Journal articles on the topic 'Premarital sex - China - Hong Kong'

The portrayal of women as prostitutes is common in Hong Kong cinema, and filmmakers have looked at sex work from various perspectives: as a social problem, as an index of women’s economic exploitation more generally, as a way to explore the relationship between economics and sexuality, as a window onto the world of sexual minorities and as erotica. Scriptwriter Elsa Chan, working in conjunction with director Herman Yau, has made two features about women in the Hong Kong sex industry—Whispers and Moans (性工作者十日談, 2007) and True Women for Sale(性工作者2 我不賣身·我賣子宮, 2008)—based on Chan’s anthropological studies of women in the sex industry in Hong Kong. Like their earlier collaboration From the Queen to the Chief Executive (等候董建華發落, 2001), these films look at the “sensational” (youth murders, prostitution) with an eye to understanding and, perhaps, remedying social injustice. In fact, the issue of “justice” and women’s role as exploited victims as well as potential agents of change link Elsa Chan’s scripts to the interests of other women filmmakers currently working in Hong Kong. Whispers and Moans and True Women for Sale offer a critical perspective on the circulation of women across borders and gesture toward a feminist intervention into the shadow economy between transnational capitalism and the socialist marketplace in China.

The present study reports the results of 2 surveys of the first behavioural surveillance system (BSS) set up to monitor sexually-related risk behaviours practised by Hong Kong-China cross-border travellers. The 2 studies interviewed 1263 and 1448 male adult Hong Kong residents in 1997 and 1998 respectively. About one-third of the respondents had had sexual intercourse with a commercial sex worker (CSW) in the past 6 months; about 20% had had sexual intercourse with a CSW or a non-regular sex partner in a single trip; about 35-40% of the CSW clients had not used a condom during the intercourse and about 20% of the respondents reported that they had contracted STD. When the results of the 2 surveys were compared, no significant changes in the outcomes of the surveillance indicators were detected; instead, some unfavourable changes in terms of condom use were observed. The effectiveness of the relevant prevention programmes in Hong Kong is not evident.

Fourteen wild species of shrubs and trees in the dioecious genus Ilex occur in Hong Kong (22°N, 114°E). All species flowered and formed fruits once each year. Sex ratios at flowering were male biased in all but one large population studied and, in most cases, this bias could not be explained by earlier flowering in males or higher female mortality. Apis cerana accounted for >87% of flower visits in all species and there was a significant positive relationship across species between the number of visits per flower per hour and the estimated mean number of flowers on a plant. The large green fruits of Ilex chapaensis Merr. were consumed only by masked palm civets, Paguma larvata, while the red or black fruits of other species were consumed by birds. The rate of fruit removal across species was positively related to sugar content and negatively related to phenolic and saponin contents. The mean number of pyrenes per fruit was 4.0–6.2 and the mean percentage of pyrenes containing seeds was 49%–90%. Most embryos were immature (heart shaped) at fruit maturity, but <50% of embryos developed further in some species. Floral investment was 0.93–5.84 times higher in male plants, but total reproductive investment was 0.62–8.3 higher in females.

The prevalence of frailty varies among socioeconomic groups. However, longitudinal data for the association between subjective social status and frailty is limited. In this study, we examined whether subjective social status was associated with incident frailty. Data were obtained from a 14-year cohort of Chinese men and women (n = 694) aged 65 years and older who participated in the MrOs study—a longitudinal study on osteoporosis and general health in Hong Kong. Subjective social status at baseline (2001–2003) was assessed using a 10-rung self-anchoring scale. Incident frailty at the 14-year follow-up (2015–2017) was defined as proposed by Fried and colleagues. Ordinal logistic regressions were used to examine the association between subjective social status (high, middle, or low) and incident frailty. After adjustment for age, sex, marital status, objective socioeconomic status, medical history, lifestyle, mental health, and cognitive function, subjective social status at baseline was negatively associated with risk of developing frailty over time (OR 2.3, 95% CI 1.2–4.6). In sex-stratified analysis, the social gradient in frailty was only found in men. Social inequality in frailty in men but not in women supports interventions specific to gender inequality and frailty.

Employed women are taking on multiple roles in the family and at work. The multiple role expectations are sources of stress and strain on working women. The attitude of working women toward their employment in socialist and capitalist societies may differ owing to the different ideological culture of the societies. This paper reports the results of a comparative study of 1,500 female respondents in the socialist cities of Beijing and Guangzhou as well as that of capitalist Hong Kong. Most respondents felt strongly about sex discrimination in the workplace. Respondents in China are more positive toward work, while respondents in Hong Kong place higher priority on the family.

Objective Drug abuse is an escalating problem in Hong Kong, especially among teenagers and young adults. A study was conducted in order to obtain the characteristics of drug abusers presenting to the Accident & Emergency department of North District Hospital, which is located in the New Territories near the Hong Kong – Shenzhen border. Design Prospective study. Setting Accident and Emergency department of a public general hospital. Patients Drug abusers presenting to the Accident and Emergency department in a six-month period. Main outcome measures Epidemiological data including demographic data, types of drug taken, place of drug abuse and magnitude of cross-border drug abuse were collected and analyzed. Results The sex distribution was male 59 and female 13 (ratio=4.5:1). The mean age was 29.2 (range 14 to 67 years). Of interest, 29.2% abused drugs at home; 29.2% abused drugs in parties such as karaoke, rave and disco; 68% abused drugs in Hong Kong; 32% abused drugs in China and 6.9% claimed themselves first-time drug abusers. The commonest drug taken was ecstasy (40.3%) – the majority (55%) in China and the rest (45%) in Hong Kong. For organic solvent abusers, 57.1% were below 18 years of age. One patient died, resulting in a mortality rate of 1.4%. Conclusion Ecstasy was the commonest drug abused on both sides of the “border”. The majority of substance abusers were teenagers or young adult males. This study confirmed the significant magnitude of psychotropic substance abuse problem among the young population in the North District, indicating the urgent need for clinical and social intervention.

Vitamin D plays an important role in skeletal health throughout life. Some studies have hypothesised that vitamin D may reduce the risk of other diseases. Our study aimed to estimate age-specific and sex-specific serum 25-hydroxyvitamin D (25(OH)D) status and to identify the determinants of serum 25(OH)D status in Hong Kong, a subtropical city in southern China. In 2009–2010, households in Hong Kong were followed up to identify acute respiratory illnesses, and sera from 2694 subjects were collected in three to four different study phases to permit measurement of 25(OH)D levels at different times of the year. A questionnaire survey on diet and lifestyle was conducted among children, with simultaneous serum collection in April and May 2010. The mean of serum 25(OH)D levels in age groups ranged from 39 to 63 nmol/l throughout the year with the mean values in all age groups in spring below 50 nmol/l. Children aged 6–17 years, and girls and women had significantly lower serum 25(OH)D levels than adults, and boys and men, respectively (allP< 0·001). We estimated that serum 25(OH)D levels in Hong Kong followed a lagged pattern relative to climatic season by 5 weeks with lowest observed levels in early spring (March). For children aged 6–17 years, reporting a suntan, having at least 1 servings of fish/week and having at least 1 serving of eggs/week were independently associated with higher serum 25(OH)D levels. Adequate sunlight exposure and increased intake of dietary vitamin D could improve vitamin D status, especially for children and females in the winter and spring.

Few studies compared HIV-related risk behaviors between cities with different sociocultural environments among men who have sex with men (MSM). This study investigated the prevalence of unprotected anal intercourse (UAI) and associated individual and socio-cultural factors among Chinese MSM in Hong Kong and Shenzhen in Mainland China, which were proximal to each other but experienced different socioeconomic developments. Amongst all the 535 participants, 40.2% had had UAI. Significant factors of UAI among Shenzhen MSM included being able to find someone to share one’s sexual orientation, disclosure of sexual orientation to family members, HIV risk perception, and use of alcohol or substances (adjusted OR ranged from 2.37 to 4.91), whilst disclosure of sexual orientation to family members was the only significant factor among Hong Kong MSM (adjusted OR = 1.64). Geographic variations in factors associated with UAI were observed. Future research and interventions need to take this into account.

Introduction Levels of utilization of health services vary socially and geographically. Differences in the rates of usage are also associated with geographical aspects of health care systems. The purpose of this study was to capture spatial variations in hospital health services utilization in the elderly population in Hong Kong, a Special Administrative Region of China. Materials and Methods We carried out a secondary analysis of a database from the Hospital Authority (HA) which covers 98% (N = 243,245) of the total registered deaths in Hong Kong during 1999 to 2005. Deaths at age 65y and above (N = 184,671) were included in the analysis. Age-sex weighted mean utilization ratio of hospital services was calculated by dividing the age-sex weighted mean usage of a particular service for each district by that for the whole territory. The variation in utilization by the seniors was analyzed in terms of four types of services: length of stay (LOS) in HA hospitals, number of inpatient admissions, number of visits to specialist outpatient department (SOPD), and attendances at accident and emergency department (AED). Results Deaths at age 65y and above contributed to 76% of the total registered deaths. Each district contributed 1.0% to 9.1% of the total number of deaths in Hong Kong. Spatial analysis of the age-sex weighted mean utilization ratio showed significant geographic variation in the use of hospital services: the range of difference in the LOS between the lowest and highest district was 44%, while some differences as high as 33%, 35% and 39% in utilization ratios were observed in relation to number of inpatient admissions, visits to SOPD, and attendances at AED respectively. However, the patterns of these variations were not consistent for the four types of service being analyzed. Conclusions Geographic variation in the utilization of hospital health services across the 18 districts in Hong Kong among the elderly population during the last three years before death was demonstrated. However, the patterns of variation were different for the types of services being examined. Further studies using primary data at an individual level are needed to explain the variations. Detailed analysis examining the relationship between service provision, accessibility and health outcomes are also indicated in order to inform the planning of health service delivery.

The incidence of cutaneous melanoma (CM) has rapidly increased over the past four decades. CM is often overlooked in East Asian populations due to its low incidence, despite East Asia making up 22% of the world’s population. Since the 1990s, Caucasian populations have seen a plateau in CM mortality rates; however, there is little data investigating the mortality rates of CM in East Asian populations. In this study, the World Health Organization Mortality Database with the joinpoint regression method, and a generalized additive model were used to investigate trends in age standardized mortality rates (ASMRs) of CM in four East Asia regions (Japan, Republic of Korea (Korea), China: Hong Kong (Hong Kong), and Singapore) over the past six decades. In addition, mortality rate ratios by different variables (i.e., sex, age group, and region) were analyzed. Our results showed ASMRs of CM in East Asia significantly increased non-linearly over the past six decades. The joinpoint regression method indicated women had greater annual percentage changes than men in Japan, Korea, and Hong Kong. Men had significantly greater mortality rate ratio (1.51, 95% CI [1.48–1.54]) than women. Mortality rate ratios in 30−59 and 60+ years were significant greater than in the 0−29 years. Compared to Hong Kong, mortality rate ratio was 0.72 (95% CI [0.70–0.74]) times, 0.73 (95% CI [0.70–0.75]) times, and 1.02 (95% CI [1.00–1.05]) times greater in Japan, Korea, and Singapore, respectively. Although there is limited research investigating CM mortality rates in East Asia, results from the present study indicate that there is a significant growth in the ASMRs of CM in East Asian populations, highlighting a need to raise awareness of CM in the general population.

A general address term in Communist China, tongzhi ‘comrade’ was appropriated by gay rights activists in Hong Kong to refer to members of sexual minorities. Examining its level of acceptance among non-activist gay and lesbian Hongkongers, this article argues that non-activists’ ideology about sexuality accounts for their rejection of tongzhi and their preference for strategies that leave same-sex desire unspecified. This study demonstrates how the discursive history of a label can both enable and impede its political efficacy. It also sheds light on the internal resistance that representatives of minority groups encounter when introducing new labels for those they supposedly speak for.

Abstract Chinese law neither expressly recognises nor prohibits same-sex unions (‘same-sex unions’ in this article refers to homosexual relationships that are legally recognised and protected by law, including marriage, civil union, (un)registered partnership, and so on). Until now, no dispute over foreign same-sex union has been brought in a Chinese court. However, the Department of Consular Affairs of China’s Ministry of Foreign Affairs has adopted a blanket non-recognition rule, alleging that same-sex unions would violate China’s (‘China’ hereinafter refers to the jurisdiction of Mainland China, excluding those of the Hong Kong SAR, the Macao SAR, and Taiwan) family law and the public interest. However, it is argued that foreign same-sex unions should be recognised unless such recognition would violate the public policy of the forum state. First, foreign same-sex unions should be regulated by the Chinese conflict rules, not by Chinese domestic law. Additionally, China is internationally obliged to recognise and protect fundamental human rights (right to marry). Secondly, under China’s conflict rules, a foreign same-sex union should be governed by the lex personalis or the law that has the closest connection with that union. Thirdly, as more than 40 jurisdictions throughout the world have legally recognised same-sex unions, and China itself has decriminalised homosexuality, same-sex unions would not necessarily be incompatible with China’s public policy. Fourthly, non-recognition of same-sex unions would instead cause public policy problems because it practically always favours one party over another, helping foreign same-sex couples to evade their responsibilities imposed by the relevant foreign law.

Background: Globally, COVID-19 vaccination programs have been rolled out. To inform health promotion, this study investigated the prevalence and associated factors of performance or being scheduled to perform at least one dose of COVID-19 vaccination (PSCV) in a Chinese adult general population. Methods: An anonymous, random telephone survey interviewed 500 adults aged 18–75 in Hong Kong, China from 14–27 May 2021. Results: The prevalence of PSCV was 21.0%, which was significantly lower among females and those aged ≤30. Positively associated factors of PSCV included perceived protection effect of vaccination, self-perceived physical fitness for vaccination, compulsory COVID-19 testing experience, perceived need to travel, general trust toward the government, and trust toward the governmental vaccination program, while negatively associated factors included perceived low efficacy of vaccination, concerns about side effects, and chronic disease status. Furthermore, the association between sex and PSCV was fully mediated by stronger concern about side effects and lower levels of self-perceived physical fitness for COVID-19 vaccination among females than males. Conclusion: Moderately low prevalence of COVID-19 vaccination was observed in Hong Kong, where there was no shortage of vaccine supply. To achieve herd immunity, health promotion is greatly warranted and may incorporate messages based on the findings of this study.

Background: The use of fasting and post-prandial glucose levels in the classification of hyperglycaemic states often identifies distinct subjects, but the factors determining these intermediate-isolated glucose intolerant states are yet to be clearly elucidated in Chinese subjects. Methods: Representative subjects (n = 2769) were randomly recruited from the Hong Kong Chinese population and glycaemic status was determined using both fasting and 2h 75 g oral glucose tolerance test glucose levels. The relationship between the groups with isolated glucose intolerance and vascular risk factors was investigated using ANOVA and logistic regression analyses. Results: Using either criterion, diabetes was identified in 265 (9.6%) subjects and glucose intolerance in 568 (20.5%) subjects. Of those 568, isolated impaired glucose tolerance (IGT) using the post-load criterion was identified in 49.5% and isolated impaired fasting glucose (IFG) in 30.5%. Ageing and hyperinsulinaemia were common determinants of IGT and IFG; with small hip circumference a marker of poorer early life development and being born in China rather than Hong Kong, a possible low birth weight marker was also associated with IFG. Hypertension, hypertriglyceridaemia and poor education were also associated with IGT. When we looked for factors differentially associated with these glucose intolerant states, female sex, greater hip circumference, high triglyceride levels, low fasting insulin levels, and not being born in China were independently associated with isolated IGT compared with isolated IFG. Conclusion: Despite common antecedents to the glucose intolerant states, isolated IFG appeared to be particularly associated with early life development, and isolated IGT was more strongly associated with obesity-related determinants such as hypertriglyceridaemia.

Purpose To compare health related quality of life (HRQOL) and handicap of stroke survivors in Hong Kong (HK) and Chengdu (CD) in Mainland China. Method Fifty-four pairs of first ever stroke patients in CD and in HK matched by age, sex and Modified Barthel Index (MBI) were interviewed using a structured questionnaire at 16–36 months after stroke. HRQOL and handicap outcomes were evaluated by the Chinese version of the Short-Form Health Survey (SF-36) and London Handicap Scale (LHS) respectively. Results Compared to stroke patients in CD, HK subjects reported significantly greater handicap, especially in the occupation domain. HK subjects also had significantly lower HRQOL Z scores in domains of role limitations due to emotional or physical problems, and bodily pain. CD subjects had more social support, but had more difficulties in meeting medical costs, and were less likely to have regular medical follow-up and dysphagia symptom. After adjusting for social and health related factors, the site differences in handicap and the role limitation (physical) domain of SF36 became insignificant. Conclusions CD stroke survivors had better scores in HRQOL and fewer handicaps than their counterparts in HK, because of social and health related factors.

In recent years, there has been a growing interest in studying translators in the workplace, but the rights of translators are an uncharted area. The objectives of this paper are twofold. First, it studies translators’ perceptions of translator rights in the workplace. Second, it develops a translator rights model inventory that compiles practitioners’ viewpoints for studying and measuring translator rights. This paper presents findings from a questionnaire survey that collected both quantitative and qualitative data from 155 translation practitioners in Greater China (China, Hong Kong and Taiwan). The findings suggest that the translators attach the greatest importance to rights related to working conditions, followed by rights related to economic and social position, and finally those related to copyright issues. It was found that the translators are quite dissatisfied with the rights they have in the workplace, because what they wish to enjoy is much less than what they expect. In addition, a translator’s social variables, such as age, level of education, major field of study, and years of translation experience, are not related to the number of rights the person enjoys in the workplace. What was found to be related is sex and region in which the translator lives.

