HKJC CTR FOR SUICIDE RESEARCH & PREVENTN



Researcher : Chan CLW

Project Title:Therapeutic group for women with infertility
Investigator(s):Chan CLW, Chan Y, Ng EHY, Ho PC
Department:Soc Work & Social Administration
Source(s) of Funding:Other Funding Scheme
Start Date:06/1999
Abstract:
To explore the psychosocial needs of infertile women; to develop a practice model for helping infertile women.


Project Title:A meaning-oriented group-based preventive intervention study on the psychological impact of Severe Acute Respiratory Syndrome (SARS): morbidity versus grow
Investigator(s):Chan CLW, Chen RYL, Chan SSC, Lee AM
Department:Soc Work & Social Administration
Source(s) of Funding:Other Funding Scheme
Start Date:06/2003
Abstract:
To test usefulness of a cognitive behavioral and meaning-oriented preventive intervention programme to reduce psychological morbidity and promote post-SARS growth among chronic patients in Hong Kong.


Project Title:The Impact of Family Strength and Filial Obligations on Bereavement Resilience amongst Chinese and Caucasian Older Adults Facing Conjugal Loss: A Cross-Cultural Comparison Study
Investigator(s):Chan CLW, Ho AHY
Department:Soc Work & Social Administration
Source(s) of Funding:Seed Funding Programme for Basic Research
Start Date:06/2008
Completion Date:05/2010
Abstract:
Amongst the numerous mental stressors individuals will experience in the course of their lives, the death of a spouse - although being a natural and expected part of the aging process - had repeatedly been ranked as the most devastating and stressful life event (1). According to most Western literature in death-related research, an estimated 10-20% of individuals will experience chronic grief for years beyond the loss (2). The detrimental impact of prolonged and complicated grief are not limited to physical and psychological sufferance, but also elevated risks for suicide and mortality, posing much public health concerns (3). Despite the grim outcomes of chronic grief, there are clear differences in the length and severity of grief reactions amongst bereaved individuals. Apart from chronic grief marked by prolonged depression, as well as common grief marked by an initial increase in depression that would gradually decrease over time, Bonnanno and Kaltman (2) reported that about 45%-55% of bereaved individuals actually experienced only minimal levels of pre-and-post loss depression with high levels of coping efficacy leading to relatively stable emotional states and unaffected functional status. These individuals depict the presence of a resilient grief reaction. Bereavement literature provides numerous hypotheses about the possible antecedents of the various patterns of grief reactions. Bonanno et al. (4) integrated reviews of past literatures, identified, and thereafter confirmed four fundamental components of successful coping and bereavement resilience among a sample of 205 elders facing conjugal loss. These four components include: (a) Coping Resources, inclusive of self-efficacy of coping, perceived social support and instrumental support; (b) Meaning of Loss, including a worldview that is more accepting of death with lower levels of death anxiety; (c) Context of Loss, whereby the intensive spousal caregiving was not required; and (d) Qualities of Marital Relationships, such as good reported martial relationship and low level of dependency. The findings reported by Bonanno et al. (4) provided a framework for better understanding important Personal and Situational factors that may influence the coping efficacy and grieving experiences of a surviving spouse. However, familial factors, which play a crucial role in the preservation of individual well-being in the face of adversity (5), have yet been thoroughly investigated. According to the Family System Theory (6), the individual is part of a larger system made of interdependent individuals who constitute a whole greater than the sum of its parts. Therefore, an individuals’ ability to cope with adversity and loss is heavily dependent on his/her family functioning (5). In other words, individual resilience is contingent upon family resilience or the ability of the family to respond to, and eventually adapt to, the situations and crises encountered over the family life cycle (7). Within the Family Resiliency framework (7, 8), resilience is viewed as involving two distinguishable but related family processes: (a) Adjustment, which involves the influence of protective factors in facilitating the family's ability and efforts to maintain its integrity, functioning, and fulfill developmental tasks in the face of risk factors, and (b) Adaptation, which involves the function of recovery factors in promoting the family's ability to recover and adapt in family crisis situations. McCubbin et al. (8) integrated reviews of past literature, and amongst others, and identified 3 dominating resiliency factors of family strength for individuals and families to cope with crisis situations; they included Family Adaptation, Family Coping, and Communication. Given the pivotal role that the family plays in the preservation of individual well-being with interpersonal loss, there is an imperative need to thoroughly examine familial factors as another major component of coping efficacy to conjugal loss and bereavement resilience. Family has always been the driving force for the Asian Chinese population. In particular, the Chinese culture emphasizes the importance of interdependence and harmonious relationships within the family system as reflected by the highly praised traditional values of filial piety and family obligations (9, 10). These values and beliefs are still very evident in contemporary Chinese family structures. Thus, the role that the family plays in individuals’ grief reactions and experiences may be even more prominent for Asian Chinese. However, little concrete information is known about the bereavement process of this specific ethnic group as the majority of past bereavement research have focused strictly on the Western Caucasian population (11), ultimately making cross-cultural comparisons an impossibility. All of the aforesaid coupled with the growing consensus that traditional models of coping with loss and existing clinical interventions for bereavement are inadequate given our lack of understanding with regards to different patterns of grief reaction (12), pinpoints the need to establish a sound empirical foundation for a new conceptualization of grief and bereavement. More importantly, there is an imperative need to identify specific factors that facilitate bereavement resilience amongst people of different ethical backgrounds as such understanding would facilitate the development of more effective and culturally relevant treatment interventions for palliative care services. This proposed study is the first attempt to identify and compare the possible familial factors that facilitate coping efficacy to grief between the Western Caucasian population and the often underrepresented Asian Chinese population. Objectives (1) To compare the different mechanism that constitute bereavement resilience and related grief reactions among two samples of elderly populations of different ethnicity, including one sample of Caucasian elderly from Canada and one sample of Asian Chinese elderly from Hong Kong, so as to construct a culturally sensitive model for understanding the grieving process. (2) To identify and compare familial factors that facilitate coping efficacy to grief and bereavement resilience amongst the Chinese and Caucasian elderly population including family cohesion, adaptability, communication and filial obligations.


