Declining suicide rates in China (1990-2017): Gender and age specific analyses.

BACKGROUND: In China suicide rates have been declining for about three decades. Patterns of suicide for women and men across the lifespan over time however have not been systematically documented. METHODS: Official suicide mortality data (from 1990 to 2017) available via China CDC were used to examine suicide patterns by gender and age in each of the 33 provincial-level regions. Suicide data were aggregated by five years, except for the year of 2017. The bar graphs were used to descriptive the change tread of the suicide rate. RESULTS: In the past three decades, the decline in female suicide rates was greater than that in the male rates, with the overall male to female (M/F) ratio changing from 0.88 in 1996 to 1.56 in 2017. The overall suicide rate of male was 8.82 and female was 5.65 per 100,000 persons in 2017. However the decline of suicide rates for people aged 70 and older was the greatest declination (33.73/per 100,000 persons) among all the age groups in China. CONCLUSION: Overall suicide rates have declined over the three decades in China, particularly among females and individuals age 70+ years. Suicide rates continue to be higher among individuals aged 50 and older (particularly among men), and this population should continue to the focus for prevention.

The temporal trend of road traffic mortality in China from 2004 to 2020.

Background: Road traffic accidents are one of the critical disasters that cause massive negative influences to the social economy and people's property, health and life safety. The purpose of this study is to analyze the temporal trend of road traffic mortality in China from 2004 to 2020, and further analyze the key factors that the influencing changes in China's road traffic mortality and provides information for the development of targeted interventions to reduce the number of preventable deaths. Methods: The data were retrieved from the Chinese Death Cause Monitoring Data Set from 2004 to 2020. The road traffic mortality rates were standardized by the Sixth National Population Census (6th NPC) data. Joinpoint regression method was manipulated to analyze temporal trends of standardized road traffic mortality. The study used annual percentage change (APC) and average annual percentage change (AAPC) calculated by the Joinpoint regression model to describe trends in road traffic mortality rates. Results: The overall age-adjusted road traffic mortality in China showed a declining trend from 2004 to 2020 (AAPC2004-2020 = - 4.2%), from 20.9 to 12.92 per 100,000. Rural road traffic mortality rates were generally higher than the one in urban areas, and males were generally higher than females. There was an overall downward trend of the standardized road traffic mortality in the East and Central regions between 2004 and 2020. It was worth noting that the road traffic mortality rates in the Western region showed an upward trend from 2006 to 2011 (APC2006-2011 = 3.3%) and continued to decline after 2011 (APC2011-2020 = - 6.7%). The road traffic mortality rates of aged 65 years and older was highest, which required focused attention. Conclusions: From 2004 to 2020, the road traffic mortality rates in China generally declined. At the same time, there was a slow reduction or even an upward trend in road traffic mortality rates among the elderly and in western regions. Rural males are a priority group for road traffic injury prevention.

A mutational signature and significantly mutated driver genes associated with immune checkpoint inhibitor response across multiple cancers.

Immune checkpoint inhibitor (ICI) treatments dramatically prolong the survival outcomes of several advanced cancers. However, as multiple studies reported, only a subset of patients could benefit from the ICI treatment. In this study, we aim to uncover novel molecular biomarkers predictive of immunotherapy efficacy across multiple cancers. Pre-treatment somatic mutational profiles and immunotherapy clinical information were obtained from 1097 samples of multiple cancers, including melanoma, non-small cell lung cancer (NSCLC), clear cell renal cell carcinoma (ccRCC), bladder carcinoma (BLCA), and head and neck squamous cell carcinoma (HNSCC). Mutational signatures, molecular subtypes, and significantly mutated genes (SMGs) were determined, and their connections with ICI response and outcome were also evaluated. We extracted a total of six mutational signatures across all samples. Among, a mutational signature featured by T > C substitutions was identified to associate with an ICI resistance. A molecular subtype determined based on mutational activities was connected with a significantly improved ICI response rate and outcome. Totaling 50 SMGs were identified, and we observed that patients with COL11A1 or COL4A6 mutations exhibited a superior ICI treatment efficacy than those without such mutations. In this study, we uncovered several novel molecular determinants of cancer immunotherapy response under a multiple-cancer setting, which provides clues for enrolling patients to receive immunotherapy and customizing personalized treatment strategies.