Background Sexualized drug use (SDU; the use of any psychoactive substance before or during sexual intercourse) is prevalent among men who have sex with men (MSM) and may aggravate the worsening HIV epidemic in this key population. Objective This observational prospective cohort study investigated factors predicting the occurrence of SDU within a 6-month follow-up period among a sample of MSM in Hong Kong. We hypothesized that perceptions related to SDU would mediate the association between the influence of social media/gay social networking apps and SDU during the follow-up period. Methods Participants were Chinese-speaking men in Hong Kong, China who had anal intercourse with at least one man in the past year. Among 600 participants who completed the baseline telephone survey, 407 (67.8%) completed another telephone survey 6 months later. Logistic regression models and path analysis were fitted. Results At Month 6, 6.9% (28/407) and 4.4% (18/407) of participants reported SDU and chemsex during the follow-up period. After adjustment for significant baseline background variables (use of pre-exposure prophylaxis; history of HIV and other sexually transmitted infections; anal intercourse with nonregular male sex partners, condomless anal intercourse with men, multiple male sex partnerships, and SDU at baseline), three constructs of the Theory of Planned Behavior (TPB) were significantly associated with SDU during the follow-up period: (1) positive attitudes toward SDU (adjusted odds ratio [AOR] 1.19, 95% CI 1.05-1.36), (2) perceived support for SDU from significant others (AOR 1.15, 95% CI 1.01-1.30), and (3) perceived behavioral control of refraining from SDU (AOR 0.76, 95% CI 0.59-0.98). Exposure to information supporting SDU on social media and gay social networking apps was also significantly associated with SDU (AOR 1.11, 95% CI 1.01-1.22). Bootstrapping analyses indicated that social media influence was indirectly associated with SDU through TPB-related perceptions of SDU (β=.04; B=.002, 95% CI 0.001-0.01). Conclusions Social media and gay social networking apps may be a major source of influence on MSM’s perceptions and actual behaviors related to SDU.

ObjectivesMen who have sex with men (MSM) are at high risk of hepatitis C virus (HCV). This study investigated predictors of first-time HCV testing uptake during a 6-month period among a sample of MSM in Hong Kong.MethodsParticipants were 351 Chinese-speaking MSM who had never received HCV testing. Participants completed two telephone surveys 6 months apart. At baseline, participants reported on sociodemographics, sexual behaviours, risk perception, depressive symptoms and anxiety symptoms. Illness representations, which refers to how people think about HCV, was measured by the Brief Illness Perception Questionnaire (BIPQ) at baseline. The BIPQ assessed identity (identifying symptoms of HCV), timeline (whether HCV is acute/chronic), consequences (severity of HCV), personal control and treatment control (whether HCV is under volitional control), concern, emotions (anger, guilt or shame) and coherence (overall comprehensibility of HCV). Six months later, participants reported on HCV testing uptake. Logistic regression was used to analyse the associations between baseline predictors and HCV testing uptake.ResultsMost participants were aged ≤30 years (55.0%) and had attained college education or above (85.2%). Among 242 participants (68.9%) who completed the month 6 follow-up, 12.4% had tested for HCV during the follow-up period. After adjustment for HIV testing and chemsex in the last year, participants who perceived more severe consequences of HCV reported higher HCV testing uptake (adjusted ORs (AOR): 2.22, 95% CI: 1.65 to 3.00). Belief that treatment can control HCV (AOR: 1.75, 95% CI: 1.35 to 2.26) and having negative emotions related to HCV (AOR: 1.59, 95% CI: 1.25 to 2.03) were also positively associated with HCV testing uptake.ConclusionsTargeted health promotion efforts are needed to increase HCV testing among MSM in Hong Kong. Healthcare workers engaged in HCV-related programming should consider modifying the illness representations of HCV. Integrating HCV and HIV testing services may also be beneficial.

As reported by the World Health Organization in 2017, there are 2 million+ young people living with HIV worldwide. The World Health Organization also reported that a third of all new HIV infections around the world are estimated to occur among youths (aged 15–25). and teen pregnancy rates are on the rise in many places. These worrying trends suggest that existing sexuality education programs and interventions may be inadequate and/or ineffective. Although the 1994 International Conference on Population and Development’s (ICPD) Programme of Action highlighted the roles of Governments to offer sex education to young people to promote teenage reproductive health, yet inconsistency exists in the related initiatives in the global context. The present article aims to provide a comprehensive literature review of the existing sexuality programs in selected places in both English-speaking (i.e., the United States of America, the United Kingdom) and Chinese-speaking contexts (i.e., Hong Kong, Mainland China, and Taiwan). Based on the review, observations and implications for sexuality education policy and practice, as well as recommendations for future research for youths are outlined.

Abstract Introduction: Non-transfusion dependent thalassemia (NTDT) includes HbH disease, β-thalassemia intermedia (β-TI) and HbE/β-thalassemia. The transfusion requirements of patients with NTDT are variable and they are all at risk of developing iron overload and other complications. The prevalent genetic changes in thalassemia are different across geographical territories, accounting largely for the diverse clinical outcomes. The complication profile of NTDT in Southern China is less well studied than other areas. Data on age-related complications is sparse. The present study aims to describe the clinical-pathological features of adult NTDT patients in Hong Kong, and to evaluate the risk factors associated with complications. Method: A single-center observational study was performed during Jan 2017 to Jun 2018. Data collection included review of medical records for demographics; globin genotypes; hepatitis B and C status; transfusion requirement; splenectomy; iron chelation therapy; complications including gallstone disease, hypothyroidism or hypogonadism, diabetes mellitus (DM), extramedullary hematopoiesis (EMH), leg ulcer, venous thrombosis and cerebral ischemia. During the study period, steady state hemoglobin (Hb) and serum ferritin levels in the recent year were obtained; organ iron deposition assessed using liver and cardiac T2* at 1.5T MRI; liver stiffness measured by Fibroscan; and presence of pulmonary arterial hypertension (PAH) evaluated by echocardiography. The disease profile and prevalence of complications were described with descriptive statistics. Factors impacting clinical parameters and development of complication were studied with univariate regressions. Age and sex adjusted β-coefficients or odd ratios were then determined with multivariable regression analysis. Results: A total of 96 Chinese patients were recruited (mean age 50±15 years; 31% patients >60 years; females 66%). There were 63 (65%) patients having deletional HbH disease, 20 (21%) with non-deletional HbH disease (ND-HbHD), and 13 (14%) with β-TI. The mean Hb was 8.9±1.1 g/dL. Transfusion requirement was never in 39 (41%), occasional in 50 (52%), and regular in 7 (7%) patients. Ten (10%) patients were splenectomized. Iron chelation was given to 21 (21%) patients and the median duration of therapy was 3 (range 1-21) years. Respectively 4 (4%) and 2 (2%) patients were hepatitis B and C carriers. The median serum ferritin was 473 [IQR 217-1029] ng/mL. The median liver iron concentration (LIC) estimated by MRI T2* was 3.6 [IQR 1.7-7.1] mg Fe/g with 26% of patients having moderate to severe liver iron overload (≥7.1 Fe mg/g). In the study population, the prevalence of liver fibrosis (liver stiffness ≥7.1kPa) was 26%, gallstones 50%, hypo-thyroidism/-gonadism 8%, DM 16%, EMH 5%, leg ulcer 1%, thrombotic events 2%, cardiac iron overload 1%. No patients had PAH (Table 1). In multivariable regression, advanced age (>60 years) was associated with lower Hb (p=0.03), higher risk of liver fibrosis (p=0.04) and DM (p<0.01). β-TI was associated with higher transfusion requirement (p<0.01), higher serum ferritin (p<0.01) and higher risk of hypo-thyroidism/-gonadism(p=0.01). Both ND-HbHD and β-TI were associated with higher LIC (p<0.01). Patients requiring regular transfusions had higher serum ferritin (p<0.01) and LIC (p<0.01). Occasionally transfused (p=0.01) and female patients (p=0.01) had higher risk of developing gallstones. Splenectomy was associated with higher serum ferritin level (p=0.03). Patients with moderate to severe liver iron overload had increased risk of liver fibrosis (p=0.01) (Table 2). Conclusions: The present study including 1/3 of elderly patients illustrates the heterogeneous clinical features of NTDT in Hong Kong in terms of transfusion requirement and body iron store. HbH disease is the most frequent type of NTDT. Liver iron overload, liver fibrosis, gallstones and DM were the most common complications. Advancing age, β-TI, ND-HbHD were associated with higher risk of developing complications. A low prevalence of EMH, cardiac iron overload, PAH, thrombosis and leg ulcer was observed. Larger prospective study is needed to confirm the prevalence of complications in NTDT in Chinese, which may be different from other ethnic groups, and at the same time to provide more insight to the pathophysiology of NTDT and facilitate establishment of future local management strategies. Disclosures No relevant conflicts of interest to declare.

ObjectiveChina’s population is ageing and fall-related injury in older Chinese people is a growing public health concern. This review aims to synthesise existing evidence on the incidence, risk factors and economic burden of fall-related injury among older Chinese people to inform health service planning.MethodsA systematic search of literature on falls and injury among older people living in China was performed in six electronic databases including both English and Chinese databases. Results were combined using narrative synthesis due to the heterogeneity of included studies.ResultsA total of 93 studies from Mainland China, Taiwan and Hong Kong were included in this review. Most of these studies were descriptive; 82 reported the incidence of fall-related injury among older Chinese people, 7 studies examined the risk factors for fall-related injury and 22 studies described the economic burden of fall-related injury. The incidence of fall-related injury reported among older Chinese people ranged from 0.6% to 19.5%. Risk factors significantly associated with fall-related injury among older Chinese included older age, female sex, walking aid use, living environments, chronic disease, medication usage, visual impairment and a fall direction other than forward. The cost of fall-related injury among older Chinese people ranged from US$16 to US$3812 per person per fall.ConclusionFalls-related injuries are a significant public health issue for older Chinese people. Further studies using prospective design to identify risk factors and the economic burden of fall-related injuries are needed.

There has been a huge revival of interest in the role of translators and their visibility. Some Translation Studies scholars have mobilized French sociologist Pierre Bourdieu’s theorical concepts of field, habitus and capital to carry out empirical research studies in an attempt to understand how translators or interpreters perceive their roles and what kind of capital they pursue. This article presents part of the findings from a large empirical study in which quantitative and qualitative approaches are combined in an attempt to carry out a thorough investigation of translators’ visibility, understood as the capacity to communicate directly with clients and/or end-users. The present article reports on the quantitative analysis of the relationship between translator’s visibility and the amount of capital that they say they receive. The analysis is based on 193 Chinese translators in China, Hong Kong, Taiwan and Macao. The findings suggest that visibility is rewarding in terms of social exchanges and learning experience, but not in terms of pay and prestige. In addition, the analysis shows that some social variables including sex, level of education, region that the translator lives in, the translator’s major field of study and the time spent on translation are not related to visibility or capital received. Meanwhile, the appearance of the translator’s name on translations is significantly related to the capital received.

ObjectivesTo investigate potential geographical and socioeconomic patterning of allostatic load (AL) in China.DesignMultilevel longitudinal study of the 2010 Chronic Disease Risk Factor Surveillance linked to the National Death Surveillance up to 31 December 2015.SettingAll 31 provinces in China, not including Hong Kong, Macao or Taiwan.Participants96 466 ≥ 18 years old (women=54.3%).ExposuresPerson-level educational attainment and mean years of education in counties.OutcomeAL was measured using clinical guidelines for nine biomarkers: body mass index; waist circumference; systolic blood pressure; diastolic blood pressure; fasting blood glucose; total cholesterol; triglycerides; high-density lipoprotein cholesterol; low-density lipoprotein cholesterol.ResultsMultilevel logistic regressions adjusted for sex, age, marital status, person-level education, county mean years of education and urban/rural reported ORs of 1.22 (95% CI 1.08 to 1.38) for 5-year all-cause mortality (n=3284) and 1.20 (1.04–1.37) for deaths from non-communicable diseases (n=2891) among people in AL quintile 5 (high) compared with quintile 1 (low). The median rate ratio estimated from unadjusted multilevel negative binomial regression showed AL clustered geographically (province=1.14; county=1.12; town=1.11; village=1.14). After adjusting for aforementioned confounders, AL remained higher with age (rate ratio 1.02, 95% CI 1.02 to 1.02), higher in women compared with men (1.17, 1.15 to 1.19), lower among singletons (0.83, 0.81 to 0.85) and widowers (0.96, 0.94 to 0.98). AL was lower among people with university-level compared with no education (0.92, 0.89 to 0.96), but higher in counties with higher mean education years (1.03, 1.01 to 1.05). A two-way interaction suggested AL was higher (1.04, 1.02 to 1.06) among those with university-level compared with no education within counties with higher mean years of education. Similar results were observed for alternative constructions of AL using 75th and 80th percentile cut-points.ConclusionsAL in China is patterned geographically. The degree of association between AL and person-level education seems to be dependent on area-level education, which may be a proxy for other contextual factors that warrant investigation.

In December 2019, a novel severe acute respiratory syndrome (SARS) from a new coronavirus (SARS-CoV-2) was recognized in the city of Wuhan, China. Rapidly, it became an epidemic in China and has now spread throughout the world reaching pandemic proportions. High mortality rates characterize SARS-CoV-2 disease (COVID-19), which mainly affects the elderly, causing unrestrained cytokines-storm and subsequent pulmonary shutdown, also suspected micro thromboembolism events. At the present time, no specific and dedicated treatments, nor approved vaccines, are available, though very promising data come from the use of anti-inflammatory, anti-malaria, and anti-coagulant drugs. In addition, it seems that males are more susceptible to SARS-CoV-2 than females, with males 65% more likely to die from the infection than females. Data from the World Health Organization (WHO) and Chinese scientists show that of all cases about 1.7% of women who contract the virus will die compared with 2.8% of men, and data from Hong Kong hospitals state that 32% of male and 15% of female COVID-19 patients required intensive care or died. On the other hand, the long-term fallout of coronavirus may be worse for women than for men due to social and psychosocial reasons. Regardless of sex- or gender-biased data obtained from WHO and those gathered from sometimes controversial scientific journals, some central points should be considered. Firstly, SARS-CoV-2 has a strong interaction with the human ACE2 receptor, which plays an essential role in cell entry together with transmembrane serine protease 2 (TMPRSS2); it is interesting to note that the ACE2 gene lays on the X-chromosome, thus allowing females to be potentially heterozygous and differently assorted compared to men who are definitely hemizygous. Secondly, the higher ACE2 expression rate in females, though controversial, might ascribe them the worst prognosis, in contrast with worldwide epidemiological data. Finally, several genes involved in inflammation are located on the X-chromosome, which also contains high number of immune-related genes responsible for innate and adaptive immune responses to infection. Other genes, out from the RAS-pathway, might directly or indirectly impact on the ACE1/ACE2 balance by influencing its main actors (e.g., ABO locus, SRY, SOX3, ADAM17). Unexpectedly, the higher levels of ACE2 or ACE1/ACE2 rebalancing might improve the outcome of COVID-19 in both sexes by reducing inflammation, thrombosis, and death. Moreover, X-heterozygous females might also activate a mosaic advantage and show more pronounced sex-related differences resulting in a sex dimorphism, further favoring them in counteracting the progression of the SARS-CoV-2 infection.