Project Title:When there is no Meaning: A Meaning-Oriented Approach for Understanding and Helping Bereaved Victims of the Sichuan 512 Earthquake
Investigator(s):Chan CLW, Leung PPY, Ho AHY
Department:Soc Work & Social Administration
Source(s) of Funding:Small Project Funding
Start Date:12/2008
Abstract:
Although earthquakes are among the most common and devastating natural disasters, relatively little research has been conducted on the mental health consequences of survivors in developing nations, especially on the more vulnerable groups of victims who have lost a close family member. A recent review of 36 studies that looked at the aftermath of disasters in developing nations, Norris (1) reported that natural disasters tend to be more devastating when they occur in the developing worlds, producing severe consequences on the mental health status of the general public. Particularly, factors such as lower levels of socioeconomic status and social support, and higher levels of social embeddedness – economic life is embedded in social relations in traditional societies – were all significantly related to poorer mental health outcomes. The two most frequently reported psychological morbidities among survivors of natural disaster are posttraumatic stress disorder (PTSD) and depression (2, 3). However, for victims of developing countries who have limited or no access to psychological support, especially those who lost a loved one and suffer from the feelings of grief and survivor guilt, the impact of disaster on their mental well-being may be much more intense and overwhelming. The looming outcomes of prolong and unresolved grief are the elevated risks for suicide and mortality (4). On the afternoon of May 12, 2008, an earthquake that measured 7.9 on the Richter scale hit the developing province of Sichuan in Mainland China. According to state official statistics, this devastating act of nature had caused a death toll of 69,181; 23,000 people reported missing, 373,606 injured, approximately 5 million left homeless, and more than 45 million people affected. During a recent site visit to Mianyang, one of the worst-hit cities which registered a death toll of 21,963, the research team had the opportunity to talk to a group of bereaved. The most common narrative derived from these interviews was, “It is meaningless”. The theme meaninglessness encompass an array of disheartening thoughts and emotions including multiple lost of life goals, hope, security, connectedness, sense of coherence and manageability in life, shattered world view, dismantled social network and interpersonal relationships. They could not make sense of their experiences, were caught in a state of confusion and trapped in a socio-emotional-existential vacuum; while some of them had even became incapacitated, lost the ability to articulate their loss and were frozen in a state of shock. Neimeyer (5) described in detailed about individuals’ innate need to find meaning when faced with the loss of their loved ones. The process of meaning reconstruction in bereavement support and counseling provides the platform for the bereaved person to make sense of their experience, to search for meaning of the trauma and especially on their losses, to find possible benefits and wisdoms from their pain, and to realign their priorities in order to reconstruct new goals and meaning in life. Berzoff (6) applied the psychodynamic theory on ego and object relations to further illuminate the important roles that narratives and meaning finding play in the transformation of self through grief. “Grief and bereavement can teach us lessons about living, and can offer us opportunities to make coherent what may have been incomprehensible before; grief can, under the best circumstances, change who we are, how we live and even the social conditions in which we live” (pp.126). The 512 earthquake had left behind countless bereaved victims devastated and lost in a search for meaning to enunciate their grief. In order to effectively address the needs of these victims living in the highly socially embedded context of Sichuan, a communal approach to healing is deemed more pertinent (1, 7). Moreover, in collectivistic China where personal and communal responsibility are based on reciprocity and the common good, it is of paramount importance for rebuilding communities and its people to be provided with the opportunity to express and recreate meaning while establishing a communal support structure (8). Such meaning-oriented foundation would pave the way for the development of both self-and-community efficacy, as well as the sense of dignified living after the ruin of established livelihood. However, a hasten introduction of such communal healing approach can be futile, if not dangerous without a thorough understanding of victim’s grieving experiences as well as their psychological states. Such effort is further complicated by the fact that the small clusters of mental health professionals in Sichuan and its neighborhood provinces, who are already facing great difficulties in serving the vast number of earthquake victims, have not received proper training and are ill-equipped to apply a communal or a meaning-oriented approach in their work. With all of the aforesaid, the current proposal entails an action-research project that applies a meaning-oriented approach for: 1) understanding the grieving experiences and psychological states of the bereaved victims of the Sichuan earthquake, and 2) helping the victims in point to make sense of their experiences and losses through narrations and meaning-reconstruction interviews. Concisely, 20 bereaved earthquake victims currently living in the resettlement site of DuJiangYan city will be recruited to participate in an in-dept qualitative interview comprising of 3 components: 1) a qualitative assessment of psychological functioning; 2) a narrative interview that facilitates meaning reconstruction to the experience of loss; and 3) an experiential exercise that capture metaphors on self conceptions - needs and aspirations - before and after the loss. The anticipated findings from this study will carry importance implications for developing a culturally-relevant Intervention Programme of Mass Trauma and Oral History Projects to be implemented on a communal level for helping much greater number of earthquake victims, while at the same time facilitating capacity building in Sichuan communities, and bolstering the entire disaster relief efforts. Objectives: 1) To understanding the grieving experiences and psychological states of the bereaved earthquake victims, 2) To help the bereaved victims in point to make sense of their losses through a meaning-oriented approach, 3) Apply results towards the development of a culturally-relevant Mass Trauma Intervention Programme that can be implemented on a communal level for helping greater number of Sichuan earthquake victims.


Project Title:Outstanding Research Student Supervisor Award 2008-2009
Investigator(s):Chan CLW
Department:Soc Work & Social Administration
Source(s) of Funding:Outstanding Research Student Supervisor Award
Start Date:12/2009
Abstract:
For recognizing, rewarding and encouraging exceptioal research achievements; and for strengthening the research culture of the University.


Project Title:Living and Dying with Dignity: Development of an Empirical Model of Dignified Palliative End-of-Life Care from the Personal, Familial and Cultural Perspectives
Investigator(s):Chan CLW, Ho AHY, Leung PPY
Department:Soc Work & Social Administration
Source(s) of Funding:General Research Fund (GRF)
Start Date:12/2009
Abstract:
1) To critically examine the concept of “living and dying with dignity” amongst Chinese patients with terminal cancer their family members; 2) To identify factors those enhance holistic palliative care provisions for improving the quality of care that preserves dignity amongst Chinese patients with terminal cancer and their families; and 3) Through the process of theory-building develop a culturally-specific model of dignity for the advancement of palliative care practices and theories for the Chinese population.


