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The purpose of this study was to explore the factor structure of the Work-Family Balance Scale (WFBS) and examine its reliability and validity in use in the urban Chinese population. The scale was validated using a sample of 605 urban Chinese residents from 7 cities. Exploratory factor analysis identified two factors: work-family conflict and work-family enrichment. The WFBS showed adequate reliability and concurrent validity. The WFBS is a reliable and valid instrument to measure work-family balance for Chinese working parents. However, further examination of the scale is needed. (Contains 4 tables.)

Background: There has been a marked rise in suicide by charcoal burning (CB) in some East Asian countries but little is known about its incidence in mainland China. We examined media-reported CB suicides and the availability of online information about the method in mainland China. Methods: We extracted and analyzed data for i) the characteristics and trends of fatal and nonfatal CB suicides reported by mainland Chinese newspapers (1998–2014); ii) trends and geographic variations in online searches using keywords relating to CB suicide (2011–2014); and iii) the content of Internet search results. Results: 109 CB suicide attempts (89 fatal and 20 nonfatal) were reported by newspapers in 13 out of the 31 provinces or provincial-level-municipalities in mainland China. There were increasing trends in the incidence of reported CB suicides and in online searches using CB-related keywords. The province-level search intensities were correlated with CB suicide rates (Spearman’s correlation coefficient = 0.43 [95% confidence interval: 0.08–0.68]). Two-thirds of the web links retrieved using the search engine contained detailed information about the CB suicide method, of which 15% showed pro-suicide attitudes, and the majority (86%) did not encourage people to seek help. Limitations: The incidence of CB suicide was based on newspaper reports and likely to be underestimated. Conclusions: Mental health and suicide prevention professionals in mainland China should be alert to the increased use of this highly lethal suicide method. Better surveillance and intervention strategies need to be developed and implemented. [ABSTRACT FROM AUTHOR]

Objective To study the effect of renal disease on the standardized mortality ratio (SMR) and life expectancy of patients with systemic lupus erythematosus (SLE). Methods Patients whose diagnosis met ≥4 American College of Rheumatology criteria for SLE were longitudinally followed up from 1995 to 2011. The cumulative survival rate, SMR, and life expectancy were calculated, and the effect of renal involvement, histologic class of lupus nephritis, renal damage, and end-stage renal disease (ESRD) on these parameters was evaluated. Results Of the 694 SLE patients studied, 368 (53%) had renal disease, and the distribution of histologic classes (among 285 patients) was class I (1%), class II (6%), class III (19%), class IV (47%), class III/IV + class V (10%), and class V (16%). Renal damage was present in 79 patients (11%), and 24 (3%) developed ESRD. The age- and sex-adjusted hazard ratios (HRs) of mortality in SLE patients with renal disease, those with renal damage, and those with ESRD, as compared to those without, were 2.23 (95% confidence interval [95% CI] 1.29-3.85), 3.59 (95% CI 2.20-5.87), and 9.20 (95% CI 4.92-17.2), respectively. Proliferative lupus nephritis (adjusted HR 2.28, 95% CI 1.22-4.24), but not the pure membranous type (adjusted HR 1.09, 95% CI 0.38-3.14), was associated with a significant increase in mortality. The age- and sex-adjusted SMRs of SLE patients without renal involvement, those with lupus nephritis, those with proliferative nephritis, those with pure membranous nephritis, those with renal damage, and those with ESRD were 4.8 (95% CI 2.8-7.5), 9.0 (95% CI 6.7-11.9), 9.8 (95% CI 6.5-14.1), 6.1 (95% CI 2.0-14.1), 14.0 (95% CI 9.1-20.5), and 63.1 (95% CI 33.6-108.0), respectively. The life expectancy of SLE patients with renal disease and those with renal damage was reduced by 15.1 years and 23.7 years, respectively, compared to the general population. Conclusion The presence of renal disease, in particular proliferative nephritis causing renal insufficiency, significantly reduces the survival and life expectancy of SLE patients. [ABSTRACT FROM AUTHOR]

