A total of 3484 Hong Kong Chinese women were interviewed in person. Screening prevalence and associated predictors, disability-adjusted life-years (DALYs), the numbers of false-positive tests and the resultant confirmatory procedures and related complications were estimated.

A total of 6.2% of women (≥18) reported regular pap but no mammography or clinical breast examination (CBE) as per local evidence-based guidelines, whereas among women aged ≥40 years, 5.2% reported regular screening by all three modalities and 55.3% had never been screened for either cancer. Women who underwent regular health checkups were consistently the most likely to have been screened, as were younger, married and socially advantaged respondents. Triennial pap screening would save 708 DALYs annually, or 528 more DALYs compared with the status quo. However, this would generate 28 600 repeat smears and 390 colposcopies from false-positive screens. Opportunistic mammographic screening averted 100 DALYs currently, but could have potentially reduced a further 546 with biennial screening. Mass screening mammography (CBE) would lead to 33 700 (20 200) false-positives per year requiring 29 900 (8300) repeat mammograms or ultrasonograms, 6800 (3000) biopsies and 620 (270) biopsy-related complications.

Screening uptake patterns are suboptimal. By making explicit the possible risks and benefits based on this template, policy makers in developing Asia with a similar female cancer burden may be able to use the information to make evidence-based decisions that are consistent with local circumstances, values and preferences.

Self-reported data were obtained from school-based surveys in six counties during 2000–04. Overweight and obesity were calculated using Cole's index.

The prevalence of overweight and obesity were 11.8% and 2.4%, respectively, higher among boys. Logistic regression analyses revealed that adolescents in Nordland, Troms and Finnmark (the northernmost counties) were 70–90% more likely to be overweight and obese compared with adolescents in Oslo (the capital and southernmost county) (OR for overweight in Finnmark = 1.7, CI = 1.3, 2.3). Lower educational plans and poor family economy were both significantly associated with overweight and obesity. So was physical inactivity (OR = 1.2, CI = 1.1, 1.3 and OR = 1.6, CI = 1.2, 2.1, respectively). Eating breakfast was positively associated with not being overweight/obese.

Overweight and obesity is associated with socio-economic factors and with factors related to food habits and nutrition, suggesting important areas for prevention.

To examine gender differences in incidence, hospitalization, hospital-based procedures and mortality for colorectal cancer.

Data were derived from the Hospital Morbidity Database, Canadian Cancer Registry and the Canadian Mortality Database.

Overall incidence and mortality rates for colorectal cancer are decreasing, but remain substantially higher for males. Absolute numbers of cases are similar for men and women. The top subsite for men was rectal cancer, which was third highest for women, whereas right colon cancer was highest for women. Male/female ratios for incidence and surgeries were highest for distal cancer and are increasing with time.

Although overall incidence rates have shown a decline, absolute numbers of new colorectal cancer cases have increased. While men have higher colorectal cancer rates, women have similar numbers and screening should target both equally. Over the years, colorectal cancer subsites are showing a rightward shift, i.e. an increase in proximal subsites, but a leftward shift in male/female ratios, i.e. a greater decrease for the more distal subsites in females. The lower rates for women for distal cancer are compatible with a degree of hormonal protection based on oral contraceptive and hormone replacement therapy. Colorectal cancer will continue to be a considerable public health problem in the foreseeable future.

A novel methodological framework was developed to overcome barriers among separate epidemic statistics and identify distinctive SARS features. Individual statistics were pair-wise linked in terms of their common features, and an integrative epidemic network was formulated.

The study of associations between important SARS characteristics considerably enhanced the mainstream epidemic analysis and improved the understanding of the relationships between the observed epidemic determinants. The response of SARS transmission to various epidemic control factors was simulated, target areas were detected, critical time and relevant factors were determined.

It was shown that by properly accounting for links between different SARS statistics, a data-based analysis can efficiently reveal systematic associations between epidemic determinants. The analysis can predict the temporal trend of the epidemic given its spatial pattern, to estimate spatial exposure given temporal evolution, and to infer the driving forces of SARS transmission given the spatial exposure distribution.

A structured, short, anonymous questionnaire was distributed to IDUs through a wide range of agencies and services in North East Scotland. A form of snowball sampling was also used.