List of Research Outputs

Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., What does psychological autopsy study tell us about charcoal burning suicide - a new and contagious method in Asia?, Suicide and Life Threatening Behavior. 2009, 39(6): 633-638.


Researcher : Chan WSC

List of Research Outputs

Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., What does psychological autopsy study tell us about charcoal burning suicide - a new and contagious method in Asia?, Suicide and Life Threatening Behavior. 2009, 39(6): 633-638.
Wong P.W.C., Chan W.S.C., Conwell Y., Conner K.R. and Yip P.S.F., A psychological autopsy study of pathological gamblers who died by suicide, Journal of Affective Disorders. Elsevier, Oxford, ROYAUME-UNI (1979) (Revue), 2010, 120(1-3): 213-216.


Researcher : Chen EYH

Project Title:10th Biennial Winter Workshop on Schizophrenia N400 and P600 Event-Related Potential Responses to Neutral and Affect-laden Semantic Stimulus in Schizophrenic Patients 2) Predictors of Short-term Functional Outcome Following First Episode Psychosis 3) spontaneous Blink Rate in First-episode Schi Predictors of Short-term Functional Outcome Following First Episode Psychosis Spontaneous Blink Rate in First-episode Schizophrenic Patients: a Prospective Follow-up Study and Temporal Evolution of Extra-pyramidal Side-effects to Conventional Anti-psychotic Medications in First-episode Psychosis
Investigator(s):Chen EYH
Department:Psychiatry
Source(s) of Funding:URC/CRCG - Conference Grants for Teaching Staff
Start Date:02/2000
Abstract:
N/A


Project Title:2nd European Conference on Schizophrenia Research Assessing the efficacy of relapse prevention in single episode psychosis patients with stable maintenance treatment for at least one year: A double-blind randomized placebo controlled trial
Investigator(s):Chen EYH
Department:Psychiatry
Source(s) of Funding:URC/CRCG - Conference Grants for Teaching Staff
Start Date:09/2009
Abstract:
N/A


List of Research Outputs

Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., Population-attributable risk of suicide conferred by axis I psychiatric diagnoses in a Hong Kong Chinese population, Psychiatric Services. 2009, 60: 1135-1138.
Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., What does psychological autopsy study tell us about charcoal burning suicide - a new and contagious method in Asia?, Suicide and Life Threatening Behavior. 2009, 39(6): 633-638.


Researcher : Cheung KSL

Project Title:XXVI IUSSP International Population Conference Common adult longevity and compression of mortality: the M Project
Investigator(s):Cheung KSL
Department:HKJC Ctr for Suicide Research & Preventn
Source(s) of Funding:URC/CRCG - Conference Grants for Teaching Staff
Start Date:09/2009
Completion Date:10/2009
Abstract:
N/A


Project Title:Hong Kong Health Expectancy and Disease Burden Study (HEDBS)
Investigator(s):Cheung KSL, Yip PSF
Department:HKJC Ctr for Suicide Research & Preventn
Source(s) of Funding:Small Project Funding
Start Date:10/2009
Abstract:
The purpose of the proposed project: Our project aims (1) to provide a better understanding of the disability and institutionalization trend by using General Household Survey and Census data. We compute age-sex specific disability-free and institutionalization-free life expectancy and its proportion to total life expectancy by the Sullivan method; (2) to compute the life expectancies free of chronic morbidity and its proportion to total life expectancy; (3) to examine the life expectancies free of diseases (i.e. cancer, heart diseases, mental illness) and its proportion to total life expectancy and quantify the burden of diseases; (4) to make projections of future population health statuses based on the prevalence rates of the institutionalization, disability, chronic morbidity and diseases; (5) to develop a “Hong Kong Health Expectancy and Disease Burden Study” web-page that can be accessible to the public in which information, bibliography database and sets of computational tools on the healthy expectancy and disease burden are available. The key issues and problems being addressed: The relationship between the mortality level and the population health status is always intriguing social scientists, demographers, gerontologists and population economists. More than thirty years ago, Gruenberg (1977) has argued “the failures of success” that people are saved by the successful technical innovations, their prolonged lives making more “unfit” survivors living longer and placing exceeding burdens on the society. His paper highlights one of most burning questions in the research of population ageing is whether the increase in life expectancy is one of good health or of bad health, with an ever-increasing accumulation of chronic diseases and disability. To put it another way, is the lengthening of life duration along with compression of morbidity or a pandemic of chronic diseases and disabilities in which a society can achieve “the successes of success”? As old age and old people are now a commonplace in all Western and industrialized countries, many studies related to the compression or expansion of morbidity and disability have been carried out in Europe since 1980s but recent reviews of national health trends show conflicting results. The latest OECD study, reviewing trends in activities in daily living (ADL) disability at age 65 and over in 12 OECD countries during the 1990s, demonstrates that there is clear evidence of a decline in disability among elderly people in only five of the twelve countries studied: Denmark, Finland, Italy, the Netherlands, and the United States. Three countries (Belgium, Japan and Sweden) report an increasing rate and two countries (Australia, Canada) a stable rate. In France and the United Kingdom, different surveys show different trends in ADL disability (OECD, 2007). These results suggest that a decline in ADL disability may be less universal than expected. More intriguingly, the OECD study shows that ADL disability at age 65 and over ranges widely from a low 7.1% in the Netherlands (HIS) to a high of 18% in the United Kingdom (GHS survey). Disability refers, as in general, to activity limitations and participation restrictions according to the International Classification of Functioning, Disability and Health (ICF) of the World Health Organization (2001). When it is not the case, the specific definition of disability is usually provided (Robine et al. 2008). It is acknowledged today in Europe, as well as in the U.S., that the various health dimensions may follow different trends over time (Robine, 2006; Ahacic et al, 2007; Parker and Thorslund, 2007). In Japan, a recent study shows that an expansion of morbidity occurred from 1995 to 2004. The increases in life expectancy during this period were in years of poor self-rated health (Yong and Saito 2009) which are different from another study (Schoeni et al. 2006) by using functioning and disability as health measures in which there was improvements in health among the Japanese in 1993-2002. Likewise, a comparative study by Ofstedal and her colleagues (2004) showed that healthy life expectancy declined steadily with age in five Asian settings (Indonesia, the Philippines, Singapore, Taiwan and Thailand) and remained fairly stable in China when the self-assessed health is used as a measure from national surveys in the mid-1990s. They found that women generally live longer, but less healthy lives than men. However, a recent paper by Liu and others (Liu et al. 2009) showed that trends in disability-free life expectancy and severity of disability and the delayed onset of disability of disability provide evidence for the compression of morbidity among the oldest-old (i.e. age 75 and older) in China. Their study documents that Chinese older adults live longer and the increases in life expectancy were concentrated in years spent without disability. Very few studies could have found in the context of Hong Kong. Except for three local studies have been done in the last few years (Cheung and Tu 2002, Chou and Leung 2008, Law and Yip 2003), but the results suggest diverging trends in disability and morbidity in Hong Kong. Cheung and Tu (2002) have used the Central Registry Rehabilitation data on disability to compute the health expectancy by the Sullivan-based prevalence method. Their results show that Hong Kong is undergoing the compression of disability among those aged 50+ between 1991-1995 and 1996-2000. Law and Yip (2003) calculated healthy life expectancy for 191 countries by age, sex and region of the world from the WHO’s health assessment of 2000. They provide a similar conclusion that the population of Hong Kong has one of the highest healthy life expectancies at birth in the world. However, another recent study (Chou and Leung 2008) showed that the prevalence of functional limitation decreased from 4.9% in 1996 to 3% in 2000 and then increased to 6.9% in 2004. Their study suggested Hong Kong is experiencing the expansion of disability within a period of 2000-2004 among community-dwelling older persons (aged 60 and older). The diverging results suggest that the importance of data quality and data sources and different calculation method could yield the results greatly various. A more comprehensive picture of Hong Kong’s population health status and a range of health dimensions should be examined by using consistent survey and census data. (999 words)