Background: Media guidelines for suicide reporting are available in many countries. However, to what extent the mass media comply with the guidelines is unknown. Few studies are available that investigate systematically whether the mass media reflect the epidemiological reality of suicide deaths in their articles. Methods: Based on the WHO media guidelines, this study investigated the characteristics of newspaper articles of suicides in three Chinese communities, namely Hong Kong, Taiwan and Guangzhou. Epidemiological comparisons were conducted to identify the age and gender differences between the suicide victims as reported in the newspapers and the official records of suicide deaths in all three places. Results: The results found that one media characteristic complied with the WHO media guidelines (ie, only about 2% of the articles were printed on the front page), but there were a number of instances of non-compliance (ie, only 4--14% provided sources for help-seeking and 27--90% printed with photos). The epidemiological comparisons revealed an over-representation of younger suicides and an under-representation of late-life suicides in the newspapers of all three places. Furthermore, female suicides were found to be under-reported in Taiwan and Guangzhou newspapers, but not in Hong Kong papers. Conclusion: Non-compliant suicide articles are prevalent in the newspapers of these three Chinese settings. The observed media misrepresentations may potentially mislead the public and the policy makers about the actual risk for suicide in some demographic groups. [ABSTRACT FROM AUTHOR]

Background: Despite increasing concern over the potential adverse effects of excessive internet use, especially in young people, there is some debate over its definition, magnitude and discriminant validity.Aims: To examine the prevalence of adolescents' internet addiction in Hong Kong, China; to test its differentiation from other correlates; and to examine its relationships with correlates in a representative community sample of adolescents.Method: A two-wave panel household survey with 208 adolescents (aged 15-19 years) was conducted. Participants were asked to self-report their patterns of internet usage, symptoms of internet addiction, suicidal ideation, psychiatric symptoms and psychosocial conditions during the study period.Results: The prevalence rate for having five or more symptoms of internet addiction was estimated to be 6.7% (95% CI 3.3-10.2). The discriminatory characteristic of internet addiction was marginally demonstrated. Positive dose-response relationships were found between the number of symptoms of internet addiction and 1-year changes in scores for suicidal ideation and depressive symptoms.Conclusions: Evidence supports the specificity of internet addiction and its symptoms seem to co-occur with individuals' suicidal ideation and depressive symptoms. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to determine the population-attributable risk (PAR) of completed suicide among Hong Kong Chinese with axis I psychiatric diagnoses. Methods: With a case-control psychological autopsy method, 150 suicide decedents aged 15-59 were compared for axis I psychiatric diagnoses and psychosocial variables with 150 randomly selected age and gender-matched persons living in the community. Results: In the presence of other, non-disease-related social risk factors (unemployment and unmanageable debt), past suicide attempt independently accounted for 44% of the PAR of suicide, followed by current major depressive disorder (27%), schizophrenia spectrum disorders (22%), and substance use disorder or pathological gambling (16%). Other diagnoses (such as anxiety and phobic disorders, dysthymia, adjustment disorders, and past major depressive episode) accounted for 24% of PAR. Conclusions: Psychiatric morbidity remains the major risk factor for suicide in Hong Kong despite well-developed psychiatric services. Mental health policy should be refined to target clinical groups at high risk of suicide. [ABSTRACT FROM AUTHOR]

The system for monitoring suicides in Hong Kong has considerable delays in reporting as the cause of death needs to be determined by a coroner's investigation. However, timely estimates of suicide rates are desirable to assist in the formulation of public health policies. This motivated us to develop a non-parametric procedure to estimate the intensity function of a Poisson process in the presence of reporting delays. We give closed form estimators of the Poisson intensity and the delay distribution, conduct simulation studies to evaluate the method proposed and derive their asymptotic properties. The method proposed is applied to estimate the intensity of suicide in Hong Kong. [ABSTRACT FROM AUTHOR]

