standard error of measurement (SEM), and reliability change index (RCI) were used in distribution-based methods.ResultsA total of 115 patients were investigated in this study, 57.4% of whom were women. The average age was 43.2 ± 13.20 years. The average MTQ and VAS scores at baseline were 31.3 ± 14.90 and 5.03 ± 2.24, respectively, while the average MTQ and VAS scores at follow-up were 15.9 ± 11.70 and 3.58 ± 2.48, respectively. Moreover, in terms of self-reported clinical impressions, 19 patients indicated that they were cured (16.5%), 24 that it was much better (20.9%), 63 that there was no change (54.8%), and 9 that it was much worse (7.8%). The MCIDs for the change in total MTQ ranged from 6.29 to 19.00, those for improvement from 1.09 to 22.75, and those for deterioration from 3.50 to 7.64.ConclusionWe selected an absolute value of 7.5 as the MCID for the MTQ score. An increase in MTQ score more than 7.5 was considered aggravation of tinnitus, and a decrease in MTQ score more than 7.5 was considered a reduction in tinnitus.

The Chinese Mandarin Version of the Esophageal-Atresia-Quality-of-Life Questionnaires for Children and Adolescents: Evaluation of Linguistic and Content Validity.

After repair of esophageal atresia (EA), children risk digestive and respiratory morbidity, but knowledge of their health-related quality of life (HRQOL) in China is lacking. The EA-QOL questionnaires were developed in Sweden and Germany to evaluate condition-specific HRQOL in children with EA aged 2-7 and 8-17. This study aimed to evaluate the linguistic and content validity of the Chinese Mandarin version of the EA-QOL questionnaires. The procedure was conducted in compliance with international standards, including a forward-backward translation procedure, expert reviews, and cognitive debriefing interviews with 14 Chinese families of children with EA (parents of 8 children aged 2-7/6 children aged 8-17 and their parents). Following forward-backward translation, minor issues were identified and solved. In interviews, all participants rated all EA-QOL items easy to understand, none expressed negative emotions about them and most described them comprehensive and relevant for EA. Leading from cognitive debriefing, three EA-QOL items in the questionnaire version for children aged 2-7 and three EA-QOL items in the questionnaire version for children aged 8-17 were modified in the Chinese language to improve cultural appropriateness and/or clarity. The Chinese Mandarin version of the EA-QOL questionnaires achieved satisfactory linguistic and content validity. This can help increase focus of HRQOL in research and clinical practice of children with EA in China.

Demoralization and Its Association with Quality of Life, Sleep Quality, Spiritual Interests, and Suicide Risk in Breast Cancer Inpatients: A Cross-Sectional Study.

With decreasing mortality, the quality of life, spiritual needs, and mental health of breast cancer patients have become increasingly important. Demoralization is a poor prognostic factor for cancer patients. The extent of demoralization in breast cancer patients and its association with these factors remains unclear. This cross-sectional study was conducted at a Taiwanese medical center. We enrolled 121 participants (34 with high demoralization and 87 with low demoralization, as per the Mandarin Version of Demoralization Scale). High demoralization was associated with reduced quality of life, sleep quality, and spiritual interests. Multivariate analyses revealed that the scores of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire ≥ 62.5 (OR = 0.21, p = 0.002) and Spiritual Interests Related to Illness Tool Chinese Version ≥ 3.66 (OR = 0.11, p < 0.001) were associated with low demoralization. Demoralized patients with depression had a poorer quality of life and sleep quality. Although not statistically significant, depressed and demoralized participants were at a higher risk of suicide. Cancer patients with both depression and demoralization had the worst prognosis. Breast cancer patients exhibited demoralization when they had unmet bio-psycho-social-spiritual needs. An early assessment of demoralization may improve holistic healthcare for breast cancer patients.

The dual role of post-stop fundamental frequency in the production and perception of stops in Mandarin-English bilinguals

