The foxconn suicides and their media prominence: is the werther effect applicable in china?

<p>Abstract</p> <p>Background</p> <p>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).</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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.</p> <p>Conclusions</p> <p>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.</p

An analysis of the Lowest Total Fertility Rate in Hong Kong SAR

Total Fertility Rate (TFR) in Hong Kong has dropped significantly over the past 30 years, from 2.48 births per woman in 1976 to 0.966 in 2005, which is one of the lowest in the world. It is mainly caused by the change of marital distribution which has contributed to about 56% of the decline in the total fertility rate for the period 1976-2001. Delay of marriage and reduction in the marital fertility rate have also been shown to be two major causes for the low TFR. A new measure, called a weighted total marital fertility rate (WTMFR), is introduced such that change of age at marriage and the fertility within marriage can be factored in explaining the decline of the fertility rate. The delay of marriage has contributed to about 52% of the reduction of WTMFR whereas the reduction of the fertility within marriage has accounted for the other 48%. Apparently, the proportion of women remaining single has been stabilized and leveled off recently. However, the preference of having smaller family size has become a norm rather than an exception. It is very unlikely to see a rebound of fertility among the Hong Kong women in the near future if there is no increase in marriages or births outside wedlock. Encouraging more births among married women so as to increase fertility is expected to have limited impact.Age at first marriage, decomposition, Hong Kong, Total fertility rate, Weighted total marital fertility rate

Antidepressant use and risk of self-harm among people aged 40 years or older: A population-based cohort and self-controlled case series study

Background: Studies on the association between antidepressants and self-harm in adults were mostly conducted over a decade ago and have inconsistent findings. We aimed to compare self-harm risks by antidepressant classes among people aged 40 years or older with depression. Methods: Individuals aged ≥40 years with depression who initiated antidepressant treatment between 2001 and 2015 were retrieved from the Hong Kong Clinical Data Analysis & Reporting system, and were followed up until December 31, 2016. We conducted self-controlled case series (SCCS) analyses to estimate the incidence rate ratio (IRR) of self-harm comparing the pre-exposure (90 days before the first antidepressant use), index exposure (the first antidepressant use), and subsequent exposure (subsequent antidepressant use) periods to nonexposed periods. We applied Cox proportional hazard regressions to estimate the hazard ratio (HR) of self-harm comparing five antidepressant classes (tricyclic and related antidepressant drugs [TCAs], selective serotonin reuptake inhibitors [SSRIs], noradrenergic and specific serotonergic antidepressants [NaSSAs], serotonin–norepinephrine reuptake inhibitors [SNRIs], and others). Findings: A total of 48,724 individuals were identified. SCCS analyses (N = 3,846) found that the increased self-harm risk occurred during the pre-exposure (IRR: 22.24; 95% CI, 20.25-24.42), index exposure (7.03; 6.34-7.80), and subsequent exposure periods (2.47; 2.18-2.79) compared to the unexposed period. Cohort analyses (N = 48,724) found an association of higher self-harm risks in short-term (one year) for NaSSAs vs. TCAs (HR, 2.13; 95% CI, 1.53-2.96), SNRIs vs. TCAs (1.64; 1.01-2.68), and NaSSAs vs. SSRIs (1.75; 1.29-2.36) in the 40-64 years group. The higher risk remained significant in long-term (> one year) for NaSSAs vs. TCAs (1.55; 1.26-1.91) and NaSSAs vs. SSRIs (1.53; 1.26-1.87). In the 65+ group, only short-term differences were observed (SSRIs vs. TCAs [1.31; 1.03-1.66], SNRIs vs. SSRIs [0.44; 0.22-0.87], and SNRIs vs. NaSSAs [0.43; 0.21-0.87]). Interpretation: Within-person comparisons did not suggest that antidepressant exposure is causally associated with an increased risk of self-harm in people with depression. Between-person comparisons revealed differences in self-harm risks between certain pairs of antidepressant classes. These findings may inform clinicians’ benefit-risk assessments when prescribing antidepressants

The Contribution of Ageing to Hospitalisation Days in Hong Kong: A Decomposition Analysis

Background: Ageing has become a serious challenge in Hong Kong and globally. It has serious implications for health expenditure, which accounts for nearly 20% of overall government expenditure. Here we assess the contribution of ageing and related factors to hospitalisation days in Hong Kong. We used hospital discharge data from all publicly funded hospitals in Hong Kong between 2001 and 2012. Methods: A decomposition method was used to examine the factors that account for the change of total hospitalisation days during the two periods, 2001-2004 and 2004-2012. The five factors include two demographic factors – population size and age-gender composition – and three service components – hospital discharge rate, number of discharge episodes per patient, and average length of stay (LOS) – which are all measured at age-gender group level. In order to assess the health cost burden in the future, we also project the total hospitalisation days up to 2041, for a range of scenarios. Results: During the decreasing period of hospitalisation days (2001-2004), the reduction of LOS contributed to about 60% of the reduction. For the period of increase (2004-2012), ageing is associated with an increase in total hospitalisation days of 1.03 million, followed by an increase in hospital discharge rates (0.67 million), an increase in the number of discharge episodes per patient (0.62 million), and population growth (0.43 million). The reduction of LOS has greatly offset these increases (-2.19 million days), and has become one of the most significant factors in containing the increasing number of hospitalisation days. Projected increases in total hospitalisation days under different scenarios have highlighted that the contribution of ageing will become even more prominent after 2022. Conclusion: Hong Kong is facing increasing healthcare burden caused by the rapid increase in demand for inpatient services due to ageing. Better management of inpatient services with the aim of increasing efficiency and reducing LOS, avoidable hospitalisation and readmission, without compromising patient satisfaction and quality of service, are crucial for containing the rapid and enormous increases in total hospitalisation days for Hong Kong. The results would be relevant to many rapidly ageing societies in this region