The pandemic of COVID-19 has afflicted every individual and has initiated a cascade of directly or indirectly involved events in precipitating mental health issues. The human species is a wanderer and hunter-gatherer by nature, and physical social distancing and nationwide lockdown have confined an individual to physical isolation. The present review article was conceived to address psychosocial and other issues and their aetiology related to the current pandemic of COVID-19. The elderly age group has most suffered the wrath of SARS-CoV-2, and social isolation as a preventive measure may further induce mental health issues. Animal model studies have demonstrated an inappropriate interacting endogenous neurotransmitter milieu of dopamine, serotonin, glutamate, and opioids, induced by social isolation that could probably lead to observable phenomena of deviant psychosocial behavior. Conflicting and manipulated information related to COVID-19 on social media has also been recognized as a global threat. Psychological stress during the current pandemic in frontline health care workers, migrant workers, children, and adolescents is also a serious concern. Mental health issues in the current situation could also be induced by being quarantined, uncertainty in business, jobs, economy, hampered academic activities, increased screen time on social media, and domestic violence incidences. The gravity of mental health issues associated with the pandemic of COVID-19 should be identified at the earliest. Mental health organization dedicated to current and future pandemics should be established along with Government policies addressing psychological issues to prevent and treat mental health issues need to be developed. References World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ [Accessed on 23 August 2020] Sim K, Chua HC. The psychological impact of SARS: a matter of heart and mind. CMAJ. 2004; 170:811e2. https://doi.org/10.1503/cmaj.1032003. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatr. 2009; 54:302e11. https://doi.org/10.1177/070674370905400504. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395:912e20. https://doi.org/10.1016/S0140-6736(20)30460-8. Robertson E, Hershenfield K, Grace SL, Stewart DE. The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatr. 2004; 49:403e7. https://doi.org/10.1177/070674370404900612. Barbisch D, Koenig KL, Shih FY. Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Med Public Health Prep. 2015; 9:547e53. https://doi.org/10.1017/dmp.2015.38. Jeong H, Yim HW, Song YJ, Ki M, Min JA, Cho J, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38: e2016048. https://doi.org/10.4178/epih.e2016048. Liu X, Kakade M, Fuller CJ, Fan B, Fang Y, Kong J, et al. Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatr. 2012; 53:15e23. https://doi.org/10.1016/j.comppsych.2011.02.003 Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psychiatry. 2013;55: S299‑ https://dx.doi.org/10.4103%2F0019-5545.105555. Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, et al. Psychological impact of COVID‑19 lockdown: An online survey from India. Indian J Psychiatry. 2020; 62:354-62. https://doi.org/ 10.4103/psychiatry.IndianJPsychiatry _427_20. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010; 40: 218–27. https://dx.doi.org/10.1007%2Fs12160-010-9210-8. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7. Bhandari S, Sharma R, Singh Shaktawat A, Banerjee S, Patel B, Tak A, et al. COVID-19 related mortality profile at a tertiary care centre: a descriptive study. Scr Med. 2020;51(2):69-73. https://doi.org/10.5937/scriptamed51-27126. Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995; 117: 497–529. https://doi.org/10.1037/0033-2909.117.3.497. Caspi A, Harrington H, Moffitt TE, Milne BJ, Poulton R. Socially isolated children 20 years later: risk of cardiovascular disease. Arch Pediatr Adolesc Med. 2006; 160(8):805-11. https://doi.org/10.1001/archpedi.160.8.805. Eaker ED, Pinsky J, Castelli WP. Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. Am J Epidemiol. 1992; 135(8):854-64. https://doi.org/10.1093/oxfordjournals.aje.a116381. Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med. 2012 Mar; 74(6):907-14. https://dx.doi.org/10.1016%2Fj.socscimed.2011.11.028. Olsen RB, Olsen J, Gunner-Svensson F, Waldstrøm B. Social networks and longevity. A 14-year follow-up study among elderly in Denmark. Soc Sci Med. 1991; 33(10):1189-95. https://doi.org/10.1016/0277-9536(91)90235-5. Patterson AC, Veenstra G. Loneliness and risk of mortality: a longitudinal investigation in Alameda County, California. Soc Sci Med. 2010; 71(1):181-6. https://doi.org/10.1016/j.socscimed.2010.03.024. Savikko N, Routassalo P, Tilvis RS, Strandberg TE, Pitkalla KH. Predictors and subjective causes of loneliness in an aged population. Arch Gerontol Geriatrics. 2005; 41:3;223-33. https://doi.org/10.1016/j.archger.2005.03.002. Health Advisory for Elderly Population of India during COVID19. Available at: https://www.mohfw.gov.in/pdf/AdvisoryforElderlyPopulation.pdf [Accessed on 13 August 2020]. Dicks D, Myers R, Kling A. Uncus and amygdala lesions: effects on social behavior in the free-ranging rhesus monkey. Science. 1969; 165:69–71. https://doi.org/10.1126/science.165.3888.69. Kanai R, Bahrami B, Duchaine B, Janik A, Banissy MJ, Rees G. Brain structure links loneliness to social perception. Curr Biol. 2012; 22(20):1975-9. https://dx.doi.org/10.1016%2Fj.cub.2012.08.045. Bender AR, Daugherty A, Raz N. Vascular risk moderates associations between hippocampal subfield volumes and memory. J Cogn Neurosci. 2013; 25:1851–62. https://doi.org/10.1162/jocn_a_00435. Raz N. Diabetes: brain, mind, insulin–what is normal and do we need to know? Nat Rev Endocrinol. 2011; 7:636–7. https://doi.org/10.1038/nrendo.2011.149. Colcombe SJ, Erickson KI, Naftali R, Andrew GW, Cohen NJ, McAuley E, et al. Aerobic fitness reduces brain tissue loss in aging humans. J Gerontol A Biol Sci Med Sci. 2003; 58:176–80. https://doi.org/10.1093/gerona/58.2.m176. Maass A, Düzel S, Goerke M, Becke A, Sobieray U, Neumann K, et al. Vascular hippocampal plasticity after aerobic exercise in older adults. Mol Psychiatry. 2015; 20, 585–93. https://doi.org/10.1038/mp.2014.114. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and Risk of Alzheimer Disease. Arch Gen Psychiatry. 2007;64(2):234–240. https://doi.org/10.1001/archpsyc.64.2.234. Kogan JH, Frankland PW, Silva AJ. Long-term memory underlying hippocampus-dependent social recognition in mice. Hippocampus. 2000;10(1):47-56. https://doi.org/10.1002/(sici)1098-1063(2000)10:1%3C47::aid-hipo5%3E3.0.co;2-6. Yorgason JT, España RA, Konstantopoulos JK, Weiner JL, Jones SR. Enduring increases in anxiety-like behavior and rapid nucleus accumbens dopamine signaling in socially isolated rats. Eur J Neurosci. 2013;37(6):1022-31. https://doi.org/10.1111/ejn.12113. Bledsoe AC, Oliver KM, Scholl JL, Forster GL. Anxiety states induced by post-weaning social isolation are mediated by CRF receptors in the dorsal raphe nucleus. Brain Res Bull. 2011;85(3-4):117-22. https://dx.doi.org/10.1016%2Fj.brainresbull.2011.03.003. Lukkes JL, Engelman GH, Zelin NS, Hale MW, Lowry CA. Post-weaning social isolation of female rats, anxiety-related behavior, and serotonergic systems. Brain Res. 2012; 1443:1-17. https://dx.doi.org/10.1016%2Fj.brainres.2012.01.005. Ago Y, Araki R, Tanaka T, Sasaga A, Nishiyama S, Takuma K, et al. Role of social encounter-induced activation of prefrontal serotonergic systems in the abnormal behaviors of isolation-reared mice. Neuropsychopharmacology. 2013; 38(8):1535-47. https://doi.org/10.1038/npp.2013.52. Veenema AH. Early life stress, the development of aggression and neuroendocrine and neurobiological correlates: what can we learn from animal models? Front Neuroendocrinol. 2009;30(4):497-518. https://doi.org/10.1016/j.yfrne.2009.03.003. Zhao X, Sun L, Jia H, Meng Q, Wu S, Li N, et al. Isolation rearing induces social and emotional function abnormalities and alters glutamate and neurodevelopment-related gene expression in rats. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(7):1173-1177. https://doi.org/10.1016/j.pnpbp.2009.06.016. Sciolino NR, Bortolato M, Eisenstein SA, Fu J, Oveisi F, Hohmann AG, et al. Social isolation and chronic handling alter endocannabinoid signaling and behavioral reactivity to context in adult rats. Neuroscience. 2010;168(2):371-86. https://dx.doi.org/10.1016%2Fj.neuroscience.2010.04.007. Ghasemi M, Phillips C, Trillo L, De Miguel Z, Das D, Salehi A. The role of NMDA receptors in the pathophysiology and treatment of mood disorders. Neurosci Biobehav Rev. 2014; 47:336-358. https://doi.org/10.1016/j.neubiorev.2014.08.017. Olivenza R, Moro MA, Lizasoain I, Lorenzo P, Fernández AP, Rodrigo J, et al. Chronic stress induces the expression of inducible nitric oxide synthase in rat brain cortex. J Neurochem. 2000;74(2):785-791. https://doi.org/10.1046/j.1471-4159.2000.740785.x. Maeng S, Zarate CA Jr, Du J, Schloesser RJ, McCammon J, Chen G, et al. Cellular mechanisms underlying the antidepressant effects of ketamine: role of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. Biol Psychiatry. 2008;63(4):349-352. https://doi.org/10.1016/j.biopsych.2007.05.028. Kalia LV, Kalia SK, Salter MW. NMDA receptors in clinical neurology: excitatory times ahead. Lancet Neurol. 2008;7(8):742-755. https://dx.doi.org/10.1016%2FS1474-4422(08)70165-0. Waxman EA, Lynch DR. N-methyl-D-aspartate Receptor Subtypes: Multiple Roles in Excitotoxicity and Neurological Disease. The Neuroscientist. 2005; 11(1), 37–49. https://doi.org/10.1177/1073858404269012. Hermes G, Li N, Duman C, Duman R. Post-weaning chronic social isolation produces profound behavioral dysregulation with decreases in prefrontal cortex synaptic-associated protein expression in female rats. Physiol Behav. 2011;104(2):354-9. https://dx.doi.org/10.1016%2Fj.physbeh.2010.12.019. Sestito RS, Trindade LB, de Souza RG, Kerbauy LN, Iyomasa MM, Rosa ML. Effect of isolation rearing on the expression of AMPA glutamate receptors in the hippocampal formation. J Psychopharmacol. 2011;25(12):1720-1729. https://doi.org/10.1177/0269881110385595. Toua C, Brand L, Möller M, Emsley RA, Harvey BH. The effects of sub-chronic clozapine and haloperidol administration on isolation rearing induced changes in frontal cortical N-methyl-D-aspartate and D1 receptor binding in rats. Neuroscience. 2010;165(2):492-499. https://doi.org/10.1016/j.neuroscience.2009.10.039. Alò R, Avolio E, Mele M, Storino F, Canonaco A, Carelli A et al. Excitatory/inhibitory equilibrium of the central amygdala nucleus gates anti-depressive and anxiolytic states in the hamster. Pharmacol Biochem Behav. 2014; 118:79-86. https://doi.org/10.1016/j.pbb.2014.01.007. St JP, Petkov VV. Changes in 5-HT1 receptors in different brain structures of rats with isolation syndrome. General pharmacology. 1990;21(2):223-5. https://doi.org/10.1016/0306-3623(90)90905-2. Miachon S, Rochet T, Mathian B, Barbagli B, Claustrat B. Long-term isolation of Wistar rats alters brain monoamine turnover, blood corticosterone, and ACTH. Brain Res Bull. 1993;32(6):611-614. https://doi.org/10.1016/0361-9230(93)90162-5. Van den Berg CL, Van Ree JM, Spruijt BM, Kitchen I. Effects of juvenile isolation and morphine treatment on social interactions and opioid receptors in adult rats: behavioural and autoradiographic studies. Eur J Neurosci. 1999;11(9):3023-3032. https://doi.org/10.1046/j.1460-9568.1999.00717.x. Vanderschuren LJ, Stein EA, Wiegant VM, Van Ree JM. Social play alters regional brain opioid receptor binding in juvenile rats. Brain Res. 1995;680(1-2):148-156. https://doi.org/10.1016/0006-8993(95)00256-p. Moles A, Kieffer BL, D'Amato FR. Deficit in attachment behavior in mice lacking the mu-opioid receptor gene. Science. 2004;304(5679):1983-1986. https://doi.org/10.1126/science.1095943. Panksepp J, Herman BH, Vilberg T, Bishop P, DeEskinazi FG. Endogenous opioids and social behavior. Neurosci Biobehav Rev. 1980;4(4):473-487. https://doi.org/10.1016/0149-7634(80)90036-6. Gong JP, Onaivi ES, Ishiguro H, Liu Q, Tagliaferro PA, Brusco A, et al. Cannabinoid CB2 receptors: immunohistochemical localization in rat brain. Brain Res. 2006;1071(1):10-23. https://doi.org/10.1016/j.brainres.2005.11.035. Breivogel CS, Sim-Selley LJ. Basic neuroanatomy and neuropharmacology of cannabinoids. Int Rev Psychiatry 2009; 21:2:113-121. https://doi.org/10.1080/09540260902782760. Haj-Mirzaian A, Amini-Khoei H, Haj-Mirzaian A, Amiri S, Ghesmati M, Zahir M, et al. Activation of cannabinoid receptors elicits antidepressant-like effects in a mouse model of social isolation stress. Brain Res Bull. 2017; 130:200-210. https://doi.org/10.1016/j.brainresbull.2017.01.018. Banach M, Piskorska B, Czuczwar SJ, Borowicz KK. Nitric Oxide, Epileptic Seizures, and Action of Antiepileptic Drugs. CNS & Neurological Disorders - Drug Targets 2011;10: 808. https://doi.org/10.2174/187152711798072347. Förstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J. 2012;33(7):829-37, 837a-837d. https://dx.doi.org/10.1093%2Feurheartj%2Fehr304. Hu Y, Wu D, Luo C, Zhu L, Zhang J, Wu H, et al. Hippocampal nitric oxide contributes to sex difference in affective behaviors. PNAS. 2012, 109 (35) 14224-14229. https://doi.org/10.1073/pnas.1207461109. Khan MI, Ostadhadi S, Zolfaghari S, Mehr SE, Hassanzadeh G, Dehpour, A et al. The involvement of NMDA receptor/NO/cGMP pathway in the antidepressant like effects of baclofen in mouse force swimming test. Neuroscience Letters. 2016; 612:52-61. https://doi.org/10.1016/j.neulet.2015.12.006. Matsumoto K, Puia G, Dong E, Pinna G. GABAA receptor neurotransmission dysfunction in a mouse model of social isolation-induced stress: Possible insights into a non-serotonergic mechanism of action of SSRIs in mood and anxiety disorders. Stress. 2007; 10:1:3-12. https://doi.org/10.1080/10253890701200997. Zlatković J, Filipović D. Chronic social isolation induces NF-κB activation and upregulation of iNOS protein expression in rat prefrontal cortex. Neurochem Int. 2013;63(3):172-179. https://doi.org/10.1016/j.neuint.2013.06.002. Haj-Mirzaian A, Amiri S, Kordjazy N, Momeny M, Razmi A, Balaei MR, et al. Lithium attenuated the depressant and anxiogenic effect of juvenile social stress through mitigating the negative impact of interlukin-1β and nitric oxide on hypothalamic-pituitary-adrenal axis function. Neuroscience. 2016; 315:271-285. https://doi.org/10.1016/j.neuroscience.2015.12.024. Larson HJ. The biggest pandemic risk? Viral misinformation. Nature 2018; 562:309. https://doi.org/10.1038/d41586-018-07034-4. Zarocostas J. How to fight an infodemic. Lancet 2020; 395:676. https://doi.org/10.1016/S0140-6736(20)30461-X. World Health Organization, 2019. Ebola Virus Disease – Democratic Republic of the Congo. Geneva, Switzerland: WHO. Available at: https://www.who.int/csr/don/28-november-2019-ebola-drc/en/ [Accessed on August 8, 2020] Times of India. Covid-19: doctors gone to collect samples attacked in Indore. Available at: https://timesofindia.indiatimes.com/videos/news/covid-19-doctors-goneto- collect-samples-attacked-in-indore/videoshow/74942153.cms; 2020 [Accessed on August 8, 2020]. Withnall A. Coronavirus: why India has had to pass new law against attacks on healthcare workers. The Independent. April 23, 2020. Semple K. “Afraid to be a nurse”: health workers under attack. The New York Times. 2020 Apr 27. The Economist. Health workers become unexpected targets during COVID-19. The Economist. May 11, 2020. Turan B, Budhwani H, Fazeli PL, Browning WR, Raper JL, Mugavero MJ, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS Behav. 2017; 21: 283–291. https://doi.org/10.1007/s10461-016-1451-5. James PB, Wardle J, Steel A, Adams J. An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross sectional study. BMC Public Health. 2020; 20: 182. https://doi.org/10.1186/s12889-020-8279-7. Aljazeera, 2020. Iran: Over 700 Dead after Drinking Alcohol to Cure Coronavirus. Aljazeera. Available at: https://www.aljazeera.com/ news/2020/04/iran-700-dead-drinking-alcohol-cure-coronavirus200427163529629.html. (Accessed June 4, 2020) Delirrad M, Mohammadi AB, 2020. New methanol poisoning outbreaks in Iran following COVID-19 pandemic. Alcohol Alcohol. 55: 347–348. https://doi.org/10.1093/alcalc/agaa036. Hassanian-Moghaddam H, Zamani N, Kolahi A-A, McDonald R, Hovda KE. Double trouble: methanol outbreak in the wake of the COVID-19 pandemic in Iran-a cross-sectional assessment. Crit Care. 2020; 24: 402. https://doi.org/10.1186/s13054-020-03140-w. Soltaninejad K. Methanol Mass Poisoning Outbreak: A Consequence of COVID-19 Pandemic and Misleading Messages on Social Media. Int J Occup Environ Med. 2020;11(3):148-150. https://dx.doi.org/10.34172%2Fijoem.2020.1983. Islam MS, Sarkar T, Khan SH, Kamal AM, Hasan SMM, Kabir A, et al. COVID-19–Related Infodemic and Its Impact on Public Health: A Global Social Media Analysis. Am J Trop Med Hyg. 2020; 00(0):1–9. https://doi.org/10.4269/ajtmh.20-0812. Hawryluck L, Gold W, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–1212. https://dx.doi.org/10.3201%2Feid1007.030703. Lee S, Chan LYY, Chau AAM, Kwok KPS, Kleinman A. The experience of SARS-related stigma at Amoy Gardens. Soc Sci Med. 2005; 61(9): 2038-2046. https://doi.org/10.1016/j.socscimed.2005.04.010. Yoon MK Kim SY Ko HS Lee MS. System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea. Int J Ment Health Syst. 2016; 10: 51. https://doi.org/10.1186/s13033-016-0083-5. Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008; 136: 997-1007. https://dx.doi.org/10.1017%2FS0950268807009156. Marjanovic Z, Greenglass ER, Coffey S. The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey. Int J Nurs Stud. 2007; 44(6): 991-998. https://doi.org/10.1016/j.ijnurstu.2006.02.012. Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004; 55: 1055-1057. https://doi.org/10.1176/appi.ps.55.9.1055. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases10May2020.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/AdvisoryformanagingHealthcareworkersworkinginCOVIDandNonCOVIDareasofthehospital.pdf (Accessed on 25 August 2020). Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforInternationalArrivals02082020.pdf [Accessed on 25 August 2020]. Cost of the lockdown? Over 10% of GDP loss for 18 states. Available at: https://timesofindia.indiatimes.com/india/cost-of-the-lockdown-over-10-of-gdp-loss-for-18-states/articleshow/76028826.cms [Accessed on 21 August 2020]. Jorda O, Singh SR, Taylor AM. Longer-Run Economic Consequences of Pandemics. Federal Reserve Bank of San Francisco Working Paper. 2020-09. https://doi.org/10.24148/wp2020-09. Firdaus G. Mental well‑being of migrants in urban center of India: Analyzing the role of social environment. Indian J Psychiatry. 2017; 59:164‑ https://doi.org/10.4103/psychiatry.indianjpsychiatry_272_15. National Crime Record Bureau. Annual Crime in India Report. New Delhi, India: Ministry of Home Affairs; 2018. 198 migrant workers killed in road accidents during lockdown: Report. Available at: https://www.hindustantimes.com/india-news/198-migrant-workers-killed-in-road-accidents-during-lockdown-report/story-hTWzAWMYn0kyycKw1dyKqL.html [Accessed on 25 August 2020]. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020; 20:689-96. https://doi.org/10.1016/S1473-3099(20)30198-5. Dalton L, Rapa E, Stein A. Protecting the psychological health of through effective communication about COVID-19. Lancet Child Adolesc Health. 2020;4(5):346-347. https://doi.org/10.1016/S2352-4642(20)30097-3. Centre for Disease Control. Helping Children Cope with Emergencies. Available at: https://www.cdc.gov/childrenindisasters/helping-children-cope.html [Accessed on 25 August 2020]. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child & Adolesc Health. 2020; 4(5):347-349. https://doi.org/10.1016/S2352-4642(20)30096-1. Sprang G, Silman M. Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters. Disaster Med Public Health Prep. 2013;7(1):105-110. https://doi.org/10.1017/dmp.2013.22. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Community Ment Health J. 2020:1-7. https://doi.org/10.1007/s10597-020-00664-x. Cao W, Fang Z, Hou, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research. 2020; 287:112934. https://doi.org/10.1016/j.psychres.2020.112934. Wang C, Zhao H. The Impact of COVID-19 on Anxiety in Chinese University Students. Front Psychol. 2020; 11:1168. https://dx.doi.org/10.3389%2Ffpsyg.2020.01168. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3): e14. https://doi.org/10.1016/s2215-0366(20)30047-x. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3(3): e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976. Lancee WJ, Maunder RG, Goldbloom DS, Coauthors for the Impact of SARS Study. Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr Serv. 2008;59(1):91-95. https://dx.doi.org/10.1176%2Fps.2008.59.1.91. Tam CWC, Pang EPF, Lam LCW, Chiu HFK. Severe acute respiratory syndrome (SARS) in Hongkong in 2003: Stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34 (7):1197-1204. https://doi.org/10.1017/s0033291704002247. Lee SM, Kang WS, Cho A-R, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018; 87:123-127. https://dx.doi.org/10.1016%2Fj.comppsych.2018.10.003. Koh D, Meng KL, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: What can we learn? Med Care. 2005;43(7):676-682. https://doi.org/10.1097/01.mlr.0000167181.36730.cc. Verma S, Mythily S, Chan YH, Deslypere JP, Teo EK, Chong SA. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singap. 2004; 33(6):743e8. Yeung J, Gupta S. Doctors evicted from their homes in India as fear spreads amid coronavirus lockdown. CNN World. 2020. Available at: https://edition.cnn.com/2020/03/25/asia/india-coronavirus-doctors-discrimination-intl-hnk/index.html. [Accessed on 24 August 2020] Violence Against Women and Girls: the Shadow Pandemic. UN Women. 2020. May 3, 2020. Available at: https://www.unwomen.org/en/news/stories/2020/4/statement-ed-phumzile-violence-against-women-during-pandemic. [Accessed on 24 August 2020]. Gearhart S, Patron MP, Hammond TA, Goldberg DW, Klein A, Horney JA. The impact of natural disasters on domestic violence: an analysis of reports of simple assault in Florida (1999–2007). Violence Gend. 2018;5(2):87–92. https://doi.org/10.1089/vio.2017.0077. Sahoo S, Rani S, Parveen S, Pal Singh A, Mehra A, Chakrabarti S, et al. Self-harm and COVID-19 pandemic: An emerging concern – A report of 2 cases from India. Asian J Psychiatr 2020; 51:102104. https://dx.doi.org/10.1016%2Fj.ajp.2020.102104. Ghosh A, Khitiz MT, Pandiyan S, Roub F, Grover S. Multiple suicide attempts in an individual with opioid dependence: Unintended harm of lockdown during the COVID-19 outbreak? Indian J Psychiatry 2020; [In Press]. The Economic Times. 11 Coronavirus suspects flee from a hospital in Maharashtra. March 16 2020. Available at: https://economictimes.indiatimes.com/news/politics-and-nation/11-coronavirus-suspects-flee-from-a-hospital-in-maharashtra/videoshow/74644936.cms?from=mdr. [Accessed on 23 August 2020]. Xiang Y, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry 2020;(3):228–229. https://doi.org/10.1016/S2215-0366(20)30046-8. Van Bortel T, Basnayake A, Wurie F, Jambai M, Koroma A, Muana A, et al. Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bull World Health Organ. 2016;94(3):210–214. https://dx.doi.org/10.2471%2FBLT.15.158543. Kumar A, Nayar KR. COVID 19 and its mental health consequences. Journal of Mental Health. 2020; ahead of print:1-2. https://doi.org/10.1080/09638237.2020.1757052. Gupta R, Grover S, Basu A, Krishnan V, Tripathi A, Subramanyam A, et al. Changes in sleep pattern and sleep quality during COVID-19 lockdown. Indian J Psychiatry. 2020; 62(4):370-8. https://doi.org/10.4103/psychiatry.indianjpsychiatry_523_20. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4): P300-302. https://doi.org/10.1016/S2215-0366(20)30073-0. Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020; 14(5): 779–788. https://dx.doi.org/10.1016%2Fj.dsx.2020.05.035. Wright R. The world's largest coronavirus lockdown is having a dramatic impact on pollution in India. CNN World; 2020. Available at: https://edition.cnn.com/2020/03/31/asia/coronavirus-lockdown-impact-pollution-india-intl-hnk/index.html. [Accessed on 23 August 2020] Foster O. ‘Lockdown made me Realise What’s Important’: Meet the Families Reconnecting Remotely. The Guardian; 2020. Available at: https://www.theguardian.com/keep-connected/2020/apr/23/lockdown-made-me-realise-whats-important-meet-the-families-reconnecting-remotely. (Accessed on 23 August 2020) Bilefsky D, Yeginsu C. Of ‘Covidivorces’ and ‘Coronababies’: Life During a Lockdown. N. Y. Times; 2020. Available at: https://www.nytimes.com/2020/03/27/world/coronavirus-lockdown-relationships.html [Accessed on 23 August 2020]

