A Markov chain model for studying suicide dynamics: an illustration of the Rose theorem

Background: High-risk strategies would only have a modest effect on suicide prevention within a population. It is best to incorporate both high-risk and population-based strategies to prevent suicide. This study aims to compare the effectiveness of suicide prevention between high-risk and population-based strategies. Methods: A Markov chain illness and death model is proposed to determine suicide dynamic in a population and examine its effectiveness for reducing the number of suicides by modifying certain parameters of the model. Assuming a population with replacement, the suicide risk of the population was estimated by determining the final state of the Markov model. Results: The model shows that targeting the whole population for suicide prevention is more effective than reducing risk in the high-risk tail of the distribution of psychological distress (i.e. the mentally ill). Conclusions: The results of this model reinforce the essence of the Rose theorem that lowering the suicidal risk in the population at large may be more effective than reducing the high risk in a small population

Global Imperative of Suicidal Ideation in 10 Countries Amid the COVID-19 Pandemic

Background: The novel coronavirus (COVID-19) has had a detrimental impact on individuals' psychological well-being; however, a multi-country comparison on the prevalence of suicidal ideation due to the virus is still lacking.Objectives: To examine the prevalence and correlates of suicidal ideation among the general population across 10 countries during the COVID-19 pandemic.Materials and methods: This was a cross-sectional study which used convenience sampling and collected data by conducting an online survey. Participants were sourced from 10 Eastern and Western countries. The Patient Health Questionnaire (PHQ-9) was used to measure the outcome variable of suicidal ideation. Ordinal regression analysis was used to identify significant predictors associated with suicidal ideation.Results: A total of 25,053 participants (22.7% male) were recruited. Results from the analysis showed that the UK and Brazil had the lowest odds of suicidal ideation compared to Macau (p p Conclusions: The findings highlight the need for joint international collaboration to formulate effective suicide prevention strategies in a timely manner and the need to implement online mental health promotion platforms. In doing so, the potential global rising death rates by suicide during the pandemic can be reduced.</p

Patients’ experience in Hong Kong hospitals: A comparison between south Asian and Chinese people

Patient experience in hospital is positively associated with both self-rated and objectively measured health outcomes. In many countries ethnic minority patients have more negative experience and bear a disproportionate burden of disease than their majority counterparts. However, hospital experience of ethnic minority patients in Asia is still unexplored. We aimed to explore the hospital experience of South Asian ethnic minority and compare that with local Chinese patients’ experience in Hong Kong. A cross-sectional study sample comprised of 783 participants (388 South Asian and 395 Chinese). Picker Patient Experience-15 (PPE-15) questionnaire was used for data collection. Simple and multiple regressions were used to compare South Asian and Chinese participants’ in-hospital stays. The regression analyses were done before and after adjusting for demographics and after Propensity Score Weighting (PSW). All estimates were accompanied by a 95% confidence interval. Two-sided tests were conducted with a significance concluded by a p-value. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Is there gender bias in research grant success in social sciences?: Hong Kong as a case study

Despite growing attention to gender disparities in higher education, women in academia still receive less research funding and recognition. Previous research on this gender gap has focused on biomedical, science, technology, engineering, and mathematics in the West—relatively silent on social sciences and Asia. This study examined how well staff gender, submission rate, success rate, and amount per award could predict annual changes in the number and amount of grant funding for academic years 2015/2016–2020/2021 in the Faculty of Social Science at the University of Hong Kong, a leading institution in social sciences in Asia. Decomposition analysis revealed that, compared to men, women had higher submission rates, which significantly contributed to an increase in the number of awards for the University in recent years in two major funding mechanisms (namely, General Research Fund and Early Career Scheme), especially from 2019/2020 to 2020/2021. Women also outperformed men in the success rate in the Early Career Scheme (i.e., within the first three years of faculty appointment). Both submission rate and success rate contributed to changes in award number and the total amount for the University over time. Overall, women had a higher submission rate, successful rate, and amount per award than their male counterparts. We have identified good practices and distinctive contextual factors in Hong Kong that likely contribute to the lack of gender bias for research grant application results in Social Sciences

Trends in healthy life expectancy in Hong Kong SAR 1996–2008

Although Hong Kong has one of the best life expectancy (LE) records in the world, second only to Japan for women, we know very little about the changes in the health status of the older adult population. Our article aims to provide a better understanding of trends in both chronic morbidity and disability for older men and women. The authors compute chronic morbidity-free and disability-free life expectancy and the proportion of both in relation to total LE using the Sullivan method to examine whether Hong Kong older adults are experiencing a compression of morbidity and disability and whether there is any gender difference in relation to mortality and morbidity. The results of this study show that Hong Kong women tend to outlive Hong Kong men but are also more likely to suffer from a ‘double disadvantage’, namely more years of life with more chronic morbidity and disability. There has also been a significant expansion of chronic morbidity, as chronic morbidity-free life expectancy (CMFLE) decreased substantially for both genders from 1996 to 2008. Although disability-free life expectancy (DFLE) increased during this period, it increased at a slower pace compared to LE. The proportion of life without chronic morbidity also declined remarkably during these 12 years. Among the advanced ages, the proportion of remaining life in good health without disability has decreased since 1996, indicating a relative expansion of disability

Who wants a slimmer body? The relationship between body weight status, education level and body shape dissatisfaction among young adults in Hong Kong