Economic Development and Gender Ratio Change in Chinese Suicide Rates (1990-2017).

Objective: The overall gender ratio in Chinese suicide rates has substantially changed during the past three decades. In this study, we investigated the social economic factors and the mechanisms that may be contributing to this fluctuation. Study Design: This is a secondary analysis using suicide mortality data from the China Centers for Disease Control and Prevention. Methods: A statistical model was performed with province as the unit of analysis. The per capita GDP and income of each provincial-level region were collected from the Economic and Statistical Yearbook. Rate and ratio were used to describe the trend of variations, and correlation analyses were conducted to examine the association between economic development and gender ratio change. Results: The China overall male to female gender ratio of suicide rates increased as the GDP per capita grew (r = 0.439; p = 0.015). The gender ratio changed from 0.88 in 1990 to 1.56 in 2017, with the reversion point between 1995 and 2000. The most radical reverse changes in the gender ratios were found in large municipalities. Conclusions: Cultural and social economic variables may explain the gender ratio changes. Increased economic development has significantly reduced psychological strains on rural young women, which in turn decreased the suicide rate among this sub-population.

Fatty Acid Synthase Mutations Predict Favorable Immune Checkpoint Inhibitor Outcome and Response in Melanoma and Non-Small Cell Lung Cancer Patients.

Fatty acid synthase (FASN) acts as the central member in fatty acid synthesis and metabolism processes, which regulate oncogenic signals and tumor immunogenicity. To date, no studies have reported the connection of FASN mutations with ICI efficacy. In this study, from 631 melanoma and 109 NSCLC patients who received ICI treatments, we retrospectively curated multiomics profiles and ICI treatment data. We also explored the potential molecular biological mechanisms behind FASN alterations. In melanoma patients, FASN mutations were observed to associate with a preferable immunotherapeutic prognosis and response rate (both p < 0.01). These connections were further corroborated by the NSCLC patients (both p < 0.01). Further analyses showed that a favorable tumor immunogenicity and immune microenvironment were involved in FASN mutations. This work confirms the clinical immunotherapy implications of FASN mutation-mediated fatty acid metabolism and provides a possible indicator for immunotherapy prognosis prediction.

Prediction model for suicide based on back propagation neural network and multilayer perceptron.

Introduction: The aim was to explore the neural network prediction model for suicide based on back propagation (BP) and multilayer perceptron, in order to establish the popular, non-invasive, brief and more precise prediction model of suicide. Materials and method: Data were collected by psychological autopsy (PA) in 16 rural counties from three provinces in China. The questionnaire was designed to investigate factors for suicide. Univariate statistical methods were used to preliminary filter factors, and BP neural network and multilayer perceptron were employed to establish the prediction model of suicide. Results: The overall percentage correct of samples was 80.9% in logistic regression model. The total coincidence rate for all samples was 82.9% and the area under ROC curve was about 82.0% in the Back Propagation Neural Network (BPNN) prediction model. The AUC of the optimal multilayer perceptron prediction model was above 90% in multilayer perceptron model. The discrimination efficiency of the multilayer perceptron model was superior to BPNN model. Conclusions: The neural network prediction models have greater accuracy than traditional methods. The multilayer perceptron is the best prediction model of suicide. The neural network prediction model has significance for clinical diagnosis and developing an artificial intelligence (AI) auxiliary clinical system.

HSPG2 Mutation Association with Immune Checkpoint Inhibitor Outcome in Melanoma and Non-Small Cell Lung Cancer.