A total of 370 individuals responded. Respondents noted the following in their two prioritized preferred options: ‘Provision of paraphernalia’ (citric acid, water and filters; 54%), ‘weekend opening hours’ (24%) and ‘antibiotic prescribing’ (23%). Other service developments noted were: ‘friendly, approachable staff’ (16%), ‘family planning’ (10.4%), ‘dressings for wounds/sores’ (9%), ‘leaflets on safer injecting’ (7.0%), ‘advice from staff on safer injecting’ (3.0%) and ‘evening opening hours’ (0.8%). Geographical gaps in current needle exchange services were identified. There was homogeneity of responses across demographic groups.

IDUs were willing to participate and suggested more provision of paraphernalia.

The evaluation was made using the current framework published by the Centers for Disease Control and Prevention, Atlanta, USA. Two groups of system stakeholders, for data input and data analysis, were interviewed using semi-structured questionnaires to assess timeliness, data quality, acceptability, usefulness, stability, portability and flexibility of the system. Validity was assessed by comparing the syndromic system with the routine traditional weekly surveillance system.

Qualitative data showed a degree of poor acceptability among people who have to enter data. Timeliness analysis showed excellent case processing time, hindered by delays in case reporting. Analysis of stability indicated a high level of technical problems. System flexibility was found to be high. Quantitative data analysis of validity indicated better agreement between syndromic and traditional surveillance when reporting on dengue fever cases as opposed to other diseases.

The sophisticated technical design of 2SE FAG has resulted in a system which is able to carry out its role as an early warning system. Efforts must be concentrated on increasing its acceptance and use by people who have to enter data and decreasing the occurrence of the frequency of technical problems.

In this cross-sectional study, 270 women were selected using probability cluster sampling method at 95% confidence interval (91.5% response rate). The Structured Clinical Interview for DSM-IV (SCID-I) and women socio-demographic information form were used to collect data.

Although the prevalence of mental disorder was 25.9% (8.5% with one diagnosis; 17.4% were two or more diagnoses), 4.7% of these women had contacted a carer in the last year for psychological reasons. According to the SCID-I assessment, the most prevalent diagnoses were major depressive disorder (7.3%), phobic disorder (4.8%) and posttraumatic stress disorder (3.6%). In this study, comorbid diagnoses were present in 67.2% of patients. Logistic regression analyses revealed that domestic violence, history of previous trauma, anemia and cutaneous leishmaniasis were significant predictors of any mental disorders (P < 0.05).

These findings highlight the need for systematic development of community-based mental health services in conjunction with primary health care services for the screening, early identification and treatment of women suffering from mental disorders, and the improvement of anemia and cutaneous leishmaniasis control programme.

Multivariate statistical techniques included 14 176 women between 20 and 69 years of age. Height and weight were measured rather than self-reported.

In Iranian adult women, obesity OR_S for the moderate and high education were 0.78 and 0.41, respectively, compared with basic level. Using low economy index as the reference, Obesity OR_S for the urban women were 1.29, 1.25 and 1.28 for the lower-middle, upper-middle and high groups, respectively. Obesity OR_S for the rural women were 1.71, 1.71 and 2.02 for the lower-middle, upper-middle and high groups, respectively. Obesity OR was 0.48 for active workforce compared with inactive group. Obesity OR was 0.70 for smokers women compared with nonsmokers. Using non-married as the reference group, Obesity OR_S were 1.23 and 2.34 for married urban and rural women, respectively.

Our results on the associations between age, smoking, education level, workforce and obesity are consistent with most studies, but between economic level and obesity are consistent with some study in developing countries.

We estimated DALY using the global burden of disease (GBD) template. For years of life lost, local mortality data were used and for years of life with disability, the GBD estimates from World Health Organization EURO A region (including the UK) were used. We used PB data to analyse how healthcare expenditure matched disease burden.

In 2005 the burden of disease in Lambeth was estimated at 36 368 DALYs (13 515 DALYs lost per 100 000) and in Southwark was 34 196 DALYs (13 244 DALYs lost per 100 000). There were gender and area differences. The ranking is different when mortality and morbidity are combined compared with mortality alone. We estimated that the average spend per DALY lost in 2005 was £11 066 in Lambeth and £9390 in Southwark.

We used a pragmatic approach to estimate overall disease burden providing a local, more comprehensive picture with important differences in spend by disease and health authority area. However, a more detailed approach to support decisions about prioritization based on modelling interventions that impact on avoidable burden of disease is recommended.