List of Research Outputs

Cheung K.S.L., Robine J.-.M., Paccaud F. and Marazzi A., Dissecting The Compression Of Mortality In Switzerland, 1876-2005, Demographic Research. Germany, Max Planck Institute for Demographic Research, 2009, 21: 569-598.
Cheung K.S.L., Yip P.S.F., Chi I., Chui E.W.T., Leung A.Y.M., Chan F.H.W. and Chan G.M.Y., Factors Associated with Healthy Longevity - A Report from the Study of Oldest-Old and Centenarians in Hong Kong, 17th Annual Congress of Gerontology. 2009.
Cheung K.S.L. and Yip P.S.F., Hong Kong And The Pearl River Delta: Cross-boundary Demographic Dynamics And Policy Implications, 香港與珠三角: 跨境人口流動與人口政策, Journal Of Youth Studies. Hong Kong, The Journal of Youth Studies, 2010, 13(1): 3-21.
Cheung K.S.L., Yip P.S.F. and Robine J.-.M., The Study of the Demography of the Centenarian, 5-COOP 2nd symposium Geneva / Archamps, Centre de Convention. 2009.
Robine J.-.M., Cheung K.S.L. and Horiuchi S., Arthur Roger Thatcher's contributions to longevity research: A Reflexion, Demographic Research. Germany, Max Planck Institute for Demographic Research, 2010, 22(18): 539-548.
Robine J.-.M., Cheung K.S.L., Horiuchi S. and Thatcher A.R., Common Adult Longevity And Compression Of Mortality: The M Project, XXVI International Population Conference (IUSSP). 2009.
Thatcher A.R., Cheung K.S.L., Horiuchi S. and Robine J.-.M., The Compression Of Deaths Above The Mode, Demographic Research. Germany, Max Planck Institute for Demographic Research, 2010, 22(17): 505-538.
Yip P.S.F., Cheung K.S.L., Law C.K. and Tsang S.K.M., Babies Born In Hong Kong To Mainland Women And Its Policy Implications For The Government, Central Policy Unit. 2009.
Yip P.S.F., Cheung K.S.L. and Law C.K., Estimating the Number of Hong Kong Permanent Residents Worldwide and Its Distribution, Central Policy Unit. 2009.
Yip P.S.F. and Cheung K.S.L., Only If We Can Age And Live Well, Helping Hand – Dementia Seminar. 2009.


Researcher : Cheung YT

List of Research Outputs

Yip P.S.F., Cheung Y.T., Chau P.H. and Law Y.W., The impact of epidemic outbreak. The case of severe acute respiratory syndrome (SARS) and suicide among older adults in Hong Kong., Crisis: The Journal of Crisis Intervention and Suicide Prevention. 2010, 31: 86-92.