Immune checkpoint inhibitors (ICIs) markedly promote the survival outcome of advanced melanoma and non-small cell lung cancer (NSCLC). Clinically, favorable ICI treatment efficacy is noticed only in a smaller proportion of patients. Heparan sulfate proteoglycan 2 (HSPG2) frequently mutates in both tumors. Herein, we aim to investigate the immunotherapeutic and immunological roles of HSPG2 mutations in melanoma and NSCLC. A total of 631 melanoma samples and 109 NSCLC samples with both somatic mutational profiles and clinical immunotherapy data were curated. In addition, by using The Cancer Genome Atlas data, genomic and immunological traits behind HSPG2 mutations were elucidated. Melanoma patients with HSPG2 mutations had a markedly extended ICI outcome than other patients. An association between HSPG2 mutations and the improved outcome was further confirmed in NSCLC. In addition, an elevated ICI response rate was presented in HSPG2-mutated NSCLC patients (81.8% vs. 29.7%, p = 0.002). Subsequent analyses revealed that HSPG2-mutated patients had a favorable abundance of response immunocytes, an inferior abundance of suppression immunocytes, enhanced mutational burden, and interferon response-relevant signaling pathways. We uncovered that HSPG2 mutations were predictive of a better ICI response and associated with preferable immunogenicity, which may be considered as a genomic determinant to customize biotherapy strategies.

The Causes of Death and Their Influence in Life Expectancy of Children Aged 5-14 Years in Low- and Middle-Income Countries From 1990 to 2019.

Introduction: Although child and adolescent health is the core of the global health agenda, the cause of death and its expected contribution to life expectancy (LE) among those aged 5-14 are under-researched across countries, especially in low- and middle-income countries (LMICs). Methods: Death rates per 10 years age group including a 5-14-year-old group were calculated by the formula, which used the population and the number of deaths segmented by the cause of death and gender from the 2019 Global Burden of Disease (GBD) study. LE and cause-eliminated LE in 10-year intervals were calculated by using life tables. Results: In 2019, the global mortality rate for children and adolescents aged 5-14 years was 0.522 (0.476-0.575) per 1,000, and its LF was 71.377 years. In different-income regions, considerable heterogeneity remains in the ranking of cause of death aged 5-14 years. The top three causes of death in low-income countries (LICs) are enteric infections [0.141 (0.098-0.201) per 1,000], other infectious diseases [0.103 (0.073-0.148) per 1,000], and neglected tropical diseases and malaria [0.102 (0.054-0.172) per 1,000]. Eliminating these mortality rates can increase the life expectancy of the 5-14 age group by 0.085, 0.062, and 0.061 years, respectively. The top three causes of death in upper-middle income countries (upper MICs) are unintentional injuries [0.066 (0.061-0.072) per 1,000], neoplasm [0.046 (0.041-0.050) per 1,000], and transport injuries [0.045 (0.041-0.049) per 1,000]. Eliminating these mortality rates can increase the life expectancy of the 5-14 age group by 0.045, 0.031, and 0.030 years, respectively. Conclusion: The mortality rate for children and adolescents aged 5-14 years among LMICs remains high. Considerable heterogeneity was observed in the main causes of death among regions. According to the main causes of death at 5-14 years old in different regions and countries at different economic levels, governments should put their priority in tailoring their own strategies to decrease preventable mortality.

Towards Higher Psychometric Properties: Testing the Psychological Strain Scales with Larger Samples.

This study aimed to further test the psychometric properties of the Psychological Strain Scales (PSS) with larger samples. A cluster sampling method was employed to recruit 13,250 college students from seven provinces in China. Descriptive statistics, item statistics, Cronbach's alpha, factor analysis, and correlation analysis were evaluated. Cronbach's alpha coefficient was 0.958 and Guttman's split-half coefficient was 0.866. All the item-total correlations were larger than 0.45 except one. Results from Exploratory Factor Analysis and Confirmatory Factor Analysis supported the four dimensions of psychological strains (value strain, aspiration strain, deprivation strain, and coping strain). The PSS was strongly correlated to the Depression, Anxiety, and Stress Scale (DASS-21), which was commonly used to measure risk for suicide and was predictive ofsuicidality as measured by the SBQ-R. The PSS was a self-report instrument with high reliability and validity which could be applied for extensive use in research to measure psychological strains.HighlightsThis is the first study testing the psychometric properties of the PSS in an unusually large sample.Confirmatory factor analysis was applied to provide empirical evidence to the four-factor structure of the PSS.Psychological strains were found to be significantly correlated with depression, anxiety, and stress symptoms and predictive of suicidality.