China is party to the 1951 Refugee Convention and the 2000 UN Trafficking Protocol, but has not extended coverage of either of the treaties to the Hong Kong Special Administrative Region of China (Hong Kong). Hong Kong does however offer non-refoulement protection on the basis of risks of torture or persecution. Further, Hong Kong legislation defines human trafficking, albeit only in terms of cross-border sex work. Victim identification also remains inadequate. The limited extant protection systems for refugees and victims of human trafficking operate separately and assume that such people are distinct with respect to their experiences and needs. These practices are often mirrored in the approaches of NGOs working in the city. Based on research undertaken by Justice Centre Hong Kong, this paper argues instead that boundaries between the two categories are blurry. The paper focuses on migrant domestic workers who may have claims to asylum and may be at the same time victims of human trafficking. It explores some of the implications for NGOs trying to secure better protections for such groups in Hong Kong. The paper concludes that siloing the refugee and the human trafficking frameworks creates a protection gap, particularly for people who enter Hong Kong as migrant domestic workers and cannot return home because they face a risk of persecution or torture.

Abstract This paper examines the impacts of state policies and NGO advocacy on female sex workers’ identity and how they manage stigma. Comparing three groups of sex workers – those born and working in mainland China, those born and working in Hong Kong, and those born in mainland China who later migrated to Hong Kong and entered the sex industry – this paper suggests that differences in state policies on prostitution and the different degrees of visibility of NGOs campaigning for sex workers’ rights are related to three strategies used by sex workers to construct a positive self-image to counteract the stigma they face: gendered obligation fulfilment, professional work and responsible citizenship. The paper illustrates that stigmatized-identity management involves complex relationships among individual interpretation, selection and mobilization of gender, work and citizenship scripts, which are contingent on structural features of the environment and may change during migration and relocation.

Abstract Background Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. Method A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015–2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. Results Eighty-four point one percent (95% CI 81.4–86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4–18.6%) were current polytobacco product users, 12.3% (10.2–14.8%) used one tobacco product and 2.52% (1.59–3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75–8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44–2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12–3.61), younger age (AORs range from 1.34–4.65, P for trend < .001) and less ready to quit (2.08, 1.09–3.97). Conclusions Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

Objective: This study examined the epidemiology of scarlet fever in Hong Kong based on notifiable disease surveillance data, in a period where a 10-fold upsurge in scarlet fever incidence occurred. High risk groups and important factors associated with scarlet fever transmission were identified.Introduction: Scarlet fever is a notifiable disease in Hong Kong for over 40 years. There was relatively low activity of scarlet fever until an outbreak in mid-2011 which resulted in two deaths and more than 1,500 cases. Scarlet fever incidence remained elevated since then with >10-fold increase comparing to that before the upsurge (1, 2). Reemergence of scarlet fever was also reported in China in 2011 and the United Kingdom in 2014 (3). We analyzed the patterns in scarlet fever incidence in Hong Kong using the notifiable disease surveillance data from 2005–2015.Methods: We analyzed 7,266 scarlet fever cases aged 14y or younger from 2005-2015, who were notified to the Department of Health. Hierarchical multivariable negative binomial models were fitted to the data to study the effects of age, sex, school holidays, and other meteorological parameters, accounting for autocorrelation, seasonal and long-term trend. Separate models were fitted to the data before and after the upsurge in 2011, excluding data in 2011 to allow for a 1-year window period.Results: We observed seasonal pattern throughout the study period (Figure). Among children aged ≤5y, the average scarlet fever incidence was 3.3 per 10,000 children in 2005-2010, which increased substantially to 18.1 per 10,000 children in 2012-2015.The final model included age, sex, school holidays in the preceding week, temperature, relative humidity, rainfall, long-term and bimodal seasonal trend. Based on the model, we identified no significant long-term trend before the upsurge in 2011, but there was a mild decreasing trend of about 8% (95% CI=6-11%) per year after the upsurge. A major peak was identified in December to January, with a milder peak in May to June.We found that the most affected groups were kindergarten students (3-5y), followed by primary school students (6-11y). Comparing to girls aged 0-2y, boys had significantly higher risk than girls except for the 0-2y age group, and boys aged 3-5y had the highest risk (adjusted incidence rate ratio (IRR)=1.47, 95% CI=1.32-1.65). School holidays were significantly associated with lower incidence of scarlet fever, with an adjusted IRR of 0.58 (95% CI=0.51–0.65) after the upsurge in 2011. Temperature was found to be negatively associated with scarlet fever incidence (adjusted IRR=0.963, 95% CI=0.940-0.987) after the upsurge.Conclusions: Our study showed that elevated activity of scarlet fever was sustained for more than 5 years after the upsurge in 2011. We found that younger children who started schools, especially for boys aged 3-5 years, had a higher risk of scarlet fever, and there was significant effect of school holidays in reducing scarlet fever incidence. Combining these findings, school-based control strategy is likely to be effective. Sustained and consistent surveillance of scarlet fever allows continued monitoring of potential change in high risk group to drive updated and effective control strategy.

Abstract Background Although dormitory residents have been identified as a high-risk group for alcohol misuse in Chinese university settings, the factors associated with their drinking behaviors has not be characterized. Methods A cross-sectional study was conducted among hostel residents in two Hong Kong universities (n = 1455) using self-administered, anonymous surveys. In addition to examining the knowledge levels and drinking-related attitudes, we examined the factors associated with binge drinking in this population using multivariable regression analysis. Results Among university dormitory residents, the prevalence of past-month binge drinking was 26.8% among males and 12.8% among females. It was noted that although respondents demonstrated attitudes conducive towards alcohol-free socialization, they exhibited low levels of alcohol-related knowledge (mean knowledge score: 3.3/ 10, SD = 2.0). While about 59% were aware that alcohol is a carcinogen and that some medications should not be taken with alcohol, only 10.4% were familiar with symptoms of alcohol poisoning and only 23% were familiar with relative amounts of alcohol in different beverage categories. Of the respondents the factors independently associated with past-month binge drinking were: male sex, older age, full-time hostel residence, drinking roommates, drinking romantic partner, participation in drinking games, and having pro-alcohol attitudes (OR ranging from 1.33-3.69). Alcohol-related knowledge was not associated with binge drinking. Conclusions Although southern China is a low alcohol consumption area, binge drinking is common among university residents and requires multi-prong interventions. Heavy drinking is a neglected health problem among urban Chinese university students. Interventions targeting binge drinkers need to counteract pro-alcohol attitudes and peer effects. Increasing alcohol knowledge may additionally help to reduce alcohol-related harms in this age group. Key messages Urban Chinese university dormitory residents demonstrate low levels of alcohol knowledge. Pro-alcohol attitudes and peers effects need to be addressed in university anti-binge drinking interventions.

Background: Same-sex marriage is currently not legalized in China, despite the considerably large number of homosexual and bisexual Chinese populations. At the same time, their holistic health status remains unclear. This is the first scoping review conducted to comprehensively examine all the available literature and map existing evidence on the holistic health of homosexual and bisexual Chinese.Methods: This scoping review used the framework of Arksey and O'Malley and followed the Preferred Reporting Items for Systematic Review and Meta-Analysis extension for scoping reviews (PRISMA-ScR). A comprehensive search strategy was carried out across 20 English (EN) and Chinese (both traditional and simplified) electronic databases from January 1, 2001, to May 31, 2020. Two reviewers conducted the reference screening and study selection independently and consulted a third senior reviewer whenever a consensus must be achieved. Data extraction was conducted using a structured data form based on the Cochrane template, after which a narrative synthesis of the findings was performed.Results: A total of 2,879 references were included in the final analysis, with 2,478 research articles, 167 reviews, and 234 theses. Regarding the study populations, the vast majority of studies centered on men only (96.46%), especially men who have sex with men (MSM). Only 1.32% of the studies targeted female sexual minorities. The geographical distribution of all research sites was uneven, with most of them being conducted in mainland China (95.96%), followed by Hong Kong (2.05%), Taiwan (2.02%), and Macau (0.06%). Regarding the specific study focus in terms of the health domain, around half of the studies (45.93%) focused on sexual health only, and an additional quarter of the studies (24.15%) investigated both sexual health and social well-being. Meanwhile, the studies focusing on mental health only accounted for approximately 15% of the total.Conclusions: This scoping review revealed that previous research focused more on male than female sexual minorities, on disease-centered surveys than person-centered interventions, and investigations on negative health conditions than positive health promotion. Therefore, investigations centered on the female sexual minorities and corresponding person-centered interventions are highly needed.Review Registration: The protocol of this review has been registered within Open Science Framework (https://osf.io/82r7z) on April 27, 2020.

Abstract Student's t test is valid for statistical inference under the normality assumption or asymptotically. By contrast, although the bootstrap t test was proposed in 1993, it is seldom adopted in medical research. We aim to demonstrate that the bootstrap t test outperforms Student's t test under normality in data. Using random data samples from normal distributions, we evaluated the testing performance, in terms of true-positive rate (TPR) and false-positive rate and diagnostic abilities, in terms of the area under the curve (AUC), of the bootstrap t test and Student's t test. We explore the AUC of both tests with varying sample size and coefficient of variation. We compare the testing outcomes using the COVID-19 serial interval (SI) data in Shenzhen and Hong Kong, China, for demonstration. With fixed TPR, the bootstrap t test maintained the equivalent accuracy in TPR, but significantly improved the true-negative rate from the Student's t test. With varying TPR, the diagnostic ability of bootstrap t test outperformed or equivalently performed as Student's t test in terms of the AUC. The equivalent performances are possible but rarely occur in practice. We find that the bootstrap t test outperforms by successfully detecting the difference in COVID-19 SI, which is defined as the time interval between consecutive transmission generations, due to sex and non-pharmaceutical interventions against the Student's t test. We demonstrated that the bootstrap t test outperforms Student's t test, and it is recommended to replace Student's t test in medical data analysis regardless of sample size.

Abstract Background The role of dietary fiber intake on risk of nasopharyngeal carcinoma (NPC) remains unclear. We examined the associations of dietary fiber intake on the risk of NPC adjusting for a comprehensive list of potential confounders. Methods Using data from a multicenter case-control study, we included 815 histologically confirmed NPC incident cases and 1502 controls in Hong Kong, China recruited in 2014–2017. Odds ratios (ORs) of NPC (cases vs controls) for dietary fiber intake from different sources at different life periods (age 13–18, age 19–30, and 10 years before recruitment) were evaluated using unconditional logistic regression, adjusting for sex, age, socioeconomic status, smoking and drinking status, occupational hazards, family history of cancer, salted fish, and total energy intake in Model 1, Epstein-Barr virus viral capsid antigen serological status in Model 2, and duration of sun exposure and circulating 25-hydroxyvitamin D in Model 3. Results Higher intake of total dietary fiber 10 years before recruitment was significantly associated with decreased NPC risk, with demonstrable dose-response relationship (P-values for trend = 0.001, 0.020 and 0.024 in Models 1–3, respectively). The adjusted ORs (95% CI) in the highest versus the lowest quartile were 0.51 (0.38–0.69) in Model 1, 0.48 (0.33–0.69) in Model 2, and 0.48 (0.33–0.70) in Model 3. However, the association was less clear after adjustment of other potential confounders (e.g. EBV) in the two younger periods (age of 13–18 and 19–30 years). Risks of NPC were significantly lower for dietary fiber intake from fresh vegetables and fruits and soybean products over all three periods, with dose-response relationships observed in all Models (P-values for trend for age 13–18, age 19–30 and 10 years before recruitment were, respectively, 0.002, 0.009 and 0.001 for Model1; 0.020, 0.031 and 0.003 for Model 2; and 0.022, 0.037 and 0.004 for Model 3). No clear association of NPC risk with dietary fiber intake from preserved vegetables, fruits and condiments was observed. Conclusion Our study has shown the protective role of dietary fiber from fresh food items in NPC risk, but no association for total dietary fiber intake was observed, probably because total intake also included intake of preserved food. Further studies with detailed dietary information and in prospective settings are needed to confirm this finding, and to explore the possible underlying biological mechanisms.

