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Background. We compared the clinico-radio-pathological characteristics of breast cancer detected through mammogram (MMG) and ultrasound (USG) and discuss the implication of the choice of imaging as the future direction of our recently launched local screening program. Methods. Retrospective study of 14613 Hong Kong Chinese female patients with histologically confirmed breast cancer registered in the Hong Kong Breast Cancer Registry between January 2006 and February 2020. Patients were classified into four groups based on the mode of breast cancer detection (detectable by both mammogram and ultrasound (MMG+/USG+), mammogram only (MMG+/USG−), ultrasound only (MMG−/USG+), or not detectable by either (MMG−/USG−). Characteristics of breast cancer detected were compared, including patient demographics, breast density on MMG, mode of presentation, tumour size, histological type, and staging. Types of mammographic abnormalities were also evaluated for MMG+ subgroups. Results. 85% of the cancers were detectable by MMG, while USG detected an additional 9%. MMG+/USG+ cancers were larger, more advanced in stage, often of symptomatic presentation, and commonly manifested as mammographic mass. MMG+/USG− cancers were more likely of asymptomatic presentation, manifested as microcalcifications, and of earlier stage and to be ductal carcinoma in situ. MMG−/USG+ cancers were more likely seen in young patients and those with denser breasts and more likely of symptomatic presentation. MMG−/USG− cancers were often smaller and found in denser breasts. Conclusion. Mammogram has a good detection rate of cancers in our local population. It has superiority in detecting early cancers by detecting microcalcifications. Our current study agrees that ultrasound is one of the key adjunct tools of breast cancer detection.

In China, approximately 70% of beverage alcohol is consumed in the form of spirits. An estimated 25% of all alcohol consumed is unrecorded, mostly spirits (bai jiu), produced outside regulatory systems in small neighborhood distilleries, mostly in rural areas. Unrecorded bai jiu drinkers are generally older, male, prefer higher-strength bai jiu, and drink daily and mostly at home. To explore possible regional differences, researchers used interview data from 2919 bai jiu drinkers in rural areas in Hebei, Anhui, and Hubei provinces in China. Results confirmed that patterns varied by province. The sample in Hubei preferred unrecorded bai jiu with a more stable preference to alcohol type, tended to drink less frequently, and reported experiencing less drinking pressure, suggesting lower-risk drinking patterns in this region. The Hebei and Anhui sample reported higher frequency and greater amount of alcohol consumption, were more likely to experience drinking pressure, indicating higher-risk patterns in alcohol use in these two regions. The results provide needed details about regional differences in unrecorded bai jiu drinking patterns that are not evident in aggregated data and suggest variations in drinking patterns that may reflect local geography, local values, traditions, and ethnic differences.

Objective: To test if precollege drinking data gathered during an online brief intervention are associated with problems and could inform screening for campus alcohol prevention efforts. Participan...

Background In China, there are approximately 70 million children, nearly 25% of the child population, who are left behind in the care of other family members when their parents migrate to urban areas, for increased economic opportunities. This paper presents a systematic review and a meta-analysis of studies that have examined the phenomenon of depression among these left-behind children (LBC). Methods Six hundred three papers published between 2000 and 2017 were retrieved from five databases (China National Knowledge Infrastructure, Wanfang, Weipu, PubMed, and Web of Science). Results Twenty-one studies (18 in Chinese and 3 in English) met the criteria for inclusion in this meta-analysis. The pooled estimate of depression among LBC was 26.4%. A significant heterogeneity has been found in reported findings, and this heterogeneity was associated with three types of study characteristics, including using an unclear definition of LBC and using invalidated depression instruments, and the geographic location. Conclusions The risk of mental health problems among this large number of LBC suggests the need to quantify the extent and distribution of their mental health state. Implications for methodological improvements for future research have been discussed.

China’s National Physical Fitness and Health Surveillance(NPFHS)survey revealed high levels of sedentary behavior among primary school-aged children. Sedentary behavior is linked to both short-term and long-term physical and mental health conditions. A comprehensive school health education program was designed and its effectiveness to raise physical activity levels in Grade 4 primary school children was evaluated. Twelve schools(6 of program, 6 of control)from six cities in two economically different provinces were selected. Students at program schools received physical activity instruction both in and out of school. Control schools carried on with their usual level of physical activity for students, as required by national educational standards. Program effectiveness was assessed by comparing students’ physical activity behaviors at pre- and post-program, and by comparing students’ physical activity scores at program schools with students’ scores at control schools. The pre-program survey of students’ behaviors was done at the end of Grade 3, and the post-program survey was done at the end of Grade 4. Multi-level modeling was used to evaluate program effectiveness to allow for missing data. Results from 4472 students showed at pre-program there was no difference in control and program schools’ student physical activity scores. At post-program students in program schools did significantly more physical activity compared to students in control schools. Students in program schools were more physically active after the comprehensive school health education program. A school-based comprehensive health education program would effectively increase children’s physical activity level in China. There is a potential to reduce sedentary behavior among children by implementing school programs that are environmental in nature; that is, activities involve not only the students, but also the school administration, teachers, parents, and community members.