Changes and explanations of suicide rates in China by province and gender over the past three decades.

OBJECTIVES: This study is aimed to summarize the declining trends of suicide rates by gender in China and in each of its provinces, and to explain the changes from a public health perspective. STUDY DESIGN: This is a study with existing data. METHODS: Data of suicide mortality were provided by China CDC (1990 to 2017). Data of suicide in each of the 33 provinces were aggregated every five years, except for the year of 2017. A statistical model was performed with the provincial region as the unit of analysis. RESULTS: The overall suicide rate in China decreased from 20.9/100,000 in 1990 to 7.2 in 2017, marking a decrease of suicide rate in China by 65%. The gender ratio has increase from 0.88 in 1990 to 1.56 in 2017. Suicide rates have been going down in each of the 33 provinces. The national suicide rates are negatively correlated with GDP per capita, population density, and life expectancy, but positively related to rural population density. CONCLUSIONS: The reduction of suicide rates in China is explained by the reduction of psychological strains which is a consequence of the fast-growing economy in the country. Given its large population and rapid decrease of the suicide deaths, China contributed to the global reduction of suicide mortalities.

An aging-related signature predicts favorable outcome and immunogenicity in lung adenocarcinoma.

Aging has been demonstrated to play vital roles in the prognosis and treatment efficacy of cancers, including lung adenocarcinoma (LUAD). This novel study aimed to construct an aging-related risk signature to evaluate the prognosis and immunogenicity of LUAD. Transcriptomic profiles and clinical information were collected from a total of 2518 LUAD patients from 12 independent cohorts. The risk signature was developed by combining specific gene expression with the corresponding regression coefficients. One cohort treated with the immune checkpoint inhibitor (ICI) was also used. Subsequently, a risk signature was developed based on 21 aging-related genes. LUAD patients with low-risk scores exhibited improved survival outcomes in both the discovery and validation cohorts. Further immunology analysis revealed elevated lymphocyte infiltration, decreased infiltration of immune-suppressive cells, immune response-related pathways, and favorable ICI predictor enrichment in the low-risk subgroup. Genomic mutation exploration indicated the enhanced mutation burden and higher mutation rates in significantly driver genes of TP53, KEAP1, SMARCA4, and RBM10 were enriched in patients with a low-risk signature. In the immunotherapeutic cohort, it was observed that low-risk aging scores were markedly associated with prolonged ICI prognosis. Overall, the estimated aging signature proved capable of evaluating the prognosis, tumor microenvironment, and immunogenicity, which further provided clues for tailoring prognosis prediction and immunotherapy strategies, apart from promoting individualized treatment plans for LUAD patients.

Suicide means, timing, intent and behavior characteristics of the suicides with schizophrenia.

BACKGROUND: Studies have been reported on suicide and schizophrenic suicide, but few compared certain characteristics of suicides with and without schizophrenia. METHODS: A sample of 392 suicides was consecutively recruited from 16 counties in three provinces of China. Psychological autopsy method was applied to collect the information through informants. The questionnaire of characteristics for suicidal behavior, Beck's Suicide Intent Scale (SIS), and the DSM-IV based SCID were applied. RESULTS: About 9.7% of the sampled suicides (n = 38) were diagnosed with schizophrenia, and they were more likely to be female and older in age. No significant differences were found on violent suicide means, but significant differences within non-violent means between two groups. Schizophrenic suicide was more likely to happen in the second quarter of the year (April - June), middle of the month (11th-20th), and in the afternoon (3:01 pm - 6:00 pm). The schizophrenic suicides had higher suicide intent than those without schizophrenia and were more inclined to be isolated, more likely to tell people their suicide intent, and less likely to prepare posthumous papers. CONCLUSION: Schizophrenic suicides have unique characteristics, and targeted preventive measures should be taken to prevent schizophrenic suicides. To accurately identify characteristics of suicide behavior is meaningful to prevent schizophrenic suicides in clinical practice.