Synonymous with globalism, the mobile phone has become an integral part of contemporary everyday life. As a global medium, the mobile phone is a compelling phenomenon that demonstrates the importance of the local in shaping and adapting the technology. The adaptation and usage of the mobile phone can be read on two levels simultaneously – the micro, individual level and the macro, socio-cultural level. Symbolic of the pervasiveness and ubiquity of global ICTs (Information and Communication Technologies) in the everyday, the mobile phone demonstrates that the experiences of the local are divergent in the face of global convergence. The cultural significance of mobile technologies sees it often as a symbol for discussion around issues of democracy, capitalism, individualism and redefinitions of place. These debates are, like all forms of mediation, riddled with paradoxes. As Michael Arnold observes, mobile media is best encapsulated by the notion of “janus-faced” which sees an ongoing process of pushing and pulling whereby one is set free to be anywhere but is on a leash to whims of others anytime. This paradox, for Arnold, is central to all technologies; the more we try to overcome various forms of distance (geographic, temporal, cultural), the more we avoid closeness and intimacy. For Jack Qui, mobile technologies are indeed the ultimate “wireless leash”. These paradoxes see themselves played in a variety of ways. This is particularly the case in the Asia-Pacific region, which houses divergence and uneven adoption, production and consumption of mobile technologies. The region simultaneously displays distinctive characteristics and a possible future of mobile media worldwide. From the so-called ‘centres’ for mobile innovation such as Tokyo and Seoul that have gained attention in global press to Asian “tigers” such as Singapore, Hong Kong and Taiwan that demonstrate high penetration rates (Singapore has a 110% penetration rate), the region often plays out its dynamics through mobile technologies. The Philippines, for example, is known as the ‘texting capital of the world’ with 300 million text messages sent per day. Moreover, the region has taken central focus for debates around the so-called democratic potential of the mobile phone through examples such as the demise of President Joseph Estrada in the Philippines and the election of President Roh in South Korea (Pertierra, Transforming Technologies; Kim). Through the use of mobile technologies and the so-called rise of the “prosumer” (consumer as producer), we can see debates about the rhetoric and reality of democracy and capitalism in the region. In the case of nascent forms of capitalism, the rise of the mobile phone in China has often been seen as China’s embrace, and redefinition, of capitalism away from being once synonymous with westernisation. As Chua Beng Huat observes, after the 1997 financial crisis in the region notions of consumerism and modernity ceased to be equated with westernization. In the case of China, the cell phone has taken on a pivotal role in everyday life with over 220 billion messages – over half the world’s SMS – sent yearly in China. Despite the ubiquity and multi-layered nature of mobile media in the region, this area has received little attention in the growing literature on mobile communication globally. Publications often explore ‘Asia’ in the context of ‘global’ media or Asia in contrast to Europe. Examples include Katz and Aakhus’s (eds.) seminal anthology Perpetual Contact, Pertierra’s (ed.) The Social Construction and Usage of Communication Technologies: European and Asian experiences and, more recently, Castells et al., Mobile Communication and Society: A Global Perspective. When publications do focus specifically on ‘Asia’, they single out particular locations in the region, such as Ito et al.’s compelling study on Japan, Personal, Portable, Pedestrian: Mobile Phones in Japanese Life and Pertierra’s eloquent discussion of the Philippines in Transforming Technologies: Altered Selves. This issue of M/C Journal attempts to address the dynamic and evolving role of mobile technologies in the Asia-Pacific region. By deploying various approaches to different issues involving mobile media, this issue aims to connect, through a regional imaginary, some of the nuances of local experience within the Asia-Pacific. As a construct, the region of the Asia-Pacific is ever evolving with constantly shifting economic and political power distributions. The rapid economic growth of parts of the region (Japan, Singapore, Taiwan, Korea, Hong Kong, and now China, Vietnam, Malaysia, the Philippines and Indonesia) over the last two to three decades, has led to increasing linkages between these nations in creating transnational networks. The boundaries of the Asia-Pacific are indeterminate and open to contestation and social construction. Initially, the Asia-Pacific was a Euro-American invention, however, its ‘Asian’ content is now playing a greater role in self-constructions, and in influencing the economic, cultural and political entity that is the Asia-Pacific. There have been alternative terms and definitions proffered to describe or delimit the area posited as the Asia-Pacific in an attempt to acknowledge, or subsume, the hierarchies inherent within the region. For example, John Eperjesi has critiqued the ‘American Pacific’ which “names the regional imaginary through which capital looked to expand into Asia and the Pacific at the turn of the [last] century” (195). Arif Dirlik has also suggested two other terms: ‘Asian Pacific’ and ‘Euro-American Pacific.’ He suggests, “the former refers not just to the region’s location, but, more important, to its human constitution; the latter refers to another human component of the region (at least at present) and also to its invention as a regional structure.” (“Asia-Pacific Idea”, 64). Together, Rob Wilson and Arif Dirlik use the configuration ‘Asia/Pacific’ to discuss the region as a space of cultural production, social migration, and transnational innovation, whereby “the slash would signify linkage yet difference” (6). These various terms are useful only insofar as they expose the ideological bases of the definitions, and identify its centre(s). In this emphasis on geography, it is important not to obscure the temporal and spatial characteristics of human activities that constitute regions. As Arif Dirlik notes, “[an] emphasis on human activity shifts attention from physical area to the construction of geography through human interactions; it also underlines the historicity of the region’s formations” (What Is in a Rim?, 4). The three-part structure of this issue seeks to provide various perspectives on the use of mobile technologies and media – from a macro, regional level, to micro, local case studies – in the context of both historical and contemporary formations and definitions of the Asia-Pacific. In an age of mobile technologies we see that rather than erode, notions of place and locality take on increasing significance. The first four papers by Jaz Hee-jeong Choi, Gerard Raiti, Yasmin Ibrahim, and Collette Snowden & Kerry Green highlight some of the key concepts and phenomena associated with mobile media in the region. Choi’s paper provides a wonderful introduction to the culture of mobile technologies in East Asia, focusing largely on South Korea, China and Japan. She problematises the rhetoric surrounding technological fetishism and techno-orientalism in definitions of ‘mobile’ and ‘digital’ East Asia and raises important questions regarding the transformation and future of East Asia’s mobile cultures. Gerard Raiti examines the behemoth of globalization from the point of view of personal intimacy. He asks us to reconsider notions of intimacy in a period marked by co-presence; particularly in light of the problematic conflation between love and technological intimacy. Yasmin Ibrahim considers the way the body is increasingly implicated through the personalisation of mobile technologies and becomes a collaborator in the creation of media events. Ibrahim argues that what she calls the ‘personal gaze’ of the consumer is contributing to the visual narratives of global and local events. What we have is a figure of the mediated mobile body that participates in the political economy of events construction. The paradoxical role of mobile technologies as both pushing and pulling us, helping and hindering us (Arnold) is taken up in Collette Snowden and Kerry Green’s paper on the role of media reporting, mobility and trauma. Extending some of Ibrahim’s comments in the specific case of the reporting of traumatic events, Snowden and Green provide a wonderful companion piece about how media reporting is being transformed by contemporary mobile practices. As an integral component of contemporary visual cultures, camera phone practices are arguably both extending and creating emerging ways of seeing and representing. In the second section, we begin our case studies exploring the socio-cultural particularities of various adaptations of mobile media within specific locations in the Asia-Pacific. Randy Jay C. Solis elaborates on Gerard Raiti’s discussion of intimacy and love by exploring how the practice of ‘texting’ has contributed to the development of romantic relationships in the Philippines in terms of its convenience and affordability. Lee Humphreys and Thomas Barker further extend this discussion by investigating the way Indonesians use the mobile phone for dating and sex. As in Solis’s article, the authors view the mobile phone as a tool of communication, identity management and social networking that mediates new forms of love, sex and romance in Indonesia, particularly through mobile dating software and mobile pornography. Li Li’s paper takes the playful obsession the Chinese and South Koreans have with lucky numbers and locates its socio-cultural roots. Through a series of semi-structured interviews, the author traces this use of lucky mobile numbers to the rise of consumerism in China and views this so-called ‘superstition’ in terms of the entry into modernity for both China and South Korea. Chih-Hui Lai’s paper explores the rise of Web 2.0. in Taiwan, which, in comparison to other locations in the region, is still relatively under-documented in terms of its usage of mobile media. Here Lai addresses this gap by exploring the burgeoning role of mobile media to access and engage with online communities through the case study of EzMoBo. In the final section we problematise Australia’s place in the Asia-Pacific and, in particular, the nation’s politically and culturally uncomfortable relationship with Asia. Described as ‘west in Asia’ by Rao, and as ‘South’ of the West by Gibson, Yue, and Hawkins, Australia’s uneasy relationship with Asia deserves its own location. We begin this section with a paper by Mariann Hardey that presents a case study of Australian university students and their relationship to, and with, the mobile phone, providing original empirical work on the country’s ‘iGeneration’. Next Linda Leung’s critique of mobile telephony in the context of immigration detention centres engages with the political dimensions of technology and difference between connection and contact. Here we reminded of the luxury of mobile technologies that are the so-called necessity of contemporary everyday life. We are also reminded of the ‘cost’ of different forms of mobility and immobility – technological, geographic, physical and socio-cultural. Leung’s discussion of displacement and mobility amongst refugees calls upon us to reconsider some of the conflations occurring around mobile telephony and new media outside the comfort of everyday urbanity. The final paper, by Peter B. White and Naomi Rosh White, addresses the urban and rural divide so pointed in Australia (with 80% of the population living in urban areas) by discussing an older, though still relevant mobile technology, the CB radio. This paper reminds us that despite the technological fetishism of urban Australia, once outside of urban contexts, we are made acutely aware of Australia as a land containing a plethora of black spots (in which mobile phones are out of range). All of the papers in this issue address, in their own way, theoretical and empirical ‘black spots’ in research and speak to the ‘future’ of mobile media in a region that, while diverse, is being increasingly brought together by technologies such as the mobile phone. Lastly, we are pleased to include a photo essay by Andrew Johnson. Entitled Zeitgeist, this series of artworks sees Johnson exploring the symbolic dimensions of the hand phone in South Korea by drawing on the metaphor of the dust mask. According the Johnson, these images refer to ‘the visibility and invisibility of communication’ that characterises the spirit of our time. The cover image is by Larissa Hjorth as part of her Snapshots: Portrait of the Mobile series conducted whilst on an Asialink residency at Ssamzie space (Seoul, South Korea) in 2005. The editors would like to offer a special note of thanks to all of our external reviewers who answered our pleas for help with willingness, enthusiasm, and especially, promptness. This issue could not have been completed without your support. References Arnold, Michael. “On the Phenomenology of Technology: The ‘Janus-Faces’ of Mobile Phones.” Information and Organization 13 (2003): 231-256. Castells, Manuel, et al., Mobile Communication and Society: A Global Perspective. Cambridge, Mass.: MIT Press, 2007. Chua, Beng Huat, ed. Consumption in Asia. London: Routledge, 2000. Dirlik, Arif. “The Asia-Pacific Idea: Reality and Representation in the Invention of a Regional Structure.” Journal of World History 3.1 (1992): 55-79. Dirlik, Arif, ed. What Is in a Rim? Critical Perspectives on the Pacific Region Idea. Boulder: Westview, 1993. Eperjesi, John. “The American Asiatic Association and the Imperialist Imaginary of the American Pacific.” Boundary 2 28.1 (Spring 2001): 195-219. Gibson, Ross. South of the West: Postcolonialism and the Narrative Construction of Australia. Bloomington and Indianapolis: Indiana UP, 1996. Ito, Mizuko, Daisuke Okabe, and Misa Matsuda, eds. Personal, Portable, Pedestrian: Mobile Phones in Japanese Life. Cambridge, Mass.: MIT Press, 2005. Katz, James E., and Mark Aakhus, eds. Perpetual Contact: Mobile Communications, Private Talk, Public Performance. Cambridge: Cambridge UP, 2002 Kim, Shin Dong. “The Shaping of New Politics in the Era of Mobile and Cyber Communication.” Mobile Democracy: Essays on Society, Self and Politics. Ed. Kristof Nyiri. Vienna: Van Passen Verlag, 2003. Pertierra, Raul, ed. The Social Construction and Usage of Communication Technologies: European and Asian Experiences. Singapore: Singapore UP, 2005. –––. Transforming Technologies: Altered Selves. Philippines: De La Salle UP, 2006. Qui, Jack. “The Wireless Leash: Mobile Messaging Service as a Means of Control.” International Journal of Communication 1 (2007): 74-91. Rao, Madanmohan, ed. News Media and New Media: The Asia-Pacific Internet Handbook. Singapore: Times Academic Press, 2004. Wilson, Robert, and Afir Dirlik, eds. Asia/Pacific as Space of Cultural Production. Durham: Duke UP, 1995. Yue, Audrey. “Asian Australian Cinema, Asian-Australian Modernity.” Diaspora: Negotiating Asian-Australia. Eds. Helen Gilbert et al. St Lucia: U of Queensland P, 2000. 190–99. Yue, Audrey, and Gay Hawkins. “Going South.” New Formations 40 (Spring 2000): 49-63. Citation reference for this article MLA Style Hjorth, Larissa, and Olivia Khoo. "Collect Calls." M/C Journal 10.1 (2007). echo date('d M. Y'); ?> <http://journal.media-culture.org.au/0703/00-editorial.php>. APA Style Hjorth, L., and O. Khoo. (Mar. 2007) "Collect Calls," M/C Journal, 10(1). Retrieved echo date('d M. Y'); ?> from <http://journal.media-culture.org.au/0703/00-editorial.php>.