Background: A surge in suicide rates in middle age people in Hong Kong and many Asian countries was recently observed. However, there is a paucity of suicide research on this subgroup of people in Asia. Methods: The next-of-kin of 85 suicide cases and 85 community subjects aged 30-49 years were interviewed by a psychological autopsy approach. Information was triangulated by interview notes, coroner's court files, and police investigation reports. Results: A multiple logistic regression analysis identified the following risk factors for suicide among the middle age people in Hong Kong: the presence of at least one psychiatric disorder (OR = 37.5, 95% CI 11.5-121.9, p < 0.001), indebtedness (OR = 9.4, 95% CI 2.2-40.8, p < 0.01), unemployment (OR = 4.8, 95% CI 1.3-17.5, p < 0.05), never married (OR = 4.2, 95% CI 1.1-16.3, p < 0.05), and lived alone (OR = 3.9, 95% CI 1.2-13.4, p < 0.05). Conclusion: The data show that socio-economical factors had a strong impact on suicide in the target group. Further research is needed to explore any positive qualities that protect the middleaged from suicide. The prevention of suicide in the middle-aged requires multiple strategies. [ABSTRACT FROM AUTHOR]

A semivarying coefficient model for the monthly numbers of suicides in Hong Kong is developed and a new estimation procedure for estimating the parametric component is proposed. The estimators are examined in a small simulation study and fitted to monthly suicide data to estimate a nonparametric long-term trend and parametric seasonal and socioeconomic effects. Fitting the model detected interpretable structure in the data that is consistent with that driving public health policy. While exploratory, the analysis motivates the collection of more detailed data and the development of more sophisticated models to help determine target groups and strategies to reduce the suicide rate in Hong Kong. [ABSTRACT FROM AUTHOR]

Background: Charcoal-burning, a new suicide method, emerged in Hong Kong during the latest economic recession. Within 2 months charcoal-burning had become the third most common suicide method.Aims: To examine the characteristics of suicides by charcoal-burning, and to delineate the pathways linking macro-level economic and social changes with the subjective experiences of those surviving a charcoal-burning suicide attempt.Method: Both quantitative and qualitative methods were used. In the coroner's records study, the first 160 cases of suicide by charcoal-burning were compared with a control group. In the ethnographic enquiry, we interviewed 25 consecutive informants who had survived serious suicide attempt using charcoal-burning.Results: People who completed suicide by the charcoal-burning method were more likely to have been economically active and physically healthy, and were less likely to have had pre-existing mental illness. Charcoal-burning suicide was associated with overindebtedness. Media reports were pivotal in linking overindebtedness and financial troubles with charcoal-burning.Conclusions: The political economy of suicide by charcoal-burning illustrated how historical, socio-economic and cultural forces shaped the lived experience that preceded suicide. [ABSTRACT FROM AUTHOR]

Summary. The human immunodeficiency virus–acquired immune deficiency syndrome (HIV–AIDS) epidemic in Hong Kong has been under surveillance in the form of voluntary reporting since 1984. However, there has been little discussion or research on the reconstruction of the HIV incidence curve. This paper is the first to use a modified back-projection method to estimate the incidence of HIV in Hong Kong on the basis of the number of positive HIV tests only. The model proposed has several advantages over the original back-projection method based on AIDS data only. First, not all HIV-infected individuals will develop AIDS by the time of analysis, but some of them may undertake an HIV test; therefore, the HIV data set contains more information than the AIDS data set. Second, the HIV diagnosis curve usually has a smoother pattern than the AIDS diagnosis curve, as it is not affected by redefinition of AIDS. Third, the time to positive HIV diagnosis is unlikely to be affected by treatment effects, as it is unlikely that an individual receives medication before the diagnosis of HIV. Fourth, the induction period from HIV infection to the first HIV positive test is usually shorter than the incubation period which is from HIV infection to diagnosis of AIDS. With a shorter induction period, more information becomes available for estimating the HIV incidence curve. Finally, this method requires the number of positive HIV diagnoses only, which is readily available from HIV–AIDS surveillance systems in many countries. It is estimated that, in Hong Kong, the cumulative number of HIV infections during the period 1979–2000 is about 2600, whereas an estimate based only on AIDS data seems to give an underestimate. [ABSTRACT FROM AUTHOR]