In non-tonal languages with a two-way laryngeal contrast, post-stop fundamental frequency (F0) tends to vary as a function of phonological voicing in stops, and listeners use it as a cue for stop voicing. In tonal languages, F0 is the most important acoustic correlate for tone, and listeners likewise rely heavily on F0 to differentiate tones. Given this ambiguity of F0 in its ability to signal phonological voicing and tone, how do speakers of a tonal language weight it in production and perception? Relatedly, do bilingual speakers of tonal and non-tonal languages use the same weights across different language contexts? To address these questions, the cross-linguistic performances from L1 (first language) Mandarin-L2 (second language) English bilinguals dominant in Mandarin in online production and perception experiments are compared. In the production experiment, the participant read aloud Mandarin and English monosyllabic words, the onsets of which typified their two-way laryngeal contrast. For the perception experiment, which utilized a forced-choice identification paradigm, both the English and Mandarin versions shared the same target audio stimuli, comprising monosyllables whose F0 contours were modeled after Mandarin Tone 1 and Tone 4, and whose onset was always a bilabial stop. The voice onset time of the bilabial stop and the onset F0 of the nucleus were manipulated orthogonally. The production results suggest that post-stop F0 following aspirated/voiceless stops was higher than that following unaspirated/voiced stops in both Mandarin and English production. However, the F0 difference in English was larger as compared to Mandarin, indicating that participants assigned more production weight to post-stop F0 in English than in Mandarin. On the perception side, participants used post-stop F0 as a cue in perceiving stops in both English and Mandarin, with higher post-stop F0 leading to more aspirated/voiceless responses, but they allocated more weight to post-stop F0 when interpreting audio stimuli as English words than as Mandarin words. Overall, these results argue for a dual function of F0 in cueing phonological voicing in stops and lexical tone across production and perception in Mandarin. Furthermore, they suggest that bilinguals are able to dynamically adjust even a secondary cue according to different language contexts.

Verification of the Mandarin Chinese version of Advance Care Planning Engagement Survey Scale in community-dwelling older people.

Advance care planning (ACP) has become increasingly critical for older people. The Advance Care Planning Engagement Survey (ACPES) develops targeted interventions for older people by measuring ACP-related behaviours, while previous studies focus only on advance directives. Moreover, while ACPES has English and Dutch versions, it does not yet have a Mandarin Chinese version (ACPES-MC) that can be used for Chinese populations. To translate the ACPES into Mandarin Chinese and test its reliability and validity in community-dwelling older people with chronic diseases. The English version of the ACPES was translated into Mandarin Chinese using Functional Assessment of Chronic Illness Therapy. Four communities were recruited in central China (N=450) by convenience sampling. Internal consistency and construct validity were used to evaluate the reliability and validity of the ACPES-MC. The ACPES-MC consists of 34 items across five domains, with good internal consistency (0.817), with each dimension ranging from 0.606 to 0.881; exploratory factor analysis was distributed to four different factors and the total variance explained was 63.537%; and confirmatory factor analysis results showed that χ2 =3791.131 (p < .001), χ2 /df=1.106, CFI=0.980, IFI=0.980, NFI=0.827 and RMR=0.027, indicating a good model fit to previous factor structures. The ACPES-MC is an effective and reliable tool that can measure the ACP-related behaviour stage of community-dwelling older people and evaluate the effect of ACP intervention. The ACPES-MC can be used in healthcare to identify potential ACP-related behaviours in community-dwelling older people with chronic diseases, including native and ethnic Chinese, evaluate their behaviour change stages and promote the application of ACP.

Reliability And Validity Of The Self-report Exercise Habits Index In Chinese College Students

PURPOSE: The purpose of this study was to examine adaptation of the “Self-Report Exercise Habits Index (SREHI)” in Chinese college students, and to evaluate reliability and validity of SREHI. METHODS: After being translated into the Mandarin version, 246 college students took part in the survey online. Five-Likert scale was conducted (1 = completely inconsistent; 5 = completely consistent) in SREHI. Criterion question was a direct question about exercise habits. T-test between top 27% and bottom 27% of total score was used for Item Analysis. Principal Component Analysis (PCA) was used for Exploratory Factor Analysis (EFA). Confirmatory Factor Analysis (CFA) and Pearson Correlation between SREHI and the criterion question were conducted to evaluate construct validity and criterion validity of SREHI. The reliability was measured by Cronbach’s alpha (α) coefficients. Data was analyzed by SPSS and AMOS. RESULTS: Differences of Items Analysis were all significant (p < 0.001). Two principal components, automaticity and repetition, were extracted and the cumulative contribution rate (Initial Eigenvalues) was 78.77% (KMO = 0.95, p < 0.001). The Confirmatory Factor Analyses (CFA) showed that χ2 = 21.250, DF = 13, RMSEA = 0.072, CFI = 0.985, GFI = 0.956. The factor load of each item to each dimension was all greater than 0.6 (p < 0.001). Average Variance Extracted value (AVE) of automaticity and repetition were 0.684 and 0.724 respectively and Construct Reliability (CR) of automaticity and repetition were 0.896 and 0.887 respectively. The square roots of AVE in both dimensions were greater than the correlation coefficient between repetition and automaticity (r = 0.645, p < 0.001). Criterion validity was significant (r = 0.528, p < 0.01). The Cronbach’s α coefficients of automaticity, repetition and the whole scale were 0.894, 0.915 and 0.914. CONCLUSIONS: Findings suggested the “Self-Reports Exercise Habit Index (SRHI)”, including two dimensions and seven items, was suited for Chinese college students with great reliability and validity.