Suicide among adults aged 30–49: A psychological autopsy study in Hong Kong

<p>Abstract</p> <p>Background</p> <p>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.</p> <p>Methods</p> <p>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.</p> <p>Results</p> <p>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).</p> <p>Conclusion</p> <p>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 middle-aged from suicide. The prevention of suicide in the middle-aged requires multiple strategies.</p

Suicide with psychiatric diagnosis and without utilization of psychiatric service

<p>Abstract</p> <p>Background</p> <p>Considerable attention has been focused on the study of suicides among those who have received help from healthcare providers. However, little is known about the profiles of suicide deceased who had psychiatric illnesses but made no contact with psychiatric services prior to their death. Behavioural model of health service use is applied to identify factors associated with the utilization of psychiatric service among the suicide deceased.</p> <p>Methods</p> <p>With respect to completed suicide cases, who were diagnosed with a mental disorder, a comparison study was made between those who had (contact group; n = 52; 43.7%) and those who had not made any contact (non-contact group; n = 67; 56.3%) with a psychiatrist during the final six months prior to death. A <it>sample </it>of 119 deceased cases aged between 15 and 59 with at least one psychiatric diagnosis assessed by the Structured Clinical Interview for DSM-IV-TR (SCID I) were selected from a psychological autopsy study in Hong Kong.</p> <p>Results</p> <p>The contact and non-contact group could be well distinguished from each other by "<it>predisposing</it>" variables: age group & gender, and most of the "<it>enabling"</it>, and "<it>need" </it>variables tested in this study. Multiple logistic regression analysis has found four factors are statistically significantly associated with non-contact suicide deceased: (i) having non-psychotic disorders (OR = 13.5, 95% CI:2.9-62.9), (ii) unmanageable debts (OR = 10.5, CI:2.4-45.3), (iii) being full/partially/self employed at the time of death (OR = 10.0, CI:1.6-64.1) and (iv) having higher levels of social problem-solving ability (SPSI) (OR = 2.0, CI:1.1-3.6).</p> <p>Conclusion</p> <p>The non-contact group was clearly different from the contact group and actually comprised a larger proportion of the suicide population that they could hardly be reached by usual individual-based suicide prevention efforts. For this reason, both universal and strategic suicide prevention measures need to be developed specifically in non-medical settings to reach out to this non-contact group in order to achieve better suicide prevention results.</p

Quick assessment of hopelessness: a cross-sectional study

BACKGROUND: Lengthy questionnaires reduce data quality and impose a burden on respondents. Previous researchers proposed that a single item ("My future seems dark to me") and a 4-item component of the Beck's Hopelessness Scale (BHS) can summarise most of the information the BHS provides. There is no clear indication of what BHS cutoff values are useful in identifying people with suicide tendency. METHODS: In a population-based study of Chinese people aged between 15 and 59 in Hong Kong, the Chinese version of the BHS and the Centre for Epidemiologic Studies – Depression scale were administered by trained interviewers and suicidal ideation and suicidal attempts were self-reported. Receiver operating characteristics curve analysis and regression analysis were used to compare the performance of the BHS and its components in identifying people with suicidality and depression. Smoothed level of suicidal tendency was assessed in relation to scores on the BHS and its component to identify thresholds. RESULTS: It is found that the 4-item component and, to a lesser extent, the single item of the BHS perform in ways similar to the BHS. There are non-linear relationship between suicidality and scores on the BHS and the 4-item component; cutoff values identified accordingly have sensitivity and specificity of about 65%. CONCLUSION: The 4-item component is a useful alternative to the BHS. Shortening of psycho-social measurement scales should be considered in order to reduce burden on patients or respondents and to improve response rate

Serological Evaluation of Mycobacterium ulcerans Antigens Identified by Comparative Genomics

A specific and sensitive serodiagnostic test for Mycobacterium ulcerans infection would greatly assist the diagnosis of Buruli ulcer and would also facilitate seroepidemiological surveys. By comparative genomics, we identified 45 potential M. ulcerans specific proteins, of which we were able to express and purify 33 in E. coli. Sera from 30 confirmed Buruli ulcer patients, 24 healthy controls from the same endemic region and 30 healthy controls from a non-endemic region in Benin were screened for antibody responses to these specific proteins by ELISA. Serum IgG responses of Buruli ulcer patients were highly variable, however, seven proteins (MUP045, MUP057, MUL_0513, Hsp65, and the polyketide synthase domains ER, AT propionate, and KR A) showed a significant difference between patient and non-endemic control antibody responses. However, when sera from the healthy control subjects living in the same Buruli ulcer endemic area as the patients were examined, none of the proteins were able to discriminate between these two groups. Nevertheless, six of the seven proteins showed an ability to distinguish people living in an endemic area from those in a non-endemic area with an average sensitivity of 69% and specificity of 88%, suggesting exposure to M. ulcerans. Further validation of these six proteins is now underway to assess their suitability for use in Buruli ulcer seroepidemiological studies. Such studies are urgently needed to assist efforts to uncover environmental reservoirs and understand transmission pathways of the M. ulcerans