Researcher : Fu KW

Project Title:Young generation’s Internet use and civic engagement in Hong Kong and Beijing: a comparative study
Investigator(s):Fu KW
Department:Journalism & Media Studies Centre
Source(s) of Funding:Seed Funding Programme for Basic Research
Start Date:05/2010
Abstract:
International and local studies consistently show that young generation depends heavily on the internet for learning, social activities, and leisure (City University of Hong Kong, 2009; Jones & Fox, 2009). This young age cohort is usually perceived, primarily by the older adults, as less self-regulative and more susceptible to the mass media’s influences (Strasburger, Wilson, & Jordan, 2009), but meanwhile many scholars argue that unduly emphasizing the negative impacts of media is theoretically, empirically, and public-policy-wise unfounded (Livingstone, 2009). Such widespread public obsession over the negative side of media impacts, named by some as moral panic or media panic, has resulted considerable social anxieties over younger age people’s online activities, and has overwhelmingly dominated the public debate. It has thereby directed much research attention disproportionately toward studying negative effects of emerging media, examples like online violence, pornography, or internet addiction, but relatively less on investigating the opportunities gained by the internet, its pro-social, or beneficial impacts (Montgomery & Gottlieb-Robles, 2006). Internet and emerging media have been recognized as the new communication channels, especially for the younger age technology-savvy generation, to facilitate their civic participation and involvement into the process of public decision making unprecedentedly (Dahlgren & Olsson, 2008; Montgomery & Gottlieb-Robles, 2006). In a telephone survey on American adults aged 18-24 in 2008, about one in every six respondents reported that they had taken part in 2 or more than 2 civic or political activities in the past 12 months (Smith, Schlozman, Verba, & Brady, 2009). While only considering online civic activities by means of blogging political contents or making political use of social networking sites, this report read, “What is most unambiguous is that posting material about political or social issues on the Web and using social networking sites politically are forms of online engagement that are dominated by the young—especially the youngest adults” (Smith, et al., 2009, p. 50). However, there is currently very limited research about youth’s online civic engagement in Hong Kong and China. For example, recent incidents in Hong Kong (Express Rail Link) and China (Google's threat to withdraw from China) have triggered much discussion about young people’s involvement in social issues and public protests, in which the participants were mainly mobilized through Internet. How some contextual factors in these two places, like political censorship in China and the new “post-80s” generation in China/Hong Kong, play their role in shaping the young people’s civic engagement is an important research question. Another interesting but unaddressed issue is whether these Hong Kong or Chinese young age people behave in same online manner and identical features cross-culturally as do their counterparts in other countries. To what extent do they exhibit similarities and differences is worth asking through conducting comparative research to address “the question of universality and simultaneously, uniqueness of findings based on nation-specific data, which cannot be answered unless we compare them with the data from other countries (Hasebrink, Ólafsson, & Štětka, 2009, p. 44).” In this regard, this proposal outlines a research project aimed at exploring the ways in which the internet and the new media could (or could not) enable/empower/enlighten the young generation to engage in civic participation with respect to the unique and specific social and cultural contexts in Hong Kong and China. Conceptualizing Online Civic Engagement With the characteristics of robustness, interactivity, rapid information dissemination, and globally borderless, the internet is routinely conceived by the public and many scholars as an major ingredient of a new political sphere for civic participation, which is usually anchored within the boundaries of democratic system and traditional party politics. Online civic participants no longer act as a passive media receiving end of political information and knowledge, but could be also an active initiator or contributor to the online political discussions. These activities could potentially challenge the normative model of public agenda-setting, serving as emerging agenda-setters via bottom-up approach but no longer through the dominant top-down approach mainly initiated by the mainstream mass media, political parties, or the governments. However, while focusing too much on the power of the internet, such view could easily invite criticisms, like “naïve Internet-optimism” (Laer & Aelst, 2010, p. 248) or technological determinism, which is a notion that excessive emphasis is put on the side of technology per se but not on the broader scope of socio-cultural contexts. Another dimension of apprehending online civic engagement is its role on identity construction, particularly during the life course of young people. As put by Dahlgren & Olsson (2008, p. 496), many young people in modern society tend to spend much time and energy on “identity work”, which is defined as their effort that “they are engaged in formulating who they are, what life goals they want to strive for, what their vocational calling will be.” By encouraging young people to articulate their views and self-expression online, Internet is able to offer multiple virtual platforms and networks for them to establish social groupings and identities, to build up capacity of being social agents, and to discover or recover their social position and meaning for the peers, the communities, and the society at large. Dahlgren & Olsson (2008) suggests that civic engagement, as reflected by the civic culture, could be conceptualized as six dimensions with mutual reciprocal relationships: 1) knowledge, 2) values, 3) trust, 4) spaces, 5) practices and skills, and 6) identities. This framework will help us in this study develop the conceptual model for addressing the following research questions. Research Questions 1) How can the internet facilitate civic participation among young age people with different demographic, socio-cultural and psycho-social backgrounds in Hong Kong and China? 2) In what ways and to what extent do the six dimensions and other contextual factors play their role in shaping young people’s online civic participation? 3) What are the similarities and differences in civic engagement between Hong Kong and Mainland Chinese young people and why? 4) What are the similarities and differences in civic engagement between Chinese and American young people and why?


Project Title:International Communication Association Annual Conference 2010 (ICA 2010) Is Internet Addiction a Distinct Construct From Other Psychopathological Conditions? Evidence From a Panel Study on a Representative Sample in Hong Kong, China
Investigator(s):Fu KW
Department:Journalism & Media Studies Centre
Source(s) of Funding:URC/CRCG - Conference Grants for Teaching Staff
Start Date:06/2010
Completion Date:06/2010
Abstract:
N/A


List of Research Outputs

Fu K.W. and Yip P.S.F., Estimating the risk for suicide following the suicide deaths of 3 Asian entertainment celebrities: a meta-analytic approach, Journal of Clinical Psychiatry. 2009, 70(6): 869-878.