Introduction Lillian Ng was born in Singapore and lived in Hong Kong and the United Kingdom before migrating to Australia with her daughter and Ah Mah Yin Jie (“Ah Mahs are a special group of people who took a vow to remain unmarried … [so they] could stick together as a group and make a living together” (Yu 118)). Ng studied classical Chinese at home, then went to an English school and later on studied Medicine. Her first book, Silver Sister (1994), was short-listed for the inaugural Angus & Robertson/Bookworld Prize in 1993 and won the Human Rights Award in 1995. Ng defines herself as a “Chinese living in Australia” (Yu 115). Food, flesh and meat are recurrent topics in Lillian Ng´s second novel Swallowing Clouds, published in 1997. These topics are related to desire and can be used as a synecdoche (a metaphor that describes part/whole relations) of the human body: food is needed to survive and pleasure can be obtained from other people´s bodies. This paper focuses on one type of meat and animal, pork and the pig, and on the relation between the two main characters, Syn and Zhu Zhiyee. Syn, the main character in the novel, is a Shanghainese student studying English in Sydney who becomes stranded after the Tiananmen Square massacre of June 1989. As she stops receiving money from her mother and fears repression if she goes back to China, she begins to work in a Chinese butcher shop, owned by Zhu Zhiyee, which brings her English lessons to a standstill. Syn and Zhu Zhiyee soon begin a two-year love affair, despite the fact that Zhu Zhiyee is married to KarLeng and has three daughters. The novel is structured as a prologue and four days, each of which has a different setting and temporal location. The prologue introduces the story of an adulterous woman who was punished to be drowned in a pig´s basket in the HuanPu River in the summer of 1918. As learnt later on, Syn is the reincarnation of this woman, whose purpose in life is to take revenge on men by taking their money. The four days, from the 4th to the 7th of June 1994, mark the duration of a trip to Beijing and Shanghai that Syn takes as member of an Australian expedition in order to visit her mother with the security of an Australian passport. During these four days, the reader learns about different Chinese landmarks, such as the Forbidden City, the Great Wall, the Ming Tomb and the Summer Palace, as well as some cultural events, such as a Chinese opera and eating typical foods like Peking duck. However, the bulk of the plot of the book deals with the sexual relationship, erotic games and fantasies of Syn and Zhu Zhiyee in the period between 1989 and 1992, as well as Syn´s final revenge in January 1993. Pigs The fact that Zhu Zhiyee is a butcher allows Lillian Ng to include references to pigs and pork throughout the novel. Some of them refer to the everyday work of a butcher shop, as the following examples illustrate: “Come in and help me with the carcass,” he [Zhu Zhiyee] pointed to a small suckling pig hung on a peg. Syn hesitated, not knowing how to handle the situation. “Take the whole pig with the peg,” he commanded (11).Under dazzling fluorescent tubes and bright spotlights, trays of red meat, pork chops and lamb cutlets sparkled like jewels … The trays edged with red cellophane frills and green underlay breathed vitality and colour into the slabs of pork ribs and fillets (15).Buckets of pig´s blood with a skim of froth took their place on the floor; gelled ones, like sliced cubes of large agate, sat in tin trays labelled in Chinese. More discreetly hidden were the gonads and penises of goats, bulls and pigs. (16)These examples are representative of Syn and Zhu Zhiyee´s relationship. The first quotation deals with their interaction: most of the time Zhu Zhiyee orders Syn how to act, either in the shop or in bed. The second extract describes the meat’s “vitality” and this is the quality of Syn's skin that mesmerised Zhu when he met her: “he was excited, electrified by the sight of her unblemished, translucent skin, unlined, smooth as silk. The glow of the warmth of human skin” (13). Moreover, the lights seem to completely illuminate the pieces of meat and this is the way Zhu Zhiyee leers at Syn´s body, as it can be read in the following extract: “he turned again to fix his gaze on Syn, which pierced and penetrated her head, her brain, eyes, permeated her whole body, seeped into her secret places and crevices” (14). The third excerpt introduces the sexual organs of some of the animals, which are sold to some customers for a high price. Meat is also sexualised by Zhu Zhiyee´s actions, such as his pinching the bottoms of chickens and comparing them with “sacrificial virgins”: “chickens, shamelessly stripped and trussed, hung by their necks, naked in their pimply white skin, seemed like sacrificial virgins. Syn often caught Zhu pinching their fleshy bottoms, while wrapping and serving them to the housewives” (15-16). Zhu also makes comments relating food with sex while he is having lunch next to Syn, which could be considered sexual harassment. All these extracts exemplify the relationship between Syn and Zhu Zhiyee: the orders, the looks and the implicit sexuality in the quotidian activities in the butcher´s shop. There are also a range of other expressions that include similes with the word `pig´ in Ng´s novel. One of the most recurrent is comparing the left arm and hand of Zhu Zhiyee´s mother with a “pig´s trotter”. Zhu Zhiyee´s mother is known as ZhuMa and Syn is very fond of her, as ZhuMa accepts her and likes her more than her own daughter-in-law. The comparison of ZhuMa´s arm and hand with a trotter may be explained by the fact that ZhuMa´s arm is swollen but also by the loving representation of pigs in Chinese culture. As Seung-Og Kim explains in his article “Burials, Pigs, and Political Prestige in Neolithic China”: In both Melanesia and Asia, pigs are viewed as a symbolic representation of human beings (Allen 1976: 42; Healey 1985; Rappaport 1967: 58; Roscoe 1989: 223-26). Piglets are treated as pets and receive a great deal of loving attention, and they in turn express affection for their human “parents.” They also share some physiological features with human beings, being omnivorous and highly reproductive (though humans do not usually have multiple litters) and similar internal anatomy (Roscoe 1989: 225). In short, pigs not only have a symbiotic relationship with humans biologically but also are of great importance symbolically (121). Consequently, pigs are held in high esteem, taken care of and loved. Therefore, comparing a part of a human´s body, such as an arm or a hand, for example, to a part of a pig´s body such as a pig´s trotter is not negative, but has positive connotations. Some descriptions of ZhuMa´s arm and hand can be read in the following excerpts: “As ZhuMa handed her the plate of cookies Syn saw her left arm, swollen like a pig´s trotter” (97); “Syn was horrified, and yet somewhat intrigued by this woman without a breast, with a pig´s trotter arm and a tummy like a chessboard” (99), “mimicking the act of writing with her pig-trotter hand” (99), and ZhuMa was praising the excellence of the opera, the singing, acting, the costumes, and the elaborate props, waving excitedly with her pig trotter arm and pointing with her stubby fingers while she talked. (170) Moreover, the expression “pig´s trotters” is also used as an example of the erotic fetishism with bound feet, as it can be seen in the following passage, which will be discussed below: I [Zhu Zhiyee] adore feet which are slender… they seem so soft, like pig´s trotters, so cute and loving, they play tricks on your mind. Imagine feeling them in bed under your blankets—soft cottonwool lumps, plump and cuddly, makes you want to stroke them like your lover´s hands … this was how the bound feet appealed to men, the erotic sensation when balanced on shoulders, clutched in palms, strung to the seat of a garden swing … no matter how ugly a woman is, her tiny elegant feet would win her many admirers (224).Besides writing about pigs and pork as part of the daily work of the butcher shop and using the expression “pig´s trotter”, “pig” is also linked to money in two sentences in the book. On the one hand, it is used to calculate a price and draw attention to the large amount it represents: “The blouse was very expensive—three hundred dollars, the total takings from selling a pig. Two pigs if he purchased two blouses” (197). On the other, it works as an adjective in the expression “piggy-bank”, the money box in the form of a pig, an animal that represents abundance and happiness in the Chinese culture: “She borrowed money from her neighbours, who emptied pieces of silver from their piggy-banks, their life savings”(54). Finally, the most frequent porcine expression in Ng´s Swallowing Clouds makes reference to being drowned in a pig´s basket, which represents 19 of the 33 references to pigs or pork that appear in the novel. The first three references appear in the prologue (ix, x, xii), where the reader learns the story of the last woman who was killed by drowning in a pig´s basket as a punishment for her adultery. After this, two references recount a soothsayer´s explanation to Syn about her nightmares and the fact that she is the reincarnation of that lady (67, 155); three references are made by Syn when she explains this story to Zhu Zhiyee and to her companion on the trip to Beijing and Shanghai (28, 154, 248); one refers to a feeling Syn has during sexual intercourse with Zhu Zhiyee (94); and one when the pig basket is compared to a cricket box, a wicker or wooden box used to carry or keep crickets in a house and listen to them singing (73). Furthermore, Syn reflects on the fact of drowning (65, 114, 115, 171, 172, 173, 197, 296) and compares her previous death with that of Concubine Pearl, the favourite of Emperor Guanxu, who was killed by order of his aunt, the Empress Dowager Cixi (76-77). The punishment of drowning in a pig´s basket can thus be understood as retribution for a transgression: a woman having an extra-marital relationship, going against the establishment and the boundaries of the authorised. Both the woman who is drowned in a pig´s basket in 1918 and Syn have extra-marital affairs and break society’s rules. However, the consequences are different: the concubine dies and Syn, her reincarnation, takes revenge. Desire, Transgression and Eroticism Xavier Pons writes about desire, repression, freedom and transgression in his book Messengers of Eros: Representations of Sex in Australian Writing (2009). In this text, he explains that desire can be understood as a positive or as a negative feeling. On the one hand, by experiencing desire, a person feels alive and has joy de vivre, and if that person is desired in return, then, the feelings of being accepted and happiness are also involved (13). On the other hand, desire is often repressed, as it may be considered evil, anarchic, an enemy of reason and an alienation from consciousness (14). According to Pons: Sometimes repression, in the form of censorship, comes from the outside—from society at large, or from particular social groups—because of desire´s subversive nature, because it is a force which, given a free rein, would threaten the higher purpose which a given society assigns to other (and usually ideological) forces … Repression may also come from the inside, via the internalization of censorship … desire is sometimes feared by the individual as a force alien to his/her true self which would leave him/her vulnerable to rejection or domination, and would result in loss of freedom (14).Consequently, when talking about sexual desire, the two main concepts to be dealt with are freedom and transgression. As Pons makes clear, “the desiring subject can be taken advantage of, manipulated like a puppet [as h]is or her freedom is in this sense limited by the experience of desire” (15). While some practices may be considered abusive, such as bondage or sado-masochism, they may be deliberately and freely chosen by the partners involved. In this case, these practices represent “an encounter between equals: dominance is no more than make-believe, and a certain amount of freedom (as much as is compatible with giving oneself up to one´s fantasies) is maintained throughout” (24). Consequently, the perception of freedom changes with each person and situation. What is transgressive depends on the norms in every culture and, as these evolve, so do the forms of transgression (Pons 43). Examples of transgressions can be: firstly, the separation of sex from love, adultery or female and male homosexuality, which happen with the free will of the partners; or, secondly, paedophilia, incest or bestiality, which imply abuse. Going against society’s norms involves taking risks, such as being discovered and exiled from society or feeling isolated as a result of a feeling of difference. As the norms change according to culture, time and person, an individual may transgress the rules and feel liberated, but later on do the same thing and feel alienated. As Pons declares, “transgressing the rules does not always lead to liberation or happiness—transgression can turn into a trap and turn out to be simply another kind of alienation” (46). In Swallowing Clouds, Zhu Zhiyee transgresses the social norms of his time by having an affair with Syn: firstly, because it is extra-marital, he and his wife, KarLeng, are Catholic and fidelity is one of the promises made when getting married; and, secondly, because he is Syn´s boss and his comments and ways of flirting with her could be considered sexual harassment. For two years, the affair is an escape from Zhu Zhiyee´s daily worries and stress and a liberation and fulfillment of his sexual desires. However, he introduces Syn to his mother and his sisters, who accept her and like her more than his wife. He feels trapped, though, when KarLeng guesses and threatens him with divorce. He cannot accept this as it would mean loss of face in their neighbourhood and society, and so he decides to abandon Syn. Syn´s transgression becomes a trap for her as Zhu, his mother and his sisters have become her only connection with the outside world in Australia and this alienates her from both the country she lives in and the people she knows. However, Syn´s transgression also turns into a trap for Zhu Zhiyee because she will not sign the documents to give him the house back and every month she sends proof of their affair to KarLeng in order to cause disruption in their household. This exposure could be compared with the humiliation suffered by the concubine when she was paraded in a pig´s basket before she was drowned in the HuangPu River. Furthermore, the reader does not know whether KarLeng finally divorces Zhu Zhiyee, which would be his drowning and loss of face and dishonour in front of society, but can imagine the humiliation, shame and disgrace KarLeng makes him feel every month. Pons also depicts eroticism as a form of transgression. In fact, erotic relations are a power game, and seduction can be a very effective weapon. As such, women can use seduction to obtain power and threaten the patriarchal order, which imposes on them patterns of behaviour, language and codes to follow. However, men also use seduction to get their own benefits, especially in political and social contexts. “Power has often been described as the ultimate aphrodisiac” (Pons 32) and this can be seen in many of the sexual games between Syn and Zhu Zhiyee in Swallowing Clouds, where Zhu Zhiyee is the active partner and Syn becomes little more than an object that gives pleasure. A clear reference to erotic fetishism is embedded in the above-mentioned quote on bound feet, which are compared to pig´s trotters. In fact, bound feet were so important in China in the millennia between the Song Dynasty (960-1276) and the early 20th century that “it was impossible to find a husband” (Holman) without them: “As women’s bound feet and shoes became the essence of feminine beauty, a fanatical aesthetic and sexual mystique developed around them. The bound foot was understood to be the most intimate and erotic part of the female anatomy, and wives, consorts and prostitutes were chosen solely on the size and shape of their feet” (Holman). Bound feet are associated in Ng’s novel with pig´s trotters and are described as “cute and loving … soft cottonwool lumps, plump and cuddly, [that] makes you want to stroke them like your lover´s hands” (224). This approach towards bound feet and, by extension, towards pig´s trotters, can be related to the fond feelings Melanesian and Asian cultures have towards piglets, which “are treated as pets and receive a great deal of loving attention” (Kim 121). Consequently, the bound feet can be considered a synecdoche for the fond feelings piglets inspire. Food and Sex The fact that Zhu Zhiyee is a butcher and works with different types of meat, including pork, that he chops it, sells it and gives cooking advice, is not gratuitous in the novel. He is used to being in close proximity to meat and death and seeing Syn’s pale skin through which he can trace her veins excites him. Her flesh is alive and represents, therefore, the opposite of meat. He wants to seduce her, which is human hunting, and he wants to study her, to enjoy her body, which can be compared to animals looking at their prey and deciding where to start eating from. Zhu´s desire for Syn seems destructive and dangerous. In the novel, bodies have a price: dead animals are paid for and eaten and their role is the satiation of human hunger. But humans, who are also animals, have a price as well: flesh is paid for, in the form of prostitution or being a mistress, and its aim is satiation of human sex. Generally speaking, sex in the novel is compared to food either in a direct or an indirect way, and making love is constantly compared to cooking, the preparation of food and eating (as in Pons 303). Many passages in Swallowing Clouds have cannibalistic connotations, all of these being used as metaphors for Zhu Zhiyee’s desire for Syn. As mentioned before, desire can be positive (as it makes a person feel alive) or negative (as a form of internal or social censorship). For Zhu Zhiyee, desire is positive and similar to a drug he is addicted to. For example, when Zhu and Syn make delivery rounds in an old Mazda van, he plays the recordings he made the previous night when they were having sex and tries to guess when each moan happened. Sex and Literature Pons explains that “to write about sex … is to address a host of issues—social, psychological and literary—which together pretty much define a culture” (6). Lillian Ng´s Swallowing Clouds addresses a series of issues. The first of these could be termed ‘the social’: Syn´s situation after the Tiananmen Massacre; her adulterous relationship with her boss and being treated and considered his mistress; the rapes in Inner Mongolia; different reasons for having an abortion; various forms of abuse, even by a mother of her mentally handicapped daughter; the loss of face; betrayal; and revenge. The second issue is the ‘psychological’, with the power relations and strategies used between different characters, psychological abuse, physical abuse, humiliation, and dependency. The third is the ‘literary’, as when the constant use of metaphors with Chinese cultural references becomes farcical, as Tseen Khoo notes in her article “Selling Sexotica” (2000: 164). Khoo explains that, “in the push for Swallowing Clouds to be many types of novels at once: [that is, erotica, touristic narrative and popular], it fails to be any one particularly successfully” (171). Swallowing Clouds is disturbing, full of stereotypes, and with repeated metaphors, and does not have a clear readership and, as Khoo states: “The explicit and implicit strategies behind the novel embody the enduring perceptions of what exotic, multicultural writing involves—sensationalism, voyeuristic pleasures, and a seemingly deliberate lack of rooted-ness in the Australian socioscape (172). Furthermore, Swallowing Clouds has also been defined as “oriental grunge, mostly because of the progression throughout the narrative from one gritty, exoticised sexual encounter to another” (Khoo 169-70).Other novels which have been described as “grunge” are Edward Berridge´s Lives of the Saints (1995), Justine Ettler´s The River Ophelia (1995), Linda Jaivin´s Eat Me (1995), Andrew McGahan´s Praise (1992) and 1988 (1995), Claire Mendes´ Drift Street (1995) or Christos Tsiolkas´ Loaded (1995) (Michael C). The word “grunge” has clear connotations with “dirtiness”—a further use of pig, but one that is not common in the novel. The vocabulary used during the sexual intercourse and games between Syn and Zhu Zhiyee is, however, coarse, and “the association of sex with coarseness is extremely common” (Pons 344). Pons states that “writing about sex is an attempt to overcome [the barriers of being ashamed of some human bodily functions], regarded as unnecessarily constrictive, and this is what makes it by nature transgressive, controversial” (344-45). Ng´s use of vocabulary in this novel is definitely controversial, indeed, so much so that it has been defined as banal or even farcical (Khoo 169-70).ConclusionThis paper has analysed the use of the words and expressions: “pig”, “pork” and “drowning in a pig’s basket” in Lillian Ng´s Swallowing Clouds. Moreover, the punishment of drowning in a pig’s basket has served as a means to study the topics of desire, transgression and eroticism, in relation to an analysis of the characters of Syn and Zhu Zhiyee, and their relationship. This discussion of various terminology relating to “pig” has also led to the study of the relationship between food and sex, and sex and literature, in this novel. Consequently, this paper has analysed the use of the term “pig” and has used it as a springboard for the analysis of some aspects of the novel together with different theoretical definitions and concepts. Acknowledgements A version of this paper was given at the International Congress Food for Thought, hosted by the Australian Studies Centre at the University of Barcelona in February 2010. References Allen, Bryan J. Information Flow and Innovation Diffusion in the East Sepic District, Papua New Guinea. PhD diss. Australian National University, Australia. 1976. Berridge, Edward. Lives of the Saints. St Lucia: U of Queensland P, 1995. C., Michael. “Toward a sound theory of Australian Grunge fiction.” [Weblog entry] Eurhythmania. 5 Mar. 2008. 4 Oct. 2010 http://eurhythmania.blogspot.com/2008/03/toward-sound-theory-of-australian.html. Ettler, Justine. The River Ophelia. Sydney: Picador, 1995. Healey, Christopher J. “Pigs, Cassowaries, and the Gift of the Flesh: A Symbolic Triad in Maring Cosmology.” Ethnology 24 (1985): 153-65. Holman, Jeanine. “Bound Feet.” Bound Feet: The History of a Curious, Erotic Custom. Ed. Joseph Rupp 2010. 11 Aug. 2010. http://www.josephrupp.com/history.html. Jaivin, Linda. Eat Me. Melbourne: The Text Publishing Company, 1995. Khoo, Tseen. “Selling Sexotica: Oriental Grunge and Suburbia in Lillian Ngs’ Swallowing Clouds.” Diaspora: Negotiating Asian-Australian. Ed. Helen Gilbert, Tseen Khoo, and Jaqueline Lo. St Lucia: U of Queensland P, 2000. 164-72. Khoo, Tseen; Danau Tanu, and Tien. "Re: Of pigs and porks” 5-9 Aug. 1997. Asian- Australian Discussion List Digest numbers 1447-1450. Apr. 2010 . Kim, Seung-Og. “Burials, Pigs, and Political Prestige in Neolithic China.” Current Anthopology 35.2 (Apr. 1994): 119-141. McGahan, Andrew. Praise. Sydney: Allen & Unwin, 1992. McGahan, Andrew. 1988. Sydney: Allen & Unwin, 1995. Mendes, Clare. Drift Street. Pymble: HarperCollins, 1995. Ng, Lillian. Swallowing Clouds. Ringwood: Penguin Books Australia,1997. Pons, Xavier. Messengers of Eros. Representations of Sex in Australian Writing. Newcastle upon Tyne: Cambridge Scholars Publishing, 2009. Rappaport, Roy. Pigs for the Ancestors. New Have: Yale UP, 1967. Roscoe, Paul B. “The Pig and the Long Yam: The Expansion of the Sepik Cultural Complex”. Ethnology 28 (1989): 219-31. Tsiolkas, Christos. Loaded. Sydney: Vintage, 1995. Yu, Ouyang. “An Interview with Lillian Ng.” Otherland Literary Journal 7, Bastard Moon. Essays on Chinese-Australian Writing (July 2001): 111-24.

