Background: In China, mental health services do not currently meet the needs of bereaved people with symptoms of prolonged grief disorder (PGD). Internet-based grief interventions may help fill this gap, but such programmes have not yet been developed or evaluated in China. The proposed study aims to investigate the effectiveness, acceptability, and feasibility of an online self-help intervention programme named Healing Grief for bereaved Chinese with prolonged grief, and to explore the psychological mechanisms of potential improvements.Methods: We designed a two-arm randomised controlled trial. At least 128 participants will be randomly assigned to either an Internet-based intervention group or a waitlist-control group. The Internet-based intervention will be developed based on the dual process model, integrating techniques of psychoeducation, behavioural activation, cognitive reappraisal, and meaning reconstruction, and will be delivered via expressive writing. The intervention comprises six modules, with two sessions in each module, and requires participants to complete two sessions per week and complete the intervention in 6 weeks. The primary outcomes include effectiveness, acceptability, and feasibility. The effectiveness will be assessed by measures of prolonged grief, posttraumatic stress, anxiety, and depressive symptoms. Acceptability and feasibility will be evaluated using survey and interview on user experience characteristics. Secondary outcomes include moderators and mediators, such as dual process coping, grief rumination, mindfulness, and continuing bond, to explore the psychological mechanisms of potential improvement. Assessments will take place at pre-intervention, post-intervention, and 3-month follow-up.Conclusion: The proposed study will determine the effectiveness, acceptability, and feasibility of the newly developed online self-help intervention for bereaved Chinese with prolonged grief and clarify how the intervention helps with symptom improvements. Such an intervention may play an important role in easing the imbalance between the delivery and receipt of bereavement psychological services in China.
In China, mental health services are not widely available for bereaved people.The proposed study will be the first one to develop and evaluate an Internet-based self-help grief intervention for bereaved Chinese with prolonged grief.The proposed study will determine whether and how the intervention helps to improve the mental health of bereaved Chinese with prolonged grief.

BACKGROUND: We aimed to assess whether early life exposure to the Chinese famine (1959-1961) modifies the association between type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD) in adulthood.
METHODS: Data from 4247 adults born between 1954 and 1964 from the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS) were analyzed. CVD in 2011 and 2015 was based on self-reported doctor\'s diagnosis of cardiac events (heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems) and stroke. Diabetes in 2011 was defined by fasting blood glucose, HbA1C, or known diabetes.
RESULTS: Diabetes in 2011 was cross-sectionally associated with an increase of CVD risk in 2011 (OR 1.91, 95%CI 1.53-2.40, P < 0.001) after adjusting for age and gender. Famine exposure changed the association between diabetes and CVD in areas severely affected by famine. The odds ratios (OR) of diabetes in 2011 for CVD in 2015 were 1.24 (95%CI 0.73-2.10), 1.27 (95%CI 0.72-2.24), 2.25 (95%CI 1.29-3.91), 4.31 (95%CI 2.07-8.97) and 1.72 (95%CI 0.84-3.51) among adults in late childhood-, mid-childhood-, early childhood-, fetal-, and nonexposed cohorts in severe famine areas, respectively.
CONCLUSIONS: T2DM is associated with the risk of CVD among Chinese adults. Fetal and early childhood exposure to the Chinese famine exacerbated the associated risk.
背景: 本研究旨在评估早年生活经历过中国饥荒(1959-1961年)是否会影响成年以后2型糖尿病(type 2 diabetes mellitus, T2DM)与心血管疾病(cardiovascular disease, CVD)之间的相关性。 方法: 分析了2011年至2015年中国健康与退休纵向研究(CHARLS)中4247名1954年至1964年间出生的成人的数据。根据自我报告医生诊断的心血管事件(心脏病发作、冠心病、心绞痛、充血性心力衰竭或其它心脏病)和卒中来确认2011年与2015年的CVD。2011年的糖尿病诊断是基于空腹血糖、HbA1C或已知糖尿病。 结果: 校正年龄与性别后, 发现2011年的糖尿病诊断与2011年CVD风险增加之间具有横向相关性(OR 1.91, 95% CI 1.53-2.40, P<0.001)。在遭受饥荒严重影响的地区, 经历过饥荒会改变糖尿病与CVD之间的相关性。在遭受过严重饥荒的地区, 儿童晚期、儿童中期、儿童早期、胎儿时期遭受过饥荒的队列和未遭受过饥荒的队列成年后在2011年的糖尿病诊断与2015年发生CVD的比值比(OR)分别为1.24(95% CI 0.73-2.10)、1.27(95% CI 0.72-2.24)、2.25(95% CI 1.29-3.91)、4.31(95% CI 2.07-8.97)和1.72(95% CI 0.84-3.51)。 结论: 中国成人中T2DM与CVD风险具有相关性。胎儿时期和儿童早期经历过中国饥荒可使相关风险加剧。.

Rates of international migration are increasing, which raises the question of how migration might influence couple relationship standards and impact on the standards of migrants forming intercultural relationships. We compared relationship standards in n = 286 Chinese living in Hong Kong, China, with standards in n = 401 Chinese migrants to a Western country (Australia) by administering the Chinese-Western Intercultural Couple Standards Scale (CWICSS). We also compared these two groups to n = 312 Westerners living in Australia. We first tested the structural invariance of the CWICSS across the three samples with a multigroup confirmatory factor analysis. There was marginal but acceptable fit of a model of two positively correlated latent factors: Couple Bond (with four indicators, such as demonstration of love and caring) and Family Responsibility (also with four indicators, such as extended family relations and preserving face). Within the limitations of the study, results suggest migration is associated predominantly with differences in women\'s, but not men\'s, relationship standards. Migrant Chinese women show alignment of Couple Bond standards with Western standards, and divergence of Family Responsibility standards from Western standards. Discussion focused on how migration and intercultural relationship experiences might differentially influence various domains of relationship standards, gender differences in migration effects on standards, and the implications for working with culturally diverse couples.