Researcher : Law CK

Project Title:An evaluative study on the efficacy of Emergency Medicine wards for deliberate self-harm patients in Tuen Mun Hospital of Hong Kong
Investigator(s):Law CK, Yip PSF, Law YW
Department:HKJC Ctr for Suicide Research & Preventn
Source(s) of Funding:Small Project Funding
Start Date:01/2009
Abstract:
Introduction Suicide has become an important health issue for Hong Kong [1] with mortality rates on the rise since 1997. Suicide is now the leading cause of death among those aged 15–34 and ranks sixth as the leading cause of death for the general population (1) while placing a greater economic burden on the Government and the economy in terms of medical cost and loss of labor productivity (2). For this reason, an effective strategy for suicide prevention is necessary to benefit both individuals and the society they live in. Previous studies on suicide, using community samples [3, 4] and clinical samples [5, 6] have identified a number of risk factors that are associated with suicidal behaviors. Among those risk factors, attempted suicide is the strongest predictor of suicide as it has been estimated that one-third to two-thirds of those completed suicide had attempted before [7]. In the area of suicide prevention for higher risk individuals, it has been widely recognized that lacking a comprehensive initial assessment, communication among professionals and organization of care are major problems in providing appropriate and timely psychiatric treatment and referrals for deliberate self-harm (DSH) patients when they attend the emergency medicine unit of hospital. To facilitate a short-term basis for monitoring and integrated treatments that permit concentration of emergency activity and resources in one area [8], the British Association of Accident and Emergency Medicine (BAEM) has recommended that setting up an observation and assessment wards at the emergency medicine department that provide one short stay bed for every 5000 attendances can improve the overall working efficiency and minimize disruption and burden to other medical services in hospitals [8, 9]. In view of that, the Hospital Authority of Hong Kong has launched a pilot scheme to set up an Emergency Medicine ward (EM ward) in the Acute and Emergency Department (A&ED) at Tuen Mun Hospital (TMH) and Queen Elizabeth Hospital (QEH) since 2003, in which urgent psychiatric consultation is available for patients in need, including those attended to A&ED by DSH. After accessed by psychiatrists with short-term care, DSH patients at lower risk with limited medical needs [10] are allowed to be discharged home with referral to psychiatric out-patient clinic and/or other services offered by psychiatric nurses and medical social workers. The short stay at EM ward can allow multi-disciplinary professionals coordinate proactively with each others so that DSH patients will receive timely psychiatric treatment, and be referred properly to ensure their drug compliance and follow-up treatment. Also, the new service enables physicians to make preparation and important decisions regarding diagnosis and follow-up treatments during the short stay in EM ward [8, 11] and this can minimize the chance of inappropriate admissions [12], in comparing with traditional practice which all DSH patients would be directly admitted to different medical wards in the hospital. Such short stay at EM ward is considered to be a more efficient and cost-effective practice in general so as to relieve the overall pressure on medical and psychiatric staff in hospital [8, 13-15]. (b) Goal and Objectives In the proposed study, we aim to understand the pattern and trend of attempted suicide in our study area and also find out whether setting up an Emergency Medicine ward (EM ward) in a hospital can effectively alleviate the overall health burden of medical practitioners that arise from deliberate self-harm (DSH) and also to examine whether the psychiatric and related services delivered by EM ward can reduce the risk of reattempting any life-threatening behaviors for DSH attempters upon discharge.


List of Research Outputs

Law C.K., Yip P.S.F. and Caine E.D., The contribution of charcoal burning to the rise and decline of suicides in Hong Kong from 1997-2007, Social Psychiatry and Psychiatric Epidemiology. 2010, Epub ahead of print.
Yip P.S.F., Cheung K.S.L., Law C.K. and Tsang S.K.M., Babies Born In Hong Kong To Mainland Women And Its Policy Implications For The Government, Central Policy Unit. 2009.
Yip P.S.F., Cheung K.S.L. and Law C.K., Estimating the Number of Hong Kong Permanent Residents Worldwide and Its Distribution, Central Policy Unit. 2009.


Researcher : Law YW

List of Research Outputs

Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., Population-attributable risk of suicide conferred by axis I psychiatric diagnoses in a Hong Kong Chinese population, Psychiatric Services. 2009, 60: 1135-1138.
Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., What does psychological autopsy study tell us about charcoal burning suicide - a new and contagious method in Asia?, Suicide and Life Threatening Behavior. 2009, 39(6): 633-638.
Yip P.S.F., Law C.K., Fu K.W., Law Y.W., Wong P.W.C. and Xu Y., Restricting the means of suicide by charcoal burning, British Journal of Psychiatry. UK, The Royal College of Psychiatrists, 2010, 196(3): 241-242.
Yip P.S.F., Cheung Y.T., Chau P.H. and Law Y.W., The impact of epidemic outbreak. The case of severe acute respiratory syndrome (SARS) and suicide among older adults in Hong Kong., Crisis: The Journal of Crisis Intervention and Suicide Prevention. 2010, 31: 86-92.
Yip P.S.F. and Law Y.W., Towards Evidence-based Suicide Prevention Programmes. Geneva, World Health Organization, 2010, 1-77.


Researcher : Wong PWC

Project Title:A multidisciplinary and integrated programme to promote and care for suicide and attempted suicide within the Eastern District
Investigator(s):Wong PWC
Department:HKJC Ctr for Suicide Research & Preventn
Source(s) of Funding:Health Care and Promotion Fund - Research Grant Projects
Start Date:05/2010
Abstract:
To generate a shared understanding of identified problems as well as a readiness among the community stakeholders to tackle the problems of suicide and related mental health issues; facilitate the implemenation of a series of coordinated and multi-layered strategies for mental health promotion with measurable outcomes; increase public awareness and knowledge about the signs and symptoms of psychiatric diseases and suicide, and to de-stigmatize mental illness and suicide; evaluate and document the effectiveness of the project to make recommendations for other districts with similar concerns; and formulate an effective referral framework for deliberate self-harm patients and find out the best practice for suicide prevention using a community-based approach. the ultimate aim is to examine the effectiveness of the community-based approach in suicide prevention in order to develop evidence-based recommendations for other districts of similar concern.


List of Research Outputs

Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., Population-attributable risk of suicide conferred by axis I psychiatric diagnoses in a Hong Kong Chinese population, Psychiatric Services. 2009, 60: 1135-1138.
Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., What does psychological autopsy study tell us about charcoal burning suicide - a new and contagious method in Asia?, Suicide and Life Threatening Behavior. 2009, 39(6): 633-638.
Fu K.W., Chan W.S.C., Wong P.W.C. and Yip P.S.F., Internet addiction: prevalence, discriminant validity and correlates among adolescents in Hong Kong, British Journal of Psychiatry. UK, The Royal College of Psychiatrists, 2010, 196: 486–492.
Wong P.W.C., Chan W.S.C., Conwell Y., Conner K.R. and Yip P.S.F., A psychological autopsy study of pathological gamblers who died by suicide, Journal of Affective Disorders. Elsevier, Oxford, ROYAUME-UNI (1979) (Revue), 2010, 120(1-3): 213-216.
Wong P.W.C., Suicidology On-line. US, 2010.
Yip P.S.F., Cheung K.S.L., Tsang S.K.M., Wong P.W.C., Tse S.S.K., Wong O.L., Laidler K.A. and Wong L., Drug Abuse Among Youths and Family Relationship , 青年濫藥與家庭關係的研究, Central Policy Unit. 2010.
Yip P.S.F., Law C.K., Fu K.W., Law Y.W., Wong P.W.C. and Xu Y., Restricting the means of suicide by charcoal burning, British Journal of Psychiatry. UK, The Royal College of Psychiatrists, 2010, 196(3): 241-242.