Background: The decreasing suicide rate in China has been regarded as a major contributor to the decline of global suicide rate in the past decade. However, previous estimations on China's suicide rates might not be accurate, since often they were based on the data from the Ministry of Health's Vital Registration ("MOH-VR") System, which is biased towards the better-off population. This study aims to compare suicide data extracted from the MOH-VR System with a more representative mortality surveillance system, namely the Center for Disease Control and Prevention's Disease Surveillance Points ("CDC-DSP") System, and update China's national and subnational suicide rates in the period of 2004-2014.Methods: The CDC-DSP data are obtained from the National Cause-of-Death Surveillance Dataset (2004-2014) and the MOH-VR data are from the Chinese Health Statistics Yearbooks (2005-2012) and the China Health and Family Planning Statistics Yearbooks (2013-2015). First, a negative binomial regression model was used to test the associations between the source of data (CDC-DSP/MOH-VR) and suicide rates in 2004-2014. Joinpoint regression analyses and Kitagawa's decomposition method are then applied to analyze the trends of the crude suicide rates.Results: Both systems indicated China's suicide rates decreased over the study period. However, before the two systems merged in 2013, the CDC-DSP System reported significantly higher national suicide rates (IRR = 1.18, 95% Confidence Interval [CI]: 1.13-1.24) and rural suicide rates (IRR = 1.29, 95% CI: 1.21-1.38) than the MOH-VR System. The CDC-DSP System also showed significant reversing points in 2011 (95% CI: 2006-2012) and 2006 (95% CI: 2006-2008) on the rural and urban suicide trends. Moreover, the suicide rates in the east and central urban regions were reversed in 2011 and 2008.Conclusions: The biased MOH-VR System underestimated China's national and rural suicide rates. Although not widely appreciated in the field of suicide research, the CDC-DSP System provides more accurate estimations on China's suicide rates and is recommended for future studies to monitor the reversing trends of suicide rates in China's more developed areas. [ABSTRACT FROM AUTHOR]

China is the only country in which the suicide rate is higher among women than men. We provide a demographic perspective on the gender differential in suicide in China. This shows that the male/female ratio of suicide increased between 1991 and 2001 and there is reason to believe this trend will continue. Among the population subgroups, only young women living in rural areas had much higher suicide rates than their male counterparts. It is argued that consideration of the gender ratio of suicide in China must take age-, gender- and region-specific suicide patterns and the population structure into account. The increasing urbanisation of China is likely to be associated with more male suicides and we predict that before long the male suicide rate will overtake that of females. [ABSTRACT FROM AUTHOR]

Background: Online sexual experiences (OSEs) are becoming increasingly common in young adults, but existing papers have reported only on specific types of OSEs and have not shown the heterogeneous nature of the repertoire of OSEs. The use patterns of OSEs remain unclear, and the relationships of OSEs with sexual risk behaviors and behavioral health outcomes have not been evaluated., Objective: This study aimed to examine the latent heterogeneity of OSEs in young adults and the associations with sexual risk behaviors and behavioral health outcomes., Methods: The 2021 Youth Sexuality Study of the Hong Kong Family Planning Association phone interviewed a random sample of 1205 young adults in Hong Kong in 2022 (male sex: 613/1205, 50.9%; mean age 23.0 years, SD 2.86 years) on lifetime OSEs, demographic and family characteristics, Patient Health Questionnaire-4 (PHQ-4) scores, sex-related factors (sexual orientation, sex knowledge, and sexual risk behaviors), and behavioral health outcomes (sexually transmitted infections [STIs], drug use, and suicidal ideation) in the past year. Sample heterogeneity of OSEs was analyzed via latent class analysis with substantive checking of the class profiles. Structural equation modeling was used to examine the direct and indirect associations between the OSE class and behavioral health outcomes via sexual risk behaviors and PHQ-4 scores., Results: The data supported 3 latent classes of OSEs with measurement invariance by sex. In this study, 33.1% (398/1205), 56.0% (675/1205), and 10.9% (132/1205) of the sample were in the abstinent class (minimal OSEs), normative class (occasional OSEs), and active class (substantive OSEs), respectively. Male participants showed a lower prevalence of the abstinent class (131/613, 21.4% versus 263/592, 44.4%) and a higher prevalence of the active class (104/613, 17.0% versus 28/592, 4.7%) than female participants. The normative class showed significantly higher sex knowledge than the other 2 classes. The active class was associated with male sex, nonheterosexual status, higher sex desire and PHQ-4 scores, and more sexual risk behaviors than the other 2 classes. Compared with the nonactive (abstinent and normative) classes, the active class was indirectly associated with higher rates of STIs (absolute difference in percentage points [Δ]=4.8%; P=.03) and drug use (Δ=7.6%; P=.001) via sexual risk behaviors, and with higher rates of suicidal ideation (Δ=2.5%; P=.007) via PHQ-4 scores., Conclusions: This study provided the first results on the 3 (abstinent, normative, and active) latent classes of OSEs with distinct profiles in OSEs, demographic and family characteristics, PHQ-4 scores, sex-related factors, and behavioral health outcomes. The active class showed indirect associations with higher rates of STIs and drug use via sexual risk behaviors and higher rates of suicidal ideation via PHQ-4 scores than the other 2 classes. These results have implications for the formulation and evaluation of targeted interventions to help young adults., (©Ted C T Fong, Derek Yee Tak Cheung, Edmond Pui Hang Choi, Daniel Y T Fong, Rainbow T H Ho, Patrick Ip, Man Chun Kung, Mona Wai Cheung Lam, Antoinette Marie Lee, William Chi Wai Wong, Tai Hing Lam, Paul S F Yip. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 26.01.2024.)