We examined patterns of incarceration among 1247 IDU participants enrolled in a 6-year prospective cohort study in Vancouver, Canada, and tested for potential associations between HIV risk behaviour and incarceration. Correlates of incarceration were identified using generalized estimating equations (GEE).

At baseline, factors significantly associated with incarceration included daily injection heroin and injection cocaine use and inconsistent condom use with casual sexual partners. In a GEE analysis, factors independently associated with incarceration included: used syringe borrowing (adjusted odds ratio [AOR] = 1.36; [95% CI: 1.16–1.60]), used syringe lending (AOR = 1.31; [95% CI: 1.12–1.55]) and inconsistent condom use with casual sexual partners (AOR = 1.16; [1.02–1.33]). All variables P < 0.05.

In our study, incarceration was independently associated with HIV transmission and acquisition behaviours. These findings suggest that increased rates of incarceration of IDU may be associated with increased HIV transmission among this group.

The study sample included 1803 adolescents (12–19 years) from the 1999–04 US National Health and Nutrition Examination Surveys. Average daily screen time (combined television, computer and video game use) was self-reported. MetS was defined according to adolescent criteria linked to the adult criteria of the National Cholesterol Education Program (≥3 of high triglycerides, high fasting glucose, high waist circumference, high blood pressure and low HDL cholesterol).

After adjustment for relevant covariates, the odds ratios (95% confidence intervals) for MetS increased in a dose–response manner (P_trend < 0.01) across ≤1 h/day (1.00, referent), 2 h/day (1.21, 0.54–2.73), 3 h/day (2.16, 0.99–4.74), 4 h/day (1.73, 0.72–4.17) and ≥5 h/day (3.07, 1.48–6.34) screen time categories. Physical activity had a minimal impact on the relation between screen time and MetS.

Screen time was associated with an increased likelihood of MetS in a dose-dependent manner independent of physical activity. These findings suggest that lifestyle-based public health interventions for youth should include a specific component aimed at reducing screen time.

To estimate coverage accurately for women aged 50–64.

Routine data from the KC63 return were used to calculate coverage for women aged 50–64 using an adjusted method that allows for the fact that women receive a first invitation to screening between 50 and 52.9 years.

The adjusted average coverage between 1996 and 2005, for women aged 50–64 was 74.3% and the standard unadjusted average measure for the same period was 68.3%. Therefore, previous measures of coverage for this age group have underestimated coverage by ~9% and the adjusted figure is actually well above the target.

In terms of coverage the programme has been performing better than previously reported. It is important to monitor the effect of an increasing workload on the programmes ability to re-invite women within three years of their last screen as maintaining coverage is an important factor in ensuring that the NHSBSP is effective in reducing mortality from breast cancer.

Children were grouped into nine cohorts based on their year of birth. The UK National BMI percentile classification was used to classify the children as overweight and obese and to examine the prevalence and trends by year of birth, sex and ethnicity.

Overall, more boys (10.1%; 9.7–10.6%) than girls (9.1%; 8.7–9.6%) were obese (P < 0.003). South Asian boys were more likely to be overweight (OR 1.92; 95% CI 1.62–2.28; P < 0.01) and obese (OR 1.53; 95% CI 1.28–1.89; P < 0.01) than South Asian girls. Overweight (1.77; 1.56–2.00; P < 0.05) and obesity (1.76; 1.50–2.06; P < 0.05) were significantly higher among South Asian boys compared with their White counterparts (baseline). After adjusting for sex, ethnicity and year of birth, South Asian children were 27% more overweight (P < 0.01) and 45% more obese (P < 0.01) compared with White children, and boys were 6% more overweight (P = 0.04) and 12% more obese (P = 0.003) compared with girls. There was an increasing trend in overweight among boys (P = 0.01) and girls (P = 0.003); and in obesity among boys (P < 0.001) and girls (P = 0.008) in children born from 1991 to 1999.

There is a significant rise in childhood obesity among 5–7-year-old children. Overweight and obesity among South Asian boys are significantly higher than that among South Asian girls. This group may be at greater risk of morbidity and mortality related to obesity and may need to be targeted appropriately for interventions to reduce obesity.

Multi-level analysis of consecutive patients treated with percutaneous coronary intervention (PCI) between April 2005 and March 2006 in Scotland, using the Scottish Coronary Revascularization Registry.