03—285 Ahmed, Mehreen (U. of Queensland, Australia). A note on phrase structure analysis and design implication for ICALL. Computer Assisted Language Learning (Lisse, The Netherlands), 15, 4 (2002), 423—33.03—286 Argaman, Osnat and Abu-Rabia, Salim (U. of Haifa, Israel). The influence of language anxiety on English reading and writing tasks among native Hebrew speakers. Language, Culture and Curriculum (Clevedon, UK), 15, 2 (2002), 143—60.03—287 Bielinska, Monika (Schlesische Universität, Katowice, Poland). Zu Semantischen Aspekten der Wortkombinatorik. [On semantic aspects of word combination.] Glottodidactica (Poznań, Poland), 28 (2002), 19—27.03—288 Bonci, Angelica (Royal Holloway, U. of London, UK). Collocational restrictions in Italian as a second language: A case control study. Tuttitalia (Rugby, UK), 26 (2002), 3—14.03—289 Brown, Charles Grant (U. of Northern British Columbia, Canada; Email: brownc@unbc.ca). Inferring and maintaining the learner model. Computer Assisted Language Learning (Lisse, The Netherlands), 15, 4 (2002), 343—55.03—290 Butler, Yuko Goto (U. of Pennsylvania, USA; Email: ybutler@gse.upenn.edu). Second language learners' theories on the use of English articles: An analysis of the metalinguistic knowledge used by Japanese students in acquiring the English article system. Studies in Second Language Acquisition (New York, USA), 24, 3 (2002), 451—80.03—291 Carroll, Susanne E. (Universität Potsdam, Germany; Email: carroll@rz.uni-potsdam.de). Induction in a modular learner. Second Language Research (London, UK), 18, 3 (2002), 224—49.03—292 Chen, Liang, Tokuda, Naoyuki and Xiao, Dahai (Sunflare Company, Tokyo, Japan; Email: chen_1@sunflare.co.jp). A POST parser-based learner model for template-based ICALL for Japanese-English writing skills. Computer Assisted Language Learning (Lisse, The Netherlands), 15, 4 (2002), 357—72.03—293 Di Biase, Bruno and Kawaguchi, Satomi (U. of Western Sydney, Australia; Email: B.DiBiase@uws.edu.au). Exploring the typological plausibility of Processability Theory: Language development in Italian second language and Japanese second language. Second Language Research (London, UK), 18, 3 (2002), 274—302.03—294 Dimroth, Christine (Max Planck Inst. for Psycholinguistics, Nijmegen, The Netherlands; Email: christine.dimroth@mpi.nl). Topics, assertions, and additive words: How L2 learners get from information structure to target-language syntax. Linguistics (Berlin, Germany), 40, 4 (2002), 891—923.03—295 Duffield, Nigel (McGill U., Canada), White, Lydia, Bruhn de Garavito, Joyce, Montrul, Silvina and Prévost, Philippe. Clitic placement in L2 French: Evidence from sentence matching. Journal of Linguistics (Cambridge, UK), 38, 3 (2002), 487—525.03—296 Francis, Norbert (Northern Arizona U., USA; Email: norbert.francis@nau.edu). Literacy, second language learning, and the development of metalinguistic awareness: A study of bilingual children's perceptions of focus on form. Linguistics and Education (New York, USA), 13, 3 (2002), 373—404.03—297 Gamper, Johann (Free U. of Bozen, Italy; Email: judith.knapp@eurac.edu) and Knapp, Judith. A review of intelligent CALL systems. Computer Assisted Language Learning (Lisse, The Netherlands), 15, 4 (2002), 329—42.03—298 Gavruseva, Elena (U. of Iowa, USA; Email: elena-gavruseva@uiowa.edu). Is there primacy of aspect in child L2 English? Bilingualism: Language and Cognition (Cambridge, UK), 5, 2 (2002), 109—30.03—299 Geeslin, Kimberly L. (Indiana U., USA; Email: kgeeslin@indiana.edu). The acquisition of Spanish copula choice and its relationship to language change. Studies in Second Language Acquisition (New York, USA), 24, 3 (2002), 419—50.03—300 Ghaith, G. M. (American U. of Beirut, Lebanon; Email: gghaith@aub.edu.lb). The relationship between cooperative learning, perception of social support, and academic achievement. System (Oxford, UK), 30, 3 (2002), 263—73.03—301 Golato, Peter (U. of Illinois, Urbana-Champaign, USA; Email: pgolato@uiuc.edu). Word parsing by late-learning French-English bilinguals. Applied Psycholinguistics (Cambridge, UK), 23, 3 (2002), 417—46.03—302 Gorostiaga, Arantxa and Balluerka, Nekane (U. of the Basque Country; Email: pspgomaa@ss.ehu.es). The influence of the social use and the history of acquisition of Euskera on comprehension and recall of scientific texts in Euskera and Castilian. Language Learning (Malden, MA, USA), 52, 3 (2002), 491—512.03—303 Hada, Yoshiaki, Ogata, Hiroaki and Yano, Yoneo (Tokushima U., Japan; Email: hada@is.tokushima-u.ac.jp). Video-based language learning environment using an online video-editing system. Computer Assisted Language Learning (Lisse, The Netherlands), 15, 4 (2002), 387—408.03—304 Håkansson, Gisela (U. of Lund, Sweden; Email: Gisela.Hakansson@ling.lu.se), Pienemann, Manfred and Sayehli, Susan. Transfer and typological proximity in the context of second language processing. Second Language Research (London, UK), 18, 3 (2002), 250—73.03—305 Hatasa, Yukiko Abe (U. of Iowa, USA; Email: yukiko-hatasa@uiowa.edu). The effects of differential timing in the introduction of Japanese syllabaries on early second language development in Japanese. The Modern Language Journal (Malden, MA, USA), 86, 3 (2002), 349—67.03—306 Hsiao, Tsung-Yuan (Nat. Taiwan Ocean U., Republic of China; Email: tyhsiao@mail.ntou.edu.tw) and Oxford, Rebecca L.. Comparing theories of language learning strategies: A confirmatory factor analysis. The Modern Language Journal (Malden, MA, USA), 86, 3 (2002), 368—83.03—307 Hu, Guangwei (Nat. Inst. of Ed., Nanyang Technological U., Singapore; Email: gwhu@nie.edu.sg). Psychological constraints on the utility of metalinguistic knowledge in second language production. Studies in Second Language Acquisition (New York, USA), 24, 3 (2002), 347—86.03—308 Hulstijn, Jan (U. of Amsterdam, The Netherlands; Email: hulstijn@hum.uva.nl). Towards a unified account of the representation, processing and acquisition of second language knowledge. Second Language Research (London, UK), 18, 3 (2002), 193—223.03—309 Itakura, Hiroko (The Hong Kong Polytechnic U.; Email: eghiroko@polyu.edu.hk). Gender and pragmatic transfer in topic development. Language, Culture and Curriculum (Clevedon, UK), 15, 2 (2002), 161—83.03—310 Jarvis, Scott (Ohio U., USA; Email: jarvis@ohio.edu). Topic continuity in L2 English article use. Studies in Second Language Acquisition (New York, USA), 24, 3 (2002), 387—418.03—311 Jung, Udo O. H. (U. of Bayreuth, Germany; Email: hmejung@gmx.de). An international bibliography of computer-assisted language learning: Fifth instalment. System (Oxford, UK), 30, 3 (2002), 349—98.03—312 Kim, Daejin (Hansei U., Republic of Korea; Email: daejkim@chollian.net) and Hall, Joan Kelly. The role of an interactive book reading program in the development of second language pragmatic competence. The Modern Language Journal (Malden, MA, USA), 86, 3 (2002), 332—48.03—313 Lee, Eun-Joo (Stanford U., USA; Email: eunlee@stanford.edu). Comparing personal references in English by a native-speaking and a Korean pre-adolescent. English Teaching (Korea), 57, 3 (2002), 125—43.03—314 Lee, Lina (U. of New Hampshire, USA; Email: llee@hopper.unh.edu). Synchronous online exchanges: A study of modification devices on non-native discourse. System (Oxford, UK), 30, 3 (2002), 275—88.03—315 Lee, Siok H. (Burnaby Sch. District & Simon Fraser U., Canada; Email: slee@alpha.sd41.bc.ca) and Carey, Stephen. Explaining Chinese learners' errors in the phonological representations of Latinate derivatives in English: A psycholinguistic perspective. Canadian Journal of Applied Linguistics (Ottawa, Canada), 5, 1/2 (2002), 65—91.03—316 Liontas, John I. (U. of Notre Dame, IN, USA; Email: jliontas@nd.edu). Exploring second language learners' notions of idiomaticity. System (Oxford, UK), 30, 3 (2002), 289—313.03—317 Macintyre, Peter D. (U. Coll. of Cape Breton, Canada; Email: peter_macintyre@uccb.ca), Baker, Susan C., Clément, Richard and Donovan, Leslie A.. Sex and age effects on willingness to communicate, anxiety, perceived competence, and L2 motivation among junior high school French immersion students. Language Learning (Malden, MA, USA), 52, 3 (2002), 537—64.03—318 Martínez, Ana Cristina Lahuerta (U. of Oviedo, Asturias, Spain; Email: lahuerta@correo.uniovi.es). Empirical examination of EFL readers' use of rhetorical information. English for Specific Purposes (Amsterdam, The Netherlands), 21, 1 (2002), 81—98.03—319 Mori, Yoshiko (Georgetown U., USA; Email: moriy@georgetown.edu). Individual differences in the integration of information from context and word parts in interpreting unknown kanji words. Applied Psycholinguistics (Cambridge, UK), 23, 3 (2002), 375—97.03—320 Morris, Frank A. (U. of Miami, USA). Negotiation moves and recasts in relation to error types and learner repair in the foreign language classroom. Foreign Language Annals (New York, USA), 35, 4 (2002), 395—404.03—321 O'Grady, William (U. of Hawai'i, USA; Email: ogrady@hawaii.edu) and Yamashita, Yoshie. Partial agreement in second-language acquisition. Linguistics (Berlin, Germany), 40, 5 (2002), 1011—19.03—322 Perdue, Clive (Université Paris VIII, France; Email: clive@univ-paris8.fr), Benazzo, Sandra and Giuliano, Patrizia. When finiteness gets marked: The relations between morphosyntactic development and use of scopal items in adult language. Linguistics (Berlin, Germany), 40, 4 (2002), 849—90.03—323 Pichette, François (U. of South Florida, USA; Email: pichette@chuma1.cas.usf.edu). Second-language vocabulary learning and the additivity hypothesis. Canadian Journal of Applied Linguistics (Ottawa, Canada), 5, 1/2 (2002), 117—30.03—324 Raymond, Patricia M. (U. of Ottawa, Canada) and Parks, Susan. Transitions: Orienting to reading and writing assignments in EAP and MBA contexts. The Canadian Modern Language Review/La Revue canadienne des langues vivantes (Toronto, Ont.), 59, 1 (2002), 152—80.03—325 Schulz, Renate A. (U. of Arizona, USA). Hilft es die Regel zu wissen um sie anzuwenden? Das Verhältnis von metalinguistischem Bewusstsein und grammatischer Kompetenz in DaF. [Does it help to know the rule to apply it? The relationship between metalinguistic consciousness and grammatical competence in German as a foreign language.] Die Unterrichtspraxis/Teaching German (Cherry Hill, NJ, USA), 36, 1 (2002), 15—24.03—326 Segler, Thomas M., Pain, Helen and Sorace, Antonella (U. of Edinburgh, Scotland, UK; Email: thomasse@dai.ed.ac.uk). Second language vocabulary acquisition and learning strategies in ICALL environments. Computer Assisted Language Learning (Lisse, The Netherlands), 15, 4 (2002), 409—22.03—327 Shehadeh, Ali (U. of Aleppo/King Saud U., Ryadh, Saudi Arabia; Email: ashhada@ksu.edu.sa). Comprehensible output, from occurrence to acquisition: An agenda for acquisitional research. Language Learning (Malden, MA, USA), 52, 3 (2002), 597—647.03—328 Tokuda, Naoyuki (SunFlare Research and Development Center, Tokyo, Japan; Email: tokuda_n@sunflare.co.jp). New developments in intelligent CALL systems in a rapidly internationalised information age. Computer Assisted Language Learning (Lisse, The Netherlands), 15, 4 (2002), 319—27.03—329 Tracy, Rosemarie (U. of Mannheim, Germany). Growing (clausal) roots: All children start out (and may remain) multilingual. Linguistics (Berlin, Germany), 40, 4 (2002), 653—86.03—330 van de Craats, Ineke (U. of Nijmegen, The Netherlands; Email: I.v.d.Craats@let.kun.nl), van Hout, Roeland and Corver, Norbert. The acquisition of possessive HAVE-clauses by Turkish and Moroccan learners of Dutch. Bilingualism: Language and Cognition (Cambridge, UK), 5, 2 (2002), 147—74.03—331 Verhoeven, Ludo (U. of Nijmegen, The Netherlands; Email: L.Verhoeven@ped.kun.nl) and Vermeer, Anne. Communicative competence and personality dimensions in first and second language learners. Applied Psycholinguistics (Cambridge, UK), 23, 3 (2002), 361—74.03—332 Wendt, Michael (U. Bremen, Germany). Kontext und Konstruktion: Fremdsprachendidaktische Theoriebildung und ihre Implikationen für die Fremdsprachenforschung. [Context and construction: Foreign language didactic theory formation and its implications for foreign language learning.] Zeitschrift für Fremdsprachenforschung (Germany), 13, 1 (2002), 1–62.03—333 Williams, Marion, Burden, Robert and Lanvers, Ursula (U. of Exeter, UK). ‘French is the Language of Love and Stuff’: Student perceptions of issues related to motivation in learning a foreign language. British Educational Research Journal (Abingdon, UK), 28, 4 (2002), 503—28.03—334 Wray, Alison (Cardiff U., UK; Email: wraya@cf.ac.uk). Formulaic language in computer-supported communication: Theory meets reality. Language Awareness (Clevedon, UK), 11, 2 (2002), 114—31.