Researcher : Yip PSF

Project Title:22nd World Congress of the International Association for Suicide Preventation (IASP) Social Burden of Suicide Risk in Hong Kong
Investigator(s):Yip PSF
Department:Statistics & Actuarial Science
Source(s) of Funding:URC/CRCG - Conference Grants for Teaching Staff
Start Date:09/2003
Abstract:
N/A


Project Title:IBC 2004 XXIInd International Biometric Conference in Parallel with ASC 2004 Australian Statistical Conference A Unification Method of Estimating Population Size via Capture-recapture Experiments
Investigator(s):Yip PSF
Department:Statistics & Actuarial Science
Source(s) of Funding:URC/CRCG - Conference Grants for Teaching Staff
Start Date:07/2004
Abstract:
N/A


Project Title:XVIII World Congress of the International Association for Suicide Prevention Suicide in Three Chinese Communities: China, Taiwan and Hong Kong
Investigator(s):Yip PSF
Department:Statistics & Actuarial Science
Source(s) of Funding:URC/CRCG - Conference Grants for Teaching Staff
Start Date:09/2005
Abstract:
N/A


Project Title:HKU Overseas Fellowship Awards 2009-10
Investigator(s):Yip PSF
Department:Soc Work & Social Administration
Source(s) of Funding:HKU Overseas Fellowship Awards
Start Date:09/2009
Abstract:
To visit the University of Melbourne, Australia to conduct collaborative projects on modeling of the contagious effect of mass media reporting and suicide, assessing the effect of exclusion period among life insured, monitoring and surveillance system for public health event, and geographical information system modeling and teaching innovation.


Project Title:Outstanding Researcher Award 2008-2009
Investigator(s):Yip PSF
Department:Soc Work & Social Administration
Source(s) of Funding:Outstanding Researcher Award
Start Date:12/2009
Abstract:
The Awards are intended to recognize, reward, and promote exceptional research accomplishments of academic and research staff.


Project Title:A Comparative Study on Quality of Suicide Prevention Websites in Hong Kong, Taiwan, and Mainland China
Investigator(s):Yip PSF
Department:Soc Work & Social Administration
Source(s) of Funding:Small Project Funding
Start Date:12/2009
Abstract:
Increasing number of people is using the Internet to access health related, including suicide prevention related, information and services. Correspondingly, concern on quality of the web-based information is also growing. However, studies on quality of web-based information are imbalanced between information available in English and in Chinese, as well as between information about physical and mental health. In the west, there are continuing studies on evaluating quality of health websites and testing validity of criteria and indicators of content quality, through quantitative or qualitative or both research methods. These studies addressed a consistent conclusion that it’s important to educate health websites owners as well as consumers to be aware of the importance of content quality. Furthermore, some “action” initiatives have been developed. Guidelines or quality criteria for health related websites have been issued by organizations in America (Winker, et al., 2000) and European countries (eEurope, 2002). Quality label, as widely used HONcode, can be applied from the non-profit organization, the Health On the Net Foundation (HON). Special search engines or online catalog and index providing reliable and trustworthy results can be visited at MedHunt (Switzerland), Medical Matrix (United States), MedWebPlus (United States), HealthWeb (United States), and HealthInsite (Australia), etc. More recently, an automated quality assessment procedure (AQA)(Griffiths, Tang, Hawking, & Christensen, 2005) was designed by Australian researchers to automatically rank depression websites according to their evidence-based quality. On the other hand, studies on non-English websites, such as French (CISMeFteam, 2007; Darmoni, Thirion, J.P., Douyere, & Piot, 2001) and Japanese(Goto, et al., 2009; Nemoto, et al., 2007) websites, have also been published. However, studies on websites in the language of Chinese are rare. Among Mainland China, Hong Kong, and Taiwan, Taiwan shows the highest awareness of quality of online health related information, which also has the most websites obtaining HONcode among the three regions. One study in Taiwan(Sing-Ling & Sin-Kuo, 2005) developed an evaluation questionnaire for nursing websites and achieved a positive conclusion on its validation. One study in Hong Kong(Yan, 2008) explored Hong Kong Internet users’ online health information seeking behavior and their confidence on health information obtained. The researcher also summed up several major criteria for health websites from questionnaire survey. The study showed that 44% of 443 participants were uncertain about the reliability of the health information that they obtained from the Internet, whereas 41% of them thought the information was reliable. Compared with Hong Kong and Taiwan, quality of health related websites seems to be relatively poor. Two Chinese papers(Li, 2004; Su, Li, & Wan, 2006) reviewed websites of centers for disease control and prevention in different administrative levels in Mainland China. They found that most of these websites are disorganized, unable to determine source and last update of information, lacking information about authorship, lacking localized and original information, lacking interactivity, and not user-friendly. However, the evaluation of these two papers was based on authors’ subjective review rather than evidence-based criteria or indicators. Another study (Ou, Zhao, & Liao, 2006) introduced HONcode briefly to its readers in Mainland China and suggested Chinese health websites to adopt it. According to the study, although HONcode has already translated into Chinese, there are very few websites from Mainland China and Hong Kong but several websites from Taiwan obtaining the certification. If we divide health related websites into physical health related and mental health related, there are much fewer studies focusing on the latter in particular. In mental health field, quality of web-based information about depression is relatively often studied (Belcher & Holdcraft, 2001; Griffiths, et al., 2005; Nemoto, et al., 2007) and the quality was found to be generally poor. If we take a closer look at websites about suicide prevention, so far there is no study focusing on evaluation of quality of these websites at all. Several studies(Biddle, Donovan, Hawton, Kapur, & Gunnell, 2008; Recupero, Harms, & Noble, 2008) examined online suicide related information by searching through popular search engines and showed that some encouraging suicide websites can be easily searched out and have quite high rankings in the search result list. To reduce the potential harm to vulnerable people, filtering or censorship on pro-suicide information is practically inefficient and sensitive on ethical and legal issues. Therefore, researchers in suicide prevention field (Becker, Mayer, Nagenborg, El-Faddagh, & Schmidt, 2004; Bell, 2007; Mishara & Weisstub, 2007) widely suggested that it would be effective to create and promote more qualified suicide prevention information online to counterbalance potential harmful information that may encourage vulnerable people to commit suicide. Recently, we have conducted a comparative study on online suicide related information in simplified Chinese and English, which is under reviewing by the Journal of Clinical Psychiatry. We found that it is more notably lack of qualified and professional suicide prevention information in Chinese websites, compared with English websites. For further study, we suggested to examine quality of suicide prevention websites carefully and sum up valid criteria for the quality evaluation. In the proposed study, we will review websites about suicide prevention in particular and will include websites not only from Mainland China, but also from Hong Kong and Taiwan. Our first aim is to evaluate quality of web based information on suicide prevention in Chinese, including simplified Chinese and traditional Chinese, and conduct a comparison between the three regions. In addition, we aim to identify valid indicators of quality of suicide prevention websites in Chinese.