Background: Global life satisfaction has been consistently linked to physical health. A deeper and culturally nuanced understanding of which domains of satisfaction may be responsible for this association has implications for developing novel, scalable, and targeted interventions to improve physical health at the population level., Objectives: This cohort study draws participants from the China Family Panel Studies (CPFS), a nationally representative cohort of 10,044 Chinese adults to assess the independent associations between three important domains of life satisfaction (and their changes) and indicators of physical health., Results: A total of 10,044 participants were included in the primary analysis (4,475 female [44.6%]; mean [SD] age, 46.2 [12.1] years). Higher baseline levels of satisfaction with job, marriage, and medical services were independently associated with better perceived physical health (0.04 < β values < 0.12). Above and beyond their baseline levels, increases in satisfaction with job, marriage, and medical services were independently associated with better perceived physical health (0.04 < β values < 0.13). On the contrary, only higher baseline levels of and increases in satisfaction with marriage showed prospective associations with lower odds of incidence of chronic health condition and hospitalization (0.84 < ORs < 0.91)., Conclusions: These findings provide policymakers and interventionists interested in leveraging psychological health assets with rich information to rank variables and develop novel interventions aimed at improving wellbeing at the population level., (© 2022. The Author(s).)

Background: Since December 2019, coronavirus disease (COVID-19) has affected over 50 000 people in Wuhan, China. However, the number of daily infection cases, hospitalization rate, lag time from onset to diagnosis date and their associations with measures introduced to slow down the spread of COVID-19 have not been fully explored., Methods: This study recruited 6872 COVID-19 patients in the Wuchang district, Wuhan. All of the patients had an onset date from 21 December 2019 to 23 February 2020. The overall and weekly hospitalization rate and lag time from onset to diagnosis date were calculated. The number of daily infections was estimated by the back-projection method based on the number of daily onset cases. Their association with major government reactions and measures was analyzed narratively., Results: The overall hospitalization rate was 45.9% (95% CI 44.7 to 47.1%) and the mean lag time from onset to diagnosis was 11.1±7.4 d. The estimated infection curve was constructed for the period from 14 December 2019 to 23 February 2020. Raising public awareness regarding self-protecting and social distancing, as well as the provision of timely testing and inpatient services, were coincident with the decline in the daily number of infections., Conclusion: Early public awareness, early identification and early quarantine, supported by appropriate infrastructure, are important elements for containing the spread of COVID-19 in the community., (© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Background: Several past studies indicated that religious beliefs, orientation, and practice are protective of suicide. Findings from recent studies in China suggest that religiosity may contribute to increased suicidality. However, few studies have examined the associations between religious affiliation across different faiths and suicidality in China., Objective: The current study examines the association between religious affiliation and suicidality among college students in six provinces in China., Methods: We conducted a cross-sectional study involving 11,407 college students from six universities in Ningxia, Shandong, Shanghai, Jilin, Qinghai, and Shaanxi. We collected the data between October 2017 and March 2018 using self-report questionnaires. They included self-report measures of depression, psychache, hopelessness, self-esteem, social support, and life purpose., Results: Participants with a Christian affiliation had 1.5 times (95% CI: 1.14, 1.99, p = 0.004) higher odds of indicating an elevated suicide risk, 3.1 times (95% CI: 1.90, 5.04, p<0.001) higher odds of indicating a previous suicide attempt, and increased overall suicidality (B = 0.105, p < 0.001) after accounting for demographic and risk/protective factors. Christians also scored the highest in depression, psychache, hopelessness, and the lowest social support, self-esteem, and purpose in life. Muslims reported decreased suicidality (B = -0.034, p = 0.031). Buddhism/Daoism yielded non-significant results in the multivariate analyses., Conclusions: Christian college students reported increased suicidality levels, perhaps due to public policies on religion. The decreased suicidality levels among Muslims may be attributed to higher perceived social support. The associations between religious affiliation and suicidality, depression, and hopelessness contrast sharply with US samples. This finding may be influenced by interactions between the religious denomination, individual, and social/political factors. This conclusion includes the possibility of anti-religious discrimination, which this paper did not investigate as a possible mediator and therefore remains a conjecture worthy of future investigation., Competing Interests: The authors have declared that no competing interests exist.