Introduction In December 2010, Nespresso, the world’s leading brand of premium-portioned coffee, opened a flagship “boutique” in Sydney’s Pitt Street Mall. This was Nespresso’s fifth boutique opening of 2010, after Brussels, Miami, Soho, and Munich. The Sydney debut coincided with the mall’s upmarket redevelopment, which explains Nespresso’s arrival in the city: strategic geographic expansion is key to the brand’s growth. Rather than panoramic ubiquity, a retail option favoured by brands like McDonalds, KFC and Starbucks, Nespresso opts for iconic, prestigious locations. This strategy has been highly successful: since 2000 Nespresso has recorded year-on-year per annum growth of 30 per cent. This has been achieved, moreover, despite a global financial downturn and an international coffee market replete with brand variety. In turn, Nespresso marks an evolution in the coffee market over the last decade. The Nespresso Story Founded in 1986, Nespresso is the fasting growing brand in the Nestlé Group. Its headquarters are in Lausanne, Switzerland, with over 7,000 employees worldwide. In 2012, Nespresso had 270 boutiques in 50 countries. The brand’s growth strategy involves three main components: premium coffee capsules, “mated” with specially designed machines, and accompanied by exceptional customer service through the Nespresso Club. Each component requires some explanation. Nespresso offers 16 varieties of Grand Crus coffee: 7 espresso blends, 3 pure origin espressos, 3 lungos (for larger cups), and 3 decaffeinated coffees. Each 5.5 grams of portioned coffee is cased in a hermetically sealed aluminium capsule, or pod, designed to preserve the complex, volatile aromas (between 800 and 900 per pod), and prevent oxidation. These capsules are designed to be used exclusively with Nespresso-branded machines, which are equipped with a patented high-pressure extraction system designed for optimum release of the coffee. These machines, of which there are 28 models, are developed with 6 machine partners, and Antoine Cahen, from Ateliers du Nord in Lausanne, designs most of them. For its consumers, members of the Nespresso Club, the capsules and machines guarantee perfect espresso coffee every time, within seconds and with minimum effort—what Nespresso calls the “ultimate coffee experience.” The Nespresso Club promotes this experience as an everyday luxury, whereby café-quality coffee can be enjoyed in the privacy and comfort of Club members’ homes. This domestic focus is a relatively recent turn in its history. Nestlé patented some of its pod technology in 1976; the compatible machines, initially made in Switzerland by Turmix, were developed a decade later. Nespresso S. A. was set up as a subsidiary unit within the Nestlé Group with a view to target the office and fine restaurant sector. It was first test-marketed in Japan in 1986, and rolled out the same year in Switzerland, France and Italy. However, by 1988, low sales prompted Nespresso’s newly appointed CEO, Jean-Paul Gillard, to rethink the brand’s focus. Gillard subsequently repositioned Nespresso’s target market away from the commercial sector towards high-income households and individuals, and introduced a mail-order distribution system; these elements became the hallmarks of the Nespresso Club (Markides 55). The Nespresso Club was designed to give members who had purchased Nespresso machines 24-hour customer service, by mail, phone, fax, and email. By the end of 1997 there were some 250,000 Club members worldwide. The boom in domestic, user-friendly espresso machines from the early 1990s helped Nespresso’s growth in this period. The cumulative efforts by the main manufacturers—Krups, Bosch, Braun, Saeco and DeLonghi—lowered the machines’ average price to around US $100 (Purpura, “Espresso” 88; Purpura, “New” 116). This paralleled consumers’ growing sophistication, as they became increasingly familiar with café-quality espresso, cappuccino and latté—for reasons to be detailed below. Nespresso was primed to exploit this cultural shift in the market and forge a charismatic point of difference: an aspirational, luxury option within an increasingly accessible and familiar field. Between 2006 and 2008, Nespresso sales more than doubled, prompting a second production factory to supplement the original plant in Avenches (Simonian). In 2008, Nespresso grew 20 times faster than the global coffee market (Reguly B1). As Nespresso sales exceeded $1.3 billion AU in 2009, with 4.8 billion capsules shipped out annually and 5 million Club members worldwide, it became Nestlé’s fastest growing division (Canning 28). According to Nespresso’s Oceania market director, Renaud Tinel, the brand now represents 8 per cent of the total coffee market; of Nespresso specifically, he reports that 10,000 cups (using one capsule per cup) were consumed worldwide each minute in 2009, and that increased to 12,300 cups per minute in 2010 (O’Brien 16). Given such growth in such a brief period, the atypical dynamic between the boutique, the Club and the Nespresso brand warrants closer consideration. Nespresso opened its first boutique in Paris in 2000, on the Avenue des Champs-Élysées. It was a symbolic choice and signalled the brand’s preference for glamorous precincts in cosmopolitan cities. This has become the design template for all Nespresso boutiques, what the company calls “brand embassies” in its press releases. More like art gallery-style emporiums than retail spaces, these boutiques perform three main functions: they showcase Nespresso coffees, machines and accessories (all elegantly displayed); they enable Club members to stock up on capsules; and they offer excellent customer service, which invariably equates to detailed production information. The brand’s revenue model reflects the boutique’s role in the broader business strategy: 50 per cent of Nespresso’s business is generated online, 30 per cent through the boutiques, and 20 per cent through call centres. Whatever floor space these boutiques dedicate to coffee consumption is—compared to the emphasis on exhibition and ambience—minimal and marginal. In turn, this tightly monitored, self-focused model inverts the conventional function of most commercial coffee sites. For several hundred years, the café has fostered a convivial atmosphere, served consumers’ social inclinations, and overwhelmingly encouraged diverse, eclectic clientele. The Nespresso boutique is the antithesis to this, and instead actively limits interaction: the Club “community” does not meet as a community, and is united only in atomised allegiance to the Nespresso brand. In this regard, Nespresso stands in stark contrast to another coffee brand that has been highly successful in recent years—Starbucks. Starbucks famously recreates the aesthetics, rhetoric and atmosphere of the café as a “third place”—a term popularised by urban sociologist Ray Oldenburg to describe non-work, non-domestic spaces where patrons converge for respite or recreation. These liminal spaces (cafés, parks, hair salons, book stores and such locations) might be private, commercial sites, yet they provide opportunities for chance encounters, even therapeutic interactions. In this way, they aid sociability and civic life (Kleinman 193). Long before the term “third place” was coined, coffee houses were deemed exemplars of egalitarian social space. As Rudolf P. Gaudio notes, the early coffee houses of Western Europe, in Oxford and London in the mid-1600s, “were characterized as places where commoners and aristocrats could meet and socialize without regard to rank” (670). From this sanguine perspective, they both informed and animated the modern public sphere. That is, and following Habermas, as a place where a mixed cohort of individuals could meet and discuss matters of public importance, and where politics intersected society, the eighteenth-century British coffee house both typified and strengthened the public sphere (Karababa and Ger 746). Moreover, and even from their early Ottoman origins (Karababa and Ger), there has been an historical correlation between the coffee house and the cosmopolitan, with the latter at least partly defined in terms of demographic breadth (Luckins). Ironically, and insofar as Nespresso appeals to coffee-literate consumers, the brand owes much to Starbucks. In the two decades preceding Nespresso’s arrival, Starbucks played a significant role in refining coffee literacy around the world, gauging mass-market trends, and stirring consumer consciousness. For Nespresso, this constituted major preparatory phenomena, as its strategy (and success) since the early 2000s presupposed the coffee market that Starbucks had helped to create. According to Nespresso’s chief executive Richard Giradot, central to Nespresso’s expansion is a focus on particular cities and their coffee culture (Canning 28). In turn, it pays to take stock of how such cities developed a coffee culture amenable to Nespresso—and therein lays the brand’s debt to Starbucks. Until the last few years, and before celebrity ambassador George Clooney was enlisted in 2005, Nespresso’s marketing was driven primarily by Club members’ recommendations. At the same time, though, Nespresso insisted that Club members were coffee connoisseurs, whose knowledge and enjoyment of coffee exceeded conventional coffee offerings. In 2000, Henk Kwakman, one of Nestlé’s Coffee Specialists, explained the need for portioned coffee in terms of guaranteed perfection, one that demanding consumers would expect. “In general”, he reasoned, “people who really like espresso coffee are very much more quality driven. When you consider such an intense taste experience, the quality is very important. If the espresso is slightly off quality, the connoisseur notices this immediately” (quoted in Butler 50). What matters here is how this corps of connoisseurs grew to a scale big enough to sustain and strengthen the Nespresso system, in the absence of a robust marketing or educative drive by Nespresso (until very recently). Put simply, the brand’s ascent was aided by Starbucks, specifically by the latter’s success in changing the mainstream coffee market during the 1990s. In establishing such a strong transnational presence, Starbucks challenged smaller, competing brands to define themselves with more clarity and conviction. Indeed, working with data that identified just 200 freestanding coffee houses in the US prior to 1990 compared to 14,000 in 2003, Kjeldgaard and Ostberg go so far as to state that: “Put bluntly, in the US there was no local coffee consumptionscape prior to Starbucks” (Kjeldgaard and Ostberg 176). Starbucks effectively redefined the coffee world for mainstream consumers in ways that were directly beneficial for Nespresso. Starbucks: Coffee as Ambience, Experience, and Cultural Capital While visitors to Nespresso boutiques can sample the coffee, with highly trained baristas and staff on site to explain the Nespresso system, in the main there are few concessions to the conventional café experience. Primarily, these boutiques function as material spaces for existing Club members to stock up on capsules, and therefore they complement the Nespresso system with a suitably streamlined space: efficient, stylish and conspicuously upmarket. Outside at least one Sydney boutique for instance (Bondi Junction, in the fashionable eastern suburbs), visitors enter through a club-style cordon, something usually associated with exclusive bars or hotels. This demarcates the boutique from neighbouring coffee chains, and signals Nespresso’s claim to more privileged patrons. This strategy though, the cultivation of a particular customer through aesthetic design and subtle flattery, is not unique. For decades, Starbucks also contrived a “special” coffee experience. Moreover, while the Starbucks model strikes a very different sensorial chord to that of Nespresso (in terms of décor, target consumer and so on) it effectively groomed and prepped everyday coffee drinkers to a level of relative self-sufficiency and expertise—and therein is the link between Starbucks’s mass-marketed approach and Nespresso’s timely arrival. Starbucks opened its first store in 1971, in Seattle. Three partners founded it: Jerry Baldwin and Zev Siegl, both teachers, and Gordon Bowker, a writer. In 1982, as they opened their sixth Seattle store, they were joined by Howard Schultz. Schultz’s trip to Italy the following year led to an entrepreneurial epiphany to which he now attributes Starbucks’s success. Inspired by how cafés in Italy, particularly the espresso bars in Milan, were vibrant social hubs, Schultz returned to the US with a newfound sensitivity to ambience and attitude. In 1987, Schultz bought Starbucks outright and stated his business philosophy thus: “We aren’t in the coffee business, serving people. We are in the people business, serving coffee” (quoted in Ruzich 432). This was articulated most clearly in how Schultz structured Starbucks as the ultimate “third place”, a welcoming amalgam of aromas, music, furniture, textures, literature and free WiFi. This transformed the café experience twofold. First, sensory overload masked the dull homogeny of a global chain with an air of warm, comforting domesticity—an inviting, everyday “home away from home.” To this end, in 1994, Schultz enlisted interior design “mastermind” Wright Massey; with his team of 45 designers, Massey created the chain’s decor blueprint, an “oasis for contemplation” (quoted in Scerri 60). At the same time though, and second, Starbucks promoted a revisionist, airbrushed version of how the coffee was produced. Patrons could see and smell the freshly roasted beans, and read about their places of origin in the free pamphlets. In this way, Starbucks merged the exotic and the cosmopolitan. The global supply chain underwent an image makeover, helped by a “new” vocabulary that familiarised its coffee drinkers with the diversity and complexity of coffee, and such terms as aroma, acidity, body and flavour. This strategy had a decisive impact on the coffee market, first in the US and then elsewhere: Starbucks oversaw a significant expansion in coffee consumption, both quantitatively and qualitatively. In the decades following the Second World War, coffee consumption in the US reached a plateau. Moreover, as Steven Topik points out, the rise of this type of coffee connoisseurship actually coincided with declining per capita consumption of coffee in the US—so the social status attributed to specialised knowledge of coffee “saved” the market: “Coffee’s rise as a sign of distinction and connoisseurship meant its appeal was no longer just its photoactive role as a stimulant nor the democratic sociability of the coffee shop” (Topik 100). Starbucks’s singular triumph was to not only convert non-coffee drinkers, but also train them to a level of relative sophistication. The average “cup o’ Joe” thus gave way to the latte, cappuccino, macchiato and more, and a world of coffee hitherto beyond (perhaps above) the average American consumer became both regular and routine. By 2003, Starbucks’s revenue was US $4.1 billion, and by 2012 there were almost 20,000 stores in 58 countries. As an idealised “third place,” Starbucks functioned as a welcoming haven that flattened out and muted the realities of global trade. The variety of beans on offer (Arabica, Latin American, speciality single origin and so on) bespoke a generous and bountiful modernity; while brochures schooled patrons in the nuances of terroir, an appreciation for origin and distinctiveness that encoded cultural capital. This positioned Starbucks within a happy narrative of the coffee economy, and drew patrons into this story by flattering their consumer choices. Against the generic sameness of supermarket options, Starbucks promised distinction, in Pierre Bourdieu’s sense of the term, and diversity in its coffee offerings. For Greg Dickinson, the Starbucks experience—the scent of the beans, the sound of the grinders, the taste of the coffees—negated the abstractions of postmodern, global trade: by sensory seduction, patrons connected with something real, authentic and material. At the same time, Starbucks professed commitment to the “triple bottom line” (Savitz), the corporate mantra that has morphed into virtual orthodoxy over the last fifteen years. This was hardly surprising; companies that trade in food staples typically grown in developing regions (coffee, tea, sugar, and coffee) felt the “political-aesthetic problematization of food” (Sassatelli and Davolio). This saw increasingly cognisant consumers trying to reconcile the pleasures of consumption with environmental and human responsibilities. The “triple bottom line” approach, which ostensibly promotes best business practice for people, profits and the planet, was folded into Starbucks’s marketing. The company heavily promoted its range of civic engagement, such as donations to nurses’ associations, literacy programs, clean water programs, and fair dealings with its coffee growers in developing societies (Simon). This bode well for its target market. As Constance M. Ruch has argued, Starbucks sought the burgeoning and lucrative “bobo” class, a term Ruch borrows from David Brooks. A portmanteau of “bourgeois bohemians,” “bobo” describes the educated elite that seeks the ambience and experience of a counter-cultural aesthetic, but without the political commitment. Until the last few years, it seemed Starbucks had successfully grafted this cultural zeitgeist onto its “third place.” Ironically, the scale and scope of the brand’s success has meant that Starbucks’s claim to an ethical agenda draws frequent and often fierce attack. As a global behemoth, Starbucks evolved into an iconic symbol of advanced consumer culture. For those critical of how such brands overwhelm smaller, more local competition, the brand is now synonymous for insidious, unstoppable retail spread. This in turn renders Starbucks vulnerable to protests that, despite its gestures towards sustainability (human and environmental), and by virtue of its size, ubiquity and ultimately conservative philosophy, it has lost whatever cachet or charm it supposedly once had. As Bryant Simon argues, in co-opting the language of ethical practice within an ultimately corporatist context, Starbucks only ever appealed to a modest form of altruism; not just in terms of the funds committed to worthy causes, but also to move thorny issues to “the most non-contentious middle-ground,” lest conservative customers felt alienated (Simon 162). Yet, having flagged itself as an ethical brand, Starbucks became an even bigger target for anti-corporatist sentiment, and the charge that, as a multinational giant, it remained complicit in (and one of the biggest benefactors of) a starkly inequitable and asymmetric global trade. It remains a major presence in the world coffee market, and arguably the most famous of the coffee chains. Over the last decade though, the speed and intensity with which Nespresso has grown, coupled with its atypical approach to consumer engagement, suggests that, in terms of brand equity, it now offers a more compelling point of difference than Starbucks. Brand “Me” Insofar as the Nespresso system depends on a consumer market versed in the intricacies of quality coffee, Starbucks can be at least partly credited for nurturing a more refined palate amongst everyday coffee drinkers. Yet while Starbucks courted the “average” consumer in its quest for market control, saturating the suburban landscape with thousands of virtually indistinguishable stores, Nespresso marks a very different sensibility. Put simply, Nespresso inverts the logic of a coffee house as a “third place,” and patrons are drawn not to socialise and relax but to pursue their own highly individualised interests. The difference with Starbucks could not be starker. One visitor to the Bloomingdale boutique (in New York’s fashionable Soho district) described it as having “the feel of Switzerland rather than Seattle. Instead of velvet sofas and comfy music, it has hard surfaces, bright colours and European hostesses” (Gapper 9). By creating a system that narrows the gap between production and consumption, to the point where Nespresso boutiques advertise the coffee brand but do not promote on-site coffee drinking, the boutiques are blithely indifferent to the historical, romanticised image of the coffee house as a meeting place. The result is a coffee experience that exploits the sophistication and vanity of aspirational consumers, but ignores the socialising scaffold by which coffee houses historically and perhaps naively made some claim to community building. If anything, Nespresso restricts patrons’ contemplative field: they consider only their relationships to the brand. In turn, Nespresso offers the ultimate expression of contemporary consumer capitalism, a hyper-individual experience for a hyper-modern age. By developing a global brand that is both luxurious and niche, Nespresso became “the Louis Vuitton of coffee” (Betts 14). Where Starbucks pursued retail ubiquity, Nespresso targets affluent, upmarket cities. As chief executive Richard Giradot put it, with no hint of embarrassment or apology: “If you take China, for example, we are not speaking about China, we are speaking about Shanghai, Hong Kong, Beijing because you will not sell our concept in the middle of nowhere in China” (quoted in Canning 28). For this reason, while Europe accounts for 90 per cent of Nespresso sales (Betts 15), its forays into the Americas, Asia and Australasia invariably spotlights cities that are already iconic or emerging economic hubs. The first boutique in Latin America, for instance, was opened in Jardins, a wealthy suburb in Sao Paulo, Brazil. In Nespresso, Nestlé has popularised a coffee experience neatly suited to contemporary consumer trends: Club members inhabit a branded world as hermetically sealed as the aluminium pods they purchase and consume. Besides the Club’s phone, fax and online distribution channels, pods can only be bought at the boutiques, which minimise even the potential for serendipitous mingling. The baristas are there primarily for product demonstrations, whilst highly trained staff recite the machines’ strengths (be they in design or utility), or information about the actual coffees. For Club members, the boutique service is merely the human extension of Nespresso’s online presence, whereby product information becomes increasingly tailored to increasingly individualised tastes. In the boutique, this emphasis on the individual is sold in terms of elegance, expedience and privilege. Nespresso boasts that over 70 per cent of its workforce is “customer facing,” sharing their passion and knowledge with Club members. Having already received and processed the product information (through the website, boutique staff, and promotional brochures), Club members need not do anything more than purchase their pods. In some of the more recently opened boutiques, such as in Paris-Madeleine, there is even an Exclusive Room where only Club members may enter—curious tourists (or potential members) are kept out. Club members though can select their preferred Grands Crus and checkout automatically, thanks to RFID (radio frequency identification) technology inserted in the capsule sleeves. So, where Starbucks exudes an inclusive, hearth-like hospitality, the Nespresso Club appears more like a pampered clique, albeit a growing one. As described in the Financial Times, “combine the reception desk of a designer hotel with an expensive fashion display and you get some idea what a Nespresso ‘coffee boutique’ is like” (Wiggins and Simonian 10). Conclusion Instead of sociability, Nespresso puts a premium on exclusivity and the knowledge gained through that exclusive experience. The more Club members know about the coffee, the faster and more individualised (and “therefore” better) the transaction they have with the Nespresso brand. This in turn confirms Zygmunt Bauman’s contention that, in a consumer society, being free to choose requires competence: “Freedom to choose does not mean that all choices are right—there are good and bad choices, better and worse choices. The kind of choice eventually made is the evidence of competence or its lack” (Bauman 43-44). Consumption here becomes an endless process of self-fashioning through commodities; a process Eva Illouz considers “all the more strenuous when the market recruits the consumer through the sysiphian exercise of his/her freedom to choose who he/she is” (Illouz 392). In a status-based setting, the more finely graded the differences between commodities (various places of origin, blends, intensities, and so on), the harder the consumer works to stay ahead—which means to be sufficiently informed. Consumers are locked in a game of constant reassurance, to show upward mobility to both themselves and society. For all that, and like Starbucks, Nespresso shows some signs of corporate social responsibility. In 2009, the company announced its “Ecolaboration” initiative, a series of eco-friendly targets for 2013. By then, Nespresso aims to: source 80 per cent of its coffee through Sustainable Quality Programs and Rainforest Alliance Certified farms; triple its capacity to recycle used capsules to 75 per cent; and reduce the overall carbon footprint required to produce each cup of Nespresso by 20 per cent (Nespresso). This information is conveyed through the brand’s website, press releases and brochures. However, since such endeavours are now de rigueur for many brands, it does not register as particularly innovative, progressive or challenging: it is an unexceptional (even expected) part of contemporary mainstream marketing. Indeed, the use of actor George Clooney as Nespresso’s brand ambassador since 2005 shows shrewd appraisal of consumers’ political and cultural sensibilities. As a celebrity who splits his time between Hollywood and Lake Como in Italy, Clooney embodies the glamorous, cosmopolitan lifestyle that Nespresso signifies. However, as an actor famous for backing political and humanitarian causes (having raised awareness for crises in Darfur and Haiti, and backing calls for the legalisation of same-sex marriage), Clooney’s meanings extend beyond cinema: as a celebrity, he is multi-coded. Through its association with Clooney, and his fusion of star power and worldly sophistication, the brand is imbued with semantic latitude. Still, in the television commercials in which Clooney appears for Nespresso, his role as the Hollywood heartthrob invariably overshadows that of the political campaigner. These commercials actually pivot on Clooney’s romantic appeal, an appeal which is ironically upstaged in the commercials by something even more seductive: Nespresso coffee. References Bauman, Zygmunt. “Collateral Casualties of Consumerism.” Journal of Consumer Culture 7.1 (2007): 25–56. Betts, Paul. “Nestlé Refines its Arsenal in the Luxury Coffee War.” Financial Times 28 Apr. (2010): 14. Bourdieu, Pierre. Distinction: A Social Critique of the Judgement of Taste. Cambridge: Harvard University Press, 1984. Butler, Reg. “The Nespresso Route to a Perfect Espresso.” Tea & Coffee Trade Journal 172.4 (2000): 50. Canning, Simon. “Nespresso Taps a Cultural Thirst.” The Australian 26 Oct. (2009): 28. Dickinson, Greg. “Joe’s Rhetoric: Finding Authenticity at Starbucks.” Rhetoric Society Quarterly 32.4 (2002): 5–27. Gapper, John. “Lessons from Nestlé’s Coffee Break.” Financial Times 3 Jan. (2008): 9. Gaudio, Rudolf P. “Coffeetalk: StarbucksTM and the Commercialization of Casual Conversation.” Language in Society 32.5 (2003): 659–91. Habermas, Jürgen. The Structural Transformation of the Public Sphere: An Inquiry into a Category of Bourgeois Society. Cambridge: MIT Press, 1962. Illouz, Eva. “Emotions, Imagination and Consumption: A New Research Agenda.” Journal of Consumer Culture 9 (2009): 377–413. Karababa, EmInegül, and GüIIz Ger. “Early Modern Ottoman Coffehouse Culture and the Formation of the Consumer Subject." Journal of Consumer Research 37.5 (2011): 737–60 Kjeldgaard, Dannie, and Jacob Ostberg. “Coffee Grounds and the Global Cup: Global Consumer Culture in Scandinavia”. Consumption, Markets and Culture 10.2 (2007): 175–87. Kleinman, Sharon S. “Café Culture in France and the United States: A Comparative Ethnographic Study of the Use of Mobile Information and Communication Technologies.” Atlantic Journal of Communication 14.4 (2006): 191–210. Luckins, Tanja. “Flavoursome Scraps of Conversation: Talking and Hearing the Cosmopolitan City, 1900s–1960s.” History Australia 7.2 (2010): 31.1–31.16. Markides, Constantinos C. “A Dynamic View of Strategy.” Sloan Management Review 40.3 (1999): 55. Nespresso. “Ecolaboration Initiative Directs Nespresso to Sustainable Success.” Nespresso Media Centre 2009. 13 Dec. 2011. ‹http://www.nespresso.com›. O’Brien, Mary. “A Shot at the Big Time.” The Age 21 Jun. (2011): 16. Oldenburg, Ray. The Great Good Place: Cafés, Coffee Shops, Community Centers, Beauty Parlors, General Stores, Bars, Hangouts, and How They Get You Through the Day. New York: Paragon House, 1989. Purpura, Linda. “New Espresso Machines to Tempt the Palate.” The Weekly Home Furnishings Newspaper 3 May (1993): 116. Purpura, Linda. “Espresso: Grace under Pressure.” The Weekly Home Furnishings Newspaper 16 Dec. (1991): 88. Reguly, Eric. “No Ordinary Joe: Nestlé Pulls off Caffeine Coup.” The Globe and Mail 6 Jul. (2009): B1. Ruzich, Constance M. “For the Love of Joe: The Language of Starbucks.” The Journal of Popular Culture 41.3 (2008): 428–42. Sassatelli, Roberta, and Federica Davolio. “Consumption, Pleasure and Politics: Slow Food and the Politico-aesthetic Problematization of Food.” Journal of Consumer Culture 10.2 (2010): 202–32. Savitz, Andrew W. The Triple Bottom Line: How Today’s Best-run Companies are Achieving Economic, Social, and Environmental Success—And How You Can Too. San Francisco: Jossey-Bass, 2006. Scerri, Andrew. “Triple Bottom-line Capitalism and the ‘Third Place’.” Arena Journal 20 (2002/03): 57–65. Simon, Bryant. “Not Going to Starbucks: Boycotts and the Out-sourcing of Politics in the Branded World.” Journal of Consumer Culture 11.2 (2011): 145–67. Simonian, Haig. “Nestlé Doubles Nespresso Output.” FT.Com 10 Jun. (2009). 2 Feb. 2012 ‹http://www.ft.com/cms/s/0/0dcc4e44-55ea-11de-ab7e-00144feabdc0.html#axzz1tgMPBgtV›. Topik, Steven. “Coffee as a Social Drug.” Cultural Critique 71 (2009): 81–106. Wiggins, Jenny, and Haig Simonian. “How to Serve a Bespoke Cup of Coffee.” Financial Times 3 Apr. (2007): 10.