List of Research Outputs

Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., Population-attributable risk of suicide conferred by axis I psychiatric diagnoses in a Hong Kong Chinese population, Psychiatric Services. 2009, 60: 1135-1138.
Chan S.S.M., Chiu H.F.K., Chen E.Y.H., Chan W.S.C., Wong P.W.C., Chan C.L.W., Law Y.W. and Yip P.S.F., What does psychological autopsy study tell us about charcoal burning suicide - a new and contagious method in Asia?, Suicide and Life Threatening Behavior. 2009, 39(6): 633-638.
Cheung K.S.L., Yip P.S.F., Chi I., Chui E.W.T., Leung A.Y.M., Chan F.H.W. and Chan G.M.Y., Factors Associated with Healthy Longevity - A Report from the Study of Oldest-Old and Centenarians in Hong Kong, 17th Annual Congress of Gerontology. 2009.
Cheung K.S.L. and Yip P.S.F., Hong Kong And The Pearl River Delta: Cross-boundary Demographic Dynamics And Policy Implications, 香港與珠三角: 跨境人口流動與人口政策, Journal Of Youth Studies. Hong Kong, The Journal of Youth Studies, 2010, 13(1): 3-21.
Cheung K.S.L., Yip P.S.F. and Robine J.-.M., The Study of the Demography of the Centenarian, 5-COOP 2nd symposium Geneva / Archamps, Centre de Convention. 2009.
Cheung K.S.L. and Yip P.S.F., Trends In Dementia-free Life Expectancy In Hong Kong Sar, 22nd Reves Conference: Public Health Intervention To Increase Health Expectancies . 2010.
Claassen C.A., Yip P.S.F., Corcoran P., Bossarte R.M., Lawrence B.A. and Currier G.W., National suicide rates a century after Durkheim: do we know enough to estimate error?, Suicide and Life Threatening Behavior. 2010, 40(3): 193-223.
Fong D.Y.T., Lee C.F., Cheung K.M.C., Cheng J.C.Y., Ng B.K.W., Lam T.P., Mak K.H., Yip P.S.F. and Luk K.D.K., A meta-analysis of the clinical effectiveness of school scoliosis screening, Spine (Phila Pa 1976). 2010, 35(10): 1061-1071.
Fu K.W. and Yip P.S.F., Estimating the risk for suicide following the suicide deaths of 3 Asian entertainment celebrities: a meta-analytic approach, Journal of Clinical Psychiatry. 2009, 70(6): 869-878.
Law C.K., Yip P.S.F. and Caine E.D., The contribution of charcoal burning to the rise and decline of suicides in Hong Kong from 1997-2007, Social Psychiatry and Psychiatric Epidemiology. 2010, Epub ahead of print.
Lee C.F., Fong D.Y.T., Cheung K.M.C., Cheng J.C.Y., Ng B.K.W., Lam T.P., Mak K.H., Yip P.S.F. and Luk K.D.K., Costs of School Scoliosis Screening: A Large, Population-Based Study, Spine (Phila Pa 1976). 2010, Epub ahead of print.
Wong P.W.C., Chan W.S.C., Conwell Y., Conner K.R. and Yip P.S.F., A psychological autopsy study of pathological gamblers who died by suicide, Journal of Affective Disorders. Elsevier, Oxford, ROYAUME-UNI (1979) (Revue), 2010, 120(1-3): 213-216.
Yip P.S.F. and Cheung K.S.L., Chronic Diseases: Challenges And Opportunities, International Conference On Promoting Chronic Care. 2010.
Yip P.S.F. and Cheung K.S.L., Demography And Dementia, Alzheimer's Disease Conference: From Public Health To Therapeutic Insights. 2010.
Yip P.S.F., Cheung K.S.L., Tsang S.K.M., Wong P.W.C., Tse S.S.K., Wong O.L., Laidler K.A. and Wong L., Drug Abuse Among Youths and Family Relationship , 青年濫藥與家庭關係的研究, Central Policy Unit. 2010.
Yip P.S.F. and Cheung K.S.L., Only If We Can Age And Live Well, Helping Hand – Dementia Seminar. 2009.
Yip P.S.F., Law C.K., Fu K.W., Law Y.W., Wong P.W.C. and Xu Y., Restricting the means of suicide by charcoal burning, British Journal of Psychiatry. UK, The Royal College of Psychiatrists, 2010, 196(3): 241-242.
Yip P.S.F., Cheung Y.T., Chau P.H. and Law Y.W., The impact of epidemic outbreak. The case of severe acute respiratory syndrome (SARS) and suicide among older adults in Hong Kong., Crisis: The Journal of Crisis Intervention and Suicide Prevention. 2010, 31: 86-92.
Yip P.S.F. and Law Y.W., Towards Evidence-based Suicide Prevention Programmes. Geneva, World Health Organization, 2010, 1-77.


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