A total of 38 operators performed 5967 PCI procedures on 8489 lesions. Crude level of DES use was 47.6%, and the results varied among hospitals (range 30.6–61.8%, ² = 341.6, P < 0.0001). There was significant between-operator variation in the null model. This was attenuated by the addition of hospital as a fixed effect. Nonetheless, the final model demonstrated significant between-operator variability [² = 0.486 (0.249–0.971)] and between-hospital variation, after case-mix adjustment.

Within Scotland, marked variation existed among hospitals in the use of DES. Operator was the most important factor at patient level, and hospital of treatment, rather than case-mix, was the most important modifier of between-operator variation. Patient selection for DES is complex and may contribute to much of the variations demonstrated. Consensus criteria would provide more detail than is included in current guidance, may aid decision-making for individual patients, reduce opportunity costs and ensure equity of access.

Body mass indices for 3-year-old children resident in three South Wales localities from 1995 to 2005 were derived from the National Community Child Health Database (NCCHD) and examined in relation to residence lower super output area (LSOA) Townsend Material Deprivation Score.

Over 11 years, 53–69% of children had height/weight measurements recorded (with little difference observed across deprivation fifths). Amalgamating the data for all 11 years showed no significant association of prevalence with LSOA socio-economic status. Annual trends varied substantially: the most deprived fifth had the lowest proportion on five, and the highest on six, occasions. Linear regression analysis suggested a greater rate of increase of overweight/obesity in children from most-deprived LSOA areas compared with those from least deprived areas (not statistically significant).

Socio-economic difference in overweight/obesity prevalence lessened between 1995 and 2005. Despite annual variation, this apparent closing of the gap has been the result of an increase in overweight/obesity prevalence in children from the most deprived areas who, initially, had a lower prevalence compared with children from least deprived areas, but by 2005, had overtaken them.

Data from two cross-sectional surveys of injecting drug users (IDUs) recruited from a syringe exchange program (N = 162, Study 1) or using respondent driven sampling (N = 350, Study 2). Behavioral surveys were administered; serum samples were collected for HIV testing. Subjects were categorized into new injectors (injecting ≤ 3 years) and long-term injectors (injecting > 3 years).

Twenty-eight of 161 (17%, Study 1) and 73/350 (21%, Study 2) of the study subjects were new injectors. HIV infection was substantial among the newer injectors: HIV prevalence was 50% (Study 1) and 34% (Study 2), and estimated HIV incidence 31/100 PY and 21/100 PY, respectively. In Study 2, new injectors were more likely to be female and ethnic Estonian and less likely to be injecting daily compared with long-term injectors. No significant difference was found among two groups on sharing injecting equipment or reported number of sexual partners.

A continuing HIV epidemic among new injectors is of critical public health concern. Interventions to prevent initiation into injecting drug use and scaling up HIV prevention programs for IDUs in Estonia are of utmost importance.

Prospective population-based study of 1.3 million women aged 56 years on average, recruited from 1996 to 2001 in England and Scotland and followed-up through NHS hospital admission record databases for gallbladder disease (cholelithiasis, cholecystitis, cholecystectomy) over a total of 7.8 million person-years.

During follow-up, 24 953 women were admitted with gallbladder disease, 87% who had a cholecystectomy. After adjusting for age, socioeconomic status and other factors, women with higher BMI at recruitment to the study were more likely to be admitted and spend more days in hospital. For 1000 person-years of follow-up, women in BMI categories of 18.5–24.9, 25–29.9, 30–39.9, 40+ kg/m² spent, respectively, 16.5[16.0–17.0], 28.6[28.3–28.8], 44.0[43.4–44.5] and 49.4[45.7–53.0] days in hospital for gallbladder disease.

On the basis of these estimates, over a quarter of all the days in hospital for gallbladder disease in middle-aged women can be attributed to obesity.

Cervical cancer incidence rates were calculated for cytology laboratory catchment areas, which reflected where local general practitioners sent cervical samples. After reviewing changes in invasive cervical cancer incidence rates in the West Midlands during the period 1988–2004 to identify unusual trends, a detailed retrospective screening history analysis was carried out for one local screening service.

An upward trend in invasive cervical cancer incidence in one laboratory catchment area was caused by an increase in cases occurring in women who had not been routinely screened. Quality assurance data provided supporting evidence for non-attendance at screening during this time.