Background: Body shape dissatisfaction has been thought to have an indispensable impact on weight control behaviors. We investigated the prevalence of body shape dissatisfaction (BSD) and explored its association with weight status, education level and other determinants among young adults in Hong Kong. Methods. Information on anthropometry, BSD, and socio-demographics was collected from a random sample of 1205 young adults (611 men and 594 women) aged 18-27 in a community-based household survey. BSD was defined as a discrepancy between current and ideal body shape based on a figure rating scale. Cross-tabulations, homogeneity tests and logistic regression models were applied. Results: The percentages of underweight men and women were 16.5% and 34.9% respectively, and the corresponding percentages of being overweight or obese were 26.7% and 13.2% for men and women respectively. Three-quarters of young adults had BSD. Among women, 30.9% of those underweight and 75.5% of those with normal weight desired a slimmer body shape. Overweight men and underweight women with lower education level were more likely to have a mismatch between weight status and BSD than those with higher education level. After controlling for other determinants, underweight women were found to have a higher likelihood to maintain their current body shapes than other women. Men were found to be less likely to have a mismatch between weight status and BSD than women. Conclusions: Overweight and obesity in men and underweight in women were prevalent among Hong Kong young adults. Inappropriate body shape desire might predispose individuals to unhealthy weight loss or gain behaviors. Careful consideration of actual weight status in body shape desire is needed in health promotion and education, especially for underweight and normal weight women and those with a low education level. © 2011 Cheung et al; licensee BioMed Central Ltd.published_or_final_versio

Understanding the Increase in Life Expectancy in Hong Kong: Contributions of Changes in Age- and Cause-Specific Mortality

To assess the mechanism responsible for the improvement in life expectancy in Hong Kong over the past several decades, Arriaga&rsquo;s decomposition method was applied to quantify the influence of the age structure and the leading causes of death on the increase in life expectancy in Hong Kong from 1986 to 2015. Our results showed that, during the observed period, the major contribution to the improvement in life expectancy in Hong Kong was attributable to the older population for both males and females. Contributions of malignant neoplasms in the period of 1986&ndash;1995, 1996&ndash;2005 and 2006&ndash;2015 were 0.613, 0.279 and 0.887 years in males and 0.391, 0.312 and 0.226 years in females, respectively. For circulatory diseases, the corresponding figures were 1.452, 0.202 and 0.832 years in males and 0.675, 0.192 and 1.069 years in females, with the largest contribution also shifting to older ages. However, these positive contributions were partly offset by the negative contribution of pneumonia, especially among those at advanced ages. Furthermore, although the impact was limited, attention should also be paid to the prevalence of some chronic diseases among the younger age groups in recent years

A Projection of Future Hospitalisation Needs in a Rapidly Ageing Society: A Hong Kong Experience

To assess the impact of ageing on hospitalisation in a rapidly ageing society. A study using retrospective and prospective data was conducted using hospitalisation data with age-specific admission rates in the period from 2001&#8315;2010 and demographic data from the period of 2001&#8315;2066 by the United Nations. The Hong Kong Special Administrative Region (SAR) with a 7 million population experiences extreme low fertility (1.1 children per woman) and long life expectancy (84 years old). Days of hospitalisation: For the period 2010&#8315;2066, the length of stay (LOS) in the age group 85+ is projected to increase by 555.3% while the LOS for the whole population is expected to increase by only 134.4% and by ageing only. In 2010, the proportion in the LOS contributed to by the oldest age group (85+) was 15%. In 2066, this proportion is projected to nearly triple (42%). Around 70% of the projected days of hospitalisation would be taken by people aged 75 years and above. It is projected that this phenomenon would be converted to a more balanced structure when the demographic transition changes into a more stable distribution. Apparently, the impact of ageing on the public hospital system has not been well understood and prepared. The determined result provides insight into monitoring the capacity of the hospital system to cope with a rapidly changing demographic society. It provides empirical evidence of the impact of ageing on the public hospitalisation system. It gives a long term projection up to the year 2066 while the situation would be different from the transient period of 2016&#8315;2030. The analysis adopts a fixed rate approach, which assumes the LOS to be only driven by demographic factors, while any improvements in health technologies and health awareness are not accounted for. Only inpatient data from the Hospital Authority were used, nonetheless, they are the best available for the study. Due to the limitation of data, proximity to death is not controlled in conducting this analysis

Self-harm attempters’ perception of community services and its implication on service provision

Objective: This study aimed at exploring the attempters’ perception of community social services included any barriers to seeking help and services. Method: The participants were patients with self-harming behavior aged 15 years or above. A set of guiding questions were designed to explore the general barriers and accessibility to community social services. A voice recording was made, which was later converted into a text transcript and then preceded for content analysis with co-occurrence and similarity matrix interpretation. Two males and nine females with a history of self-harm aged between 24 and 58 years were recruited for the interviews. Result: The participants had diverse experiences and backgrounds, and attitudes toward community social services. However, there was a shared perception of the need to enhance community social services. There were four main themes and 12 sub themes identified. The main theme included the service availability, service accessibility, affordability and acceptability. For details, participants were unaware of the available types of care/social services in the community, and were unaware about the nearby social services. They also suggested extending service hours and focused services should be offered to help people with different backgrounds and needs. Actually, those with experience of service utilization had both positive and negative perspectives and they gave suggestions for service delivery, mainly extending service hours and offering focused services such as for gambling control and financial planning. In view of interaction with service providers, counseling skills and trust were highly appreciated by the participants. Conclusion: The results identified common circumstances of falling into financial hardship (gambling) and social fragmentation (divorce, poor family relationships, and poor marital relationships), which also suggested to enhance services on center location, service arrangement, and skill of caregivers. Keywords: Cognition, Community health services, Patients, Self mutilatio