A multicenter survey on the current status of chronic cough and its impact on quality of life in Guangdong, China.

BackgroundChronic cough is a troublesome clinical problem with long-term impacts at the patient level. However, the burden of chronic cough in China is largely unknown. Thus, we performed a multicenter cross-sectional survey on the current status of chronic cough and its impact on quality of life in Guangdong, south China.MethodsUsing a standardized questionnaire, we extracted and analyzed the relevant data on demographics, number of visits to a doctor, previous diagnosis, previous medications used and initial diagnosis. Cough-specific quality of life was measured by the Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC).ResultsOf 933 patients from 13 tertiary medical centers in Guangdong, 52.2% were female, the median age was 40.0 [interquartile range (IQR), 31.0–52.0] years, and the median duration of chronic cough was 6.0 (IQR, 3.0–24.0) months. Over half (n=452, 54.0%) of the patients had visited physicians ≥3 times for cough. In terms of previous diagnosis, bronchitis (n=432, 46.5%) had been most frequently diagnosed, followed by pharyngitis (n=246, 26.5%) and asthmatic cough (n=98, 10.5%). A majority of patients with chronic cough had used antitussive agents (n=539, 58.5%), antibiotics (n=374, 40.6%) and traditional Chinese medicine (TCM) (n=294, 31.9%). Among the three subscales of the LCQ-MC, we observed lower scores in the mental health domain than in the physical and social domains (both P<0.001). Additionally, lower LCQ-MC scores were found in females and patients who saw the doctor >3 times for both the total and three subscale scores (all P<0.05).ConclusionsMisdiagnosis and inappropriate treatment are prevalent in patients with chronic cough and lead to considerable antibiotic abuse. Chronic cough markedly affects suffers’ quality of life, especially for women.

Chinese (Mandarin) translation of the incremental shuttle walk test and its validity and reliability: A cross-sectional study.

To date, there are no published validated Chinese versions of the incremental shuttle walk test (ISWT) instructions despite its wide clinical applications. Translation of the Chinese ISWT instruction is done in an ad-hoc manner within the Chinese-speaking populations, affecting the test's reliability and validity since translation can differ significantly between individuals. This warrants the need for psychometric testing of such translation. To develop a Chinese (Mandarin) version of the ISWT instructions (ISWT-CHN) that is conceptually equivalent to the original English version (ISWT-ENG) and establish its reliability and validity. Forward and backward translations from the ISWT-ENG were done to generate the ISWT-CHN. Face and content validity was determined during the translation process. Intra-rater and inter-rater reliability of the ISWT-CHN, construct and criterion validity were established by analysing the ISWT and the gold standard cardiopulmonary exercise test results. The Item-Content validity index (I-CVI), Scale-level-Content validity index (S-CVI), and content validity ratio (CVR) of the ISWT-CHN were 1.0. Intra-class Correlation Coefficient (ICC) for inter-rater reliability between two raters were excellent (, 95% CI 0.97-1.0, ; m, m). The intra-rater reliability of both Raters A (, 95% CI 0.53-0.98, ; m, m) and B (, 95% CI 0.76-0.96, ; m, m) were good. In a sample of 32 healthy participants, both ISWT-CHN and ISWT-ENG instruction results showed low-positive correlations with the VO determined from the cardiopulmonary exercise test (r = 0.439, ; , ). There is a very high correlation between ISWT-ENG and ISWT-CHN results with no statistically significant differences (, ). The construct and criterion validity of the ISWT-CHN were established. This study developed the ISWT-CHN and showed that it is a valid and reliable measure conceptually comparable to the ISWT-ENG. It will benefit the determination of functional exercise capacity in Chinese-speaking populations. •This study is aimed to develop a Chinese (Mandarin) version of the ISWT instructions.•The ISWT Chinese translation is valid and reliable that is conceptually comparable to the original English instruction.•The translated ISWT-Chinese instruction will enable the use of ISWT among the Chinese-speaking populations.