Studies on the mortalities of drug abusers in China are scarce. This study explores the deaths of methamphetamine, opioid, and ketamine abusers in Shanghai (2004-2017) and Wuhan (2005-2017). Chi-square/Fisher's exact tests were used to compare the differences in terms of region, gender, age, cause of death, and the method used in the last drug abuse. Poisson regression models were used to estimate the rate ratios ("RRs") and annual percentage changes ("APCs"). 314 heroin, 43 methamphetamine, and 4 ketamine abusers were included. Furthermore, simultaneously, 6 abusers used heroin and methamphetamine, and 7 abusers used methamphetamine and ketamine. Heroin-related deaths have declined in Shanghai (APC, -16.1; 95 % CI, -18.4 to -11.3) and Wuhan (APC, -16.0; 95 % CI, -18.9 to -10.6), whereas methamphetamine-related deaths have increased in Wuhan (APC, 12.8; 95 % CI, 0.0 to 29.2). On the whole, in the two cities, males were more frequently observed than females in heroin-related deaths (4.4, 230/52). However, the gender ratios for methamphetamine- (1.8, 34/19) and ketamine-related deaths (1.2, 6/5) were close to one. In view of the mortality rates of the drug abusers in most Chinese cities were still unclear, it is thus important to improve mortality surveillance of the drug abusers at the national level., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Injury scales have two main applications on homicide investigations, namely, to evaluate the severity of the victims' injuries and to identify the profiles of the offenders. However, few studies have examined the quality of the various injury scales in serving the two purposes. In this study, homicides from Shanghai and Wuhan, China (n=439) have been used to examine nine injury scales. The results showed that seven out of the nine scales were useful. Compared to one-to-one homicides, offenders who killed two or more people tended to inflict more fatal injuries and made fewer number of attacks on the victims' heads and necks. Among all homicide cases, victims of stranger homicides tended to have fewer total number of wounds, as well as less severity of wounds on the heads, necks, and faces compared to those of intimate partner homicides. As to one-to-one homicides, only the severity of wounds on the face could assist to distinguish stranger homicides from intimate partner homicides. When a male victim died in a one-to-one homicide, the high number of total wounds along with the high number and severity of wounds on the head and neck could indicate that the offender was a female., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: This present study aims to estimate the structural validity, internal consistency reliability of the LSNS-6 and examine the associations between the LSNS-6 and suicidal outcomes among mainland Chinese older adults., Methods: This validation study used a big representative sample (N = 2819) of older adults in Beijing from the Sample Survey on Aged Population in Urban/Rural China. Confirmatory factor analyses (CFA) were applied to examine the factor structures of the Chinese version of LSNS-6. Internal consistency reliability of the LSNS-6 was examined by Cronbach's alpha coefficient and the corrected item-total correlation. Logistic regression analyses were used to explore the associations between the LSNS-6 and late-life death wishes, suicidal ideation in mainland Chinese., Findings: This present study showed good internal consistency and consistent factor structure of the LSNS-6 as well as its subscales. The present data demonstrated the LSNS-6 could be a useful tool for assessing social networks among older mainland Chinese. Interestingly, among the mainland Chinese, late-life suicidality was highly associated with the LSNS-6 family subscale, rather than the friends subscale., Conclusion: The LSNS-6 could be a useful tool for assessing social networks among older mainland Chinese. In addition, suggestion is made to improve social networks, especially in family bonds and support, as a promising strategy in reducing late-life suicide risks in mainland China., Competing Interests: The authors have declared that no competing interests exist.