Immunological and clinical immunotherapy implications of NLRP3 mutations in melanoma.

Recent studies have demonstrated the role of Nod-like receptor protein 3 (NLRP3) inflammasome in promoting melanoma progression. Immune checkpoint inhibitors (ICI) treatment dramatically extended the survival outcomes for advanced melanoma patients. Nevertheless, immunologic and immunotherapy implications of NLRP3 mutations in melanoma were obscure. Herein, we utilized publicly genomic data of 750 melanoma patients to explore the association of NLRP3 mutations with immunologic and genomic features. In addition, we curated 336 advanced/metastatic melanoma patients treated with ICI agents from 6 published studies to analyze the response rate and survival outcome in relation to NLRP3 mutations. We observed that patients with NLRP3 mutations had a significantly higher tumor mutation burden (P < 0.001) and neoantigen burden (P < 0.001). Moreover, significantly lower tumor heterogeneity (P = 0.048) and purity (P = 0.022) were also observed in this mutated subgroup. Elevated infiltration of immune-response cells, decreased enrichment of immune-suppressive cells, and immune response-related circuits were markedly enriched in patients with NLRP3 mutations. In the pooled ICI-treated cohort, NLRP3 mutations were linked with the higher response rate (P = 0.031) and preferable survival outcome (P = 0.006). NLRP3 mutations were identified to associate with the elevated mutational burden, favorable immune infiltration, and preferable ICI efficacy. Findings derived from our study suggest that NLRP3 mutations may serve as a potential biomarker for evaluating melanoma immunotherapy response.

Characteristics and Risk Factors for Suicide in People with Schizophrenia in Comparison to Those without Schizophrenia.

BACKGROUND: Little research has been conducted that compares suicide cases with and without schizophrenia. The aim of the present study was to identify demographic, personal, social, relational, and psychological characteristics among suicides identified posthumously with schizophrenia compared to those without. METHODS: The DSM-IV was used to independently assess the presence of schizophrenia among suicide cases by two psychiatrists. Data on risk factors was collected through a psychological autopsy method, which included structured interviews of two informants for each suicide case (a family member and a close friend). Interview questions included demographic characteristics, suicide risk factors, the Beck Hopelessness Scale, Dickman's Impulsivity Inventory, the Spielberger State-Trait Anxiety Inventory, the Hamilton Depression Scale and the Duke Social Support Inventory. RESULTS: The prevalence of schizophrenia was 9.69% among suicide cases in this sample. The schizophrenia suicide group was more likely to be female, older, in poorer physical health, suffer from chronic disease, suffer other psychological disorders, and have a family history of psychological disorders compared to those not diagnosed schizophrenia. Other important risk factors included more frequent past suicide attempts, increased levels of depression and anxiety, lower levels of impulsivity, lower help seeking from friends, and lower social interaction social support. CONCLUSIONS: There is a notable link between schizophrenia and suicide in China. Identification of social, personal, relational, and psychological risk factors could beneficially guide attempts to improve future preventive measures against suicide among those with schizophrenia in China.

Predictors of Undiagnosed Diabetes among Middle-Aged and Seniors in China: Application of Andersen's Behavioral Model.