Assigning a screening status to invasive cervical cancers provides valuable information through which to understand the reasons for changes in cancer incidence with time in local screening services. These data can be used to identify areas of potential concern, thereby facilitating quality assurance activities.

Mass media reports in the United States on emerging and chronic health hazards (severe acute respiratory syndrome (SARS), bioterrorism, West Nile Fever, AIDS, smoking and physical inactivity) were counted for the year 2003, using LexisNexis database. The number of media reports for each health risk was correlated with the corresponding death rate as reported by the Centers for Disease Control and Prevention.

The number of media reports inversely correlated with the actual number of deaths for the health risks evaluated. SARS and bioterrorism killed less than a dozen people in 2003, but together generated over 100 000 media reports, far more than those covering smoking and physical inactivity, which killed nearly a million Americans.

Emerging health hazards are over-reported in mass media by comparison to common threats to public health. Since premature mortality in industrialized societies is most often due to well-known risks such as smoking and physical inactivity, their under-representation on public agendas may cause suboptimal prioritization of public health resources.

Pregnant local residents living within 3 km of a landfill site (‘exposed’ group, n = 200) or elsewhere in the Rhondda valleys (‘unexposed’ group, n = 400) were interviewed by health visitors or midwives. The response rate was 83%.

No difference was found in the TTP distributions between the exposed and unexposed groups. Relationships of TTP with covariates were consistent with the literature.

In a context of public and scientific concern about possible reproductive toxicity, an interview study of TTP was highly acceptable to local women. A large enough sample to generate stable TTP distributions was readily achieved.

Time series of NHS Direct calls concerning ‘cold/flu’ and fever syndromes for England and Wales were compared against influenza-like-illness clinical incidence data and laboratory reports of influenza. Poisson regression models were used to derive NHS Direct thresholds. The early warning potential of thresholds was evaluated retrospectively for 2002–06 and prospectively for winter 2006–07.

NHS Direct ‘cold/flu’ and fever calls generally rose and peaked at the same time as clinical and laboratory influenza data. We derived a national ‘cold/flu’ threshold of 1.2% of total calls and a fever (5–14 years) threshold of 9%. An initial lower fever threshold of 7.7% was discarded as it produced false alarms. Thresholds provided 2 weeks advanced warning of seasonal influenza activity during three of the four winters studied retrospectively, and 6 days advance warning during prospective evaluation.

Syndromic thresholds based on NHS Direct data provide advance warning of influenza circulating in the community. We recommend that age-group specific thresholds be developed for other clinical influenza surveillance systems in the UK and elsewhere.

The study was based on data from annual postal surveys among 15- to 64-year-olds in 1981–2005 (average response rate 73%). The data set for this study comprised men and women aged 25–64 years (n = 73 471). Logistic models were used to test the effect of the 1995 TCAA across employment status while controlling for the effect of changes in the real price of tobacco and in gross domestic product per capita, and adjusting for age, education, secular trend and prevalence of ever-smokers in each birth cohort.

Controlling for confounding factors, the odds ratio (OR) for daily smoking after 1995 among employed men was 0.83 (95% CI 0.73–0.94) compared with the OR (1.0) for the period ending 1994. The corresponding figure for employed women was 0.78 (95% CI 0.68–0.91). The results can be interpreted as a positive effect of the 1995 TCAA on employees’ daily smoking. Moreover, a similar decrease in daily smoking was not seen among those not targeted by the TCAA (including farmers, students, housewives, pensioners and the unemployed).

Smoking behaviour was and can be influenced by national tobacco policy measures.

All non-drug-controlled interventions (≥3 months) in Mainland China, which used anthropometric outcome measures, were selected from three Chinese and nine international electronic databases (before May 2006) and included in this systematic review.

A total of 20 studies met the selection criteria and were included in the review. Among them only one was published in an international journal. Most studies combined at least physical activity, dietary intervention and health education. Seventeen studies (85%) reported significant effects in anthropometric measurement outcomes.

Comprehensive interventions with at least physical activity, dietary intervention and health education may be effective in reducing obesity in Chinese children. The role of grandparents as carers in the one-child society is worth considering further. Current evidence of effective interventions for adults is limited. Publication bias in Chinese databases should be taken into account.