Background: Media reporting of suicide and its relationship with actual suicide has rarely been investigated in Mainland China. The "Foxconn suicides" is a description referring to a string of suicides/attempts during 2010, all of which were related to a giant electrical manufacturing company, Foxconn. This study aimed to examine the clustering and copycat effects of the Foxconn suicides, and to investigate temporal patterns in how they were reported by the media in Mainland China, Hong Kong (HK), and Taiwan (TW)., Methods: Relevant articles were collected from representative newspapers published in three big cities in Mainland China (Beijing (BJ), Shenzhen (SZ), and Guangzhou (GZ)), HK, and TW, together with searching intensity data on the topic conducted using the Baidu search engine in Mainland China. The temporal clustering effects of the Foxconn suicides and their media prominence were assessed using the Kolmogorov-Smirnov test. The media reports of the Foxconn suicides' temporal patterns were explored using a nonparametric curve estimation method (that is, the local linear method). The potential mutual interactions between the Foxconn suicides and their media prominence were also examined, using logistic and Poisson regression methods., Results: The results support a temporal clustering effect for the Foxconn suicides. The BJ-based newspapers' reporting and the occurrence of a Foxconn suicide/attempt are each found to be associated with an elevated chance of a further Foxconn suicide 3 days later. The occurrence of a Foxconn suicide also immediately influenced the intensity of both Baidu searching and newspaper reporting. Regional diversity in suicide reporting tempo-patterns within Mainland China, and similarities between HK and TW, are also demonstrated., Conclusions: The Foxconn suicides were temporally clustered. Their occurrences were influenced by the reporting of BJ-based newspapers, and contagion within the company itself. Further suicide research and prevention work in China should consider its special media environment.

Background: Long-term mortality and the risk factors for premature death among patients with schizophrenia living in rural communities are unknown., Aims: To explore the 10-year mortality and its risk factors among patients with schizophrenia., Method: We used data from a 10-year prospective follow-up study (1994-2004) of mortality among people with schizophrenia, and death registration data for Xinjin County, Chengdu, China., Results: The mortality rate was 2228 per 100,000 person-years during follow-up. Both all-cause mortality and suicide rates were significantly greater in male than in female patients. Age at illness onset (>45 years), duration of illness (> or =10 years), age greater than 50 years, physical illness, in ability to work, male gender, and never having received treatment were identified as independent predictors of increased mortality., Conclusions: Higher mortality rates in male patients may contribute to the higher prevalence of schizophrenia in women compared with men in China. The findings of risk factors for mortality should be taken into account when developing interventions to improve outcomes among people with schizophrenia.

With the advancement of assisted reproduction technologies, people are offered wider choices to choose the gender of their offspring and to construct 'ideal-typed' families with specific gender structure. Gender selection is welcomed by many societies with gender-specific preference, especially those patriarchal societies such as Chinese communities. It is not only a medical procedure but also a social orientation, which reveals much of the underlying preference towards gender. This paper explores the cultural dimensions to gender selection and its psychosocial meanings and implications in Chinese societies, especially after the establishment of One Child Policy in China. Problems associated with son preference in the culture with strong gender stereotyping are addressed. We believe that gender selection for social reasons should not be allowed since undesirable outcomes will be resulted under such strict population control program.