Undiagnosed diabetes is a threat to public health. This study aims to identify potential variables related to undiagnosed diabetes using Andersen's behavioral model. Baseline data including blood test data from the China Health and Retirement Longitudinal Study (CHARLS) were adopted. First, we constructed health service related variables based on Andersen model. Second, univariate analysis and multiple logistic regression were used to analyze the relations of variables to undiagnosed diabetes. The strength of relationships was presented by odds ratios (ORs) and 95% confidence intervals (CIs). Finally, the prediction of multiple logistic regression model was assessed using the Receiver Operating Characteristic (ROC) curve and the area under the ROC curve (AUC). According to diagnosis standards, 1234 respondents had diabetes, among which 560 were undiagnosed and 674 were previously diagnosed. Further analysis showed that the following variables were significantly associated with undiagnosed diabetes: age as the predisposing factor; medical insurance, residential places and geographical regions as enabling factors; having other chronic diseases and self-perceived health status as need factors. Moreover, the prediction of regression model was assessed well in the form of ROC and AUC. Andersen model provided a theoretical framework for detecting variables of health service utilization, which may not only explain the undiagnosed reasons but also provide clues for policy-makers to balance health services among diverse social groups in China.

Evolutionary warning system for COVID-19 severity: Colony predation algorithm enhanced extreme learning machine.

Coronavirus Disease 2019 (COVID-19) was distributed globally at the end of December 2019 due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early diagnosis and successful COVID-19 assessment are missing, clinical care is ineffective, and deaths are high. In this study, we investigate whether the level of biochemical indicators helps to discriminate and classify the severity of the COVID-19 using the machine learning method. This research creates an efficient intelligence method for the diagnosis of COVID-19 from the perspective of biochemical indexes. The framework is proposed by integrating an enhanced new stochastic called the colony predation algorithm (CPA) with a kernel extreme learning machine (KELM), abbreviated as ECPA-KELM. The core feature of the approach is the ECPA algorithm which incorporates the two main operators that have been abstained from the grey wolf optimizer and moth-flame optimizer to improve and restore the CPA research functions and are simultaneously used to optimize the parameters and to select features for KELM. The ECPA output is checked thoroughly using IEEE CEC2017 benchmark to verify the capacity of the proposed methodology. Finally, in the diagnosis of COVID-19 using biochemical indexes, the designed ECPA-KELM model and other competing KELM models based on other optimization are used. Checking statistical results will display improved predictive properties for all metrics and higher stability. ECPA-KELM can also be used to discriminate and classify the severity of the COVID-19 as a possible computer-aided method and provide effective early warning for the treatment and diagnosis of COVID-19.

Novel Molecular Determinants of Response or Resistance to Immune Checkpoint Inhibitor Therapies in Melanoma.

Background: Immune checkpoint inhibitor (ICI) therapy dramatically prolongs melanoma survival. Currently, the identified ICI markers are sometimes ineffective. The objective of this study was to identify novel determinants of ICI efficacy. Methods: We comprehensively curated pretreatment somatic mutational profiles and clinical information from 631 melanoma patients who received blockade therapy of immune checkpoints (i.e., CTLA-4, PD-1/PD-L1, or a combination). Significantly mutated genes (SMGs), mutational signatures, and potential molecular subtypes were determined. Their association with ICI responses was assessed simultaneously. Results: We identified 27 SMGs, including four novel SMGs (COL3A1, NRAS, NARS2, and DCC) that are associated with ICI efficacy and well-known driver genes. COL3A1 mutations were associated with improved ICI overall survival (hazard ratio (HR): 0.64, 95% CI: 0.45-0.91, p = 0.012), whereas immune resistance was observed in patients with NRAS mutations (HR: 1.42, 95% CI: 1.10-1.82, p = 0.006). The presence of the tobacco smoking-related signature was significantly correlated with inferior prognoses (HR: 1.42, 95% CI: 1.11-1.82, p = 0.005). In addition, the signature resembling that of alkylating agents and a newly discovered signature both exhibited extended prognoses (both HR < 1, p < 0.05). Based on the activities of the extracted 6 mutational signatures, we identified one immune subtype that was significantly associated with better ICI outcomes (HR: 0.44, 95% CI: 0.23-0.87, p = 0.017). Conclusion: We uncovered several novel SMGs and re-annotated mutational signatures that are linked to immunotherapy response or resistance. In addition, an immune subtype was found to exhibit favorable prognoses. Further studies are required to validate these findings.

Relationship and Effects of Community Problems on Anxiety and Suicide: A Case-Control Psychological Autopsy Study.

This study aimed to explore the relationship and the effects of community problems on anxiety and suicide. Data were from a case-control psychological autopsy study (392 suicides and 416 community living controls) carried out in 16 rural counties from three provinces in China. The World Health Organization Suicide Prevention-Multisite Intervention Study on Suicidal behaviors scale of community stress and problems and Spielberger State-Trait Anxiety Inventory were used to measure the community problems and trait anxiety. Spearman's correlation and multivariable regression methods were used to probe the effect of community problems on anxiety and suicide. There were 12 and 6 community problems correlated with anxiety (rs = 0.169, p < 0.001) and suicide (rs = 0.081, p = 0.022), respectively. Medical care, alcohol abuse, superstition, and job security were important community problems for anxiety and suicide. Community problems had stronger correlation with anxiety than suicide. It might be an effective method to reduce anxiety and suicide risk by solving different community problems.

Stronger psychological strains increase the odds of suicide death: A comparison between suicides and suicide attempters.

AIM: This study was aimed to compare the psychological strains between suicides and suicide attempters, so as to verify the hypothesis whether the stronger psychological strains increase the odds of suicide death. METHOD: The suicide data were collected by a psychological autopsy (PA) study, and the suicide attempt data were from the same rural areas in China. Information was obtained with face to face structured questionnaires interviews. A social value conflict scale, measures of aspiration and deprivation, and Moos's Coping Response Inventory (CRI) were used to measure psychological strains. The Spearman correlation and Logistic regression method were applied to analyse and estimate the odds ratio (OR) of fatality of suicide behaviours from psychological strains. RESULTS: The value strain, aspiration strain, deprivation strain, and coping strain were all significantly stronger among the suicides than suicide attempters (P < 0.001). Each psychological strain had statistical correlation with suicide behaviour (P < 0.001). The univariable and multivariable Logistic regressions all indicated that rural residence, being never married, and the psychological strains were the independent lethality factors of suicidal behaviours. CONCLUSIONS: Psychological strains were the independent lethality factors of suicide behaviours. Stronger psychological strains increase the odds of suicide death. The intervention based on the Strain Theory of Suicide could decrease the odds risk of suicide death.

Epidemic of chronic diseases and the related healthy lifestyle interventions in rural areas of Shandong Province, China.

BACKGROUND: There were amounts of previous studies on chronic diseases, but few studies on the prevalence of chronic disease and the healthy lifestyle intervention in recent years, China. This study aimed to investigate the prevalence of chronic disease and the implementation of healthy lifestyle intervention in rural areas of China, so as to put forward health promotion measures to control the chronic diseases effectively. METHOD: A large cross-sectional study (N = 2168) on community diagnosis and chronic disease was carried out in Shandong province, China. The chronic disease questionnaire and the healthy lifestyle intervention questionnaires were recruited to survey the chronic diseases and the implementation of healthy lifestyle intervention. Physical examination and biochemical indicators examination were carried out by the medical staffs and clinical laboratory. RESULTS: The current diagnosed prevalence of hypertension, diabetes, hyperlipidemia for total sample, female, male were 24.97, 24.6, 25.5, 7.60, 8.9, 6.0 and 40.27%, 45.9, 33.3% respectively in rural China. The one-year prevalence of myocardial infarction (MI) and stroke of the total sample, female, male were 1.06, 1.0, 1.1 and 2.09%, 2.2, 2.0% respectively. Healthy lifestyles interventions were not effective in rural China. The current active smoking rate and passive smoking rate were 25.68 and 42.65%. 27.86% of the population drunk alcohol within a month and 47.01% of them participated in the actions to control salt daily intake. Only 1.07 and 7.89% of the population participated in medium to high intensity physical exercises. CONCLUSIONS: The prevalence of common chronic diseases were still high and the implementation of healthy lifestyle intervention were not optimal in rural area, China. Challenges to prevent chronic diseases were still severe, so medical institutes, government and individuals would put forward effective strategies to reduce the prevalence and public health promotion project should be effectively strengthened.