ObjectiveAs part of a national initiative to reduce child obesity, a comprehensive school-based nutrition education intervention to change eating behaviours among grade 4 primary-school students was developed, implemented and evaluated.DesignThe intervention was developed by school staff, with technical assistance from outside health education specialists. The programme included school facility upgrades, school teacher/staff training, curriculum changes and activities for parents. Student scores on nine key eating behaviours were assessed prior to and after the programme. The quality of programme implementation in the schools was monitored by technical assistance teams.SettingShandong Province (high household income) and Qinghai Province (low household income), China. Three programme schools and three control schools in each province.ParticipantsStudents in grade 4 (age 8–9 years).ResultsThere were significant positive changes in self-reported eating behaviour scores from pre- to post-assessment in programme schools. At post-test students in programme schools had significantly higher scores than students in control schools after controlling for other variables. The programme was more effective in the high-income province. Observations by the technical assistance teams suggested the programme was implemented more completely in Shandong. The teams noted the challenges for implementing and evaluating programmes like these.ConclusionsThis intervention increased healthy eating behaviours among 4th graders in both provinces and had more effect in the more affluent province. Results suggest that a scaled-up initiative using existing school and public health resources could change eating practices in a large population over time. The intervention also provided lessons for implementing and evaluating similar nutrition programmes.

This study explored bystanders’ willingness to help a friend who flushes when drinking to reduce his/her drinking. Alcohol-related facial flushing is an indicator of an inherited variant enzyme, aldehyde dehydrogenase (ALDH), that impairs alcohol metabolism and increases drinkers’ lifetime risk of certain aerodigestive cancers. Individuals who flush should reduce their alcohol exposure, but they may continue to drink if social pressures and rules of etiquette make not drinking socially risky. The analysis used data from 2912 undergraduate students from 13 universities in southwestern, central and northeastern China from a survey asking how they respond to someone’s flushing in various scenarios. Latent class analysis grouped students by similar responses to flushing. A multinomial logistic regression explored how class membership was associated with knowledge, drinking status, and reactions to one’s own flushing. Five classes were derived from the latent class analysis, ranging from always intervene to mostly hesitate to help; in between were classes of students who were willing to help in some scenarios and hesitant in other scenarios. Only 11.6% students knew the connection between facial flushing and impaired alcohol metabolism, and knowledgeable students were somewhat more likely to assist when they saw someone flushing. In the absence of knowledge, other factors—such as drinking status, the gender of the bystander, the gender of the person who flushed, and degree of friendship with the person who flushed—determined how willing a person was to help someone reduce or stop drinking. Class membership was predicted by knowledge, gender, drinking status, and reactions to one’s own flushing. Of these 4 factors, knowledge and reactions to one’s own flushing could be influenced through alcohol education programs. It will take some time for alcohol education to catch up to and change social and cultural patterns of drinking. Meanwhile, motivational strategies should be developed to increase the willingness of bystanders to assist friends and to create a social expectation that flushers should stop or reduce their drinking.

About 70% of the beverage alcohol consumed in China annually is spirits. Recorded spirits make up most spirit consumption, but about 25% of total alcohol consumption (1.7 L pure alcohol per capita annually) is unrecorded spirits (bai jiu), either homemade or made in unregulated distilleries. In some parts of China, the consumption of unrecorded spirits is higher than average. This paper compares the patterns of use of unrecorded distilled spirits and recorded distilled spirits among rural residents in Central China. Interviews were conducted with 3298 individuals in 21 towns/villages in 10 counties in the Hubei, Anhui, and Hebei provinces in the People’s Republic of China. Unrecorded bai jiu drinkers chose it because of its taste and its low price. It was consumed mostly by older men, mostly at home with family, more regularly and at higher alcohol by volume (ABV) compared to recorded alcohol. Recorded bai jiu drinkers were more likely to drink away from their homes, consumed more bai jiu at memorable drinking occasions, and reported feeling sick after drinking more often than unrecorded bai jiu drinkers. This comparison of patterns of use of unrecorded bai jiu and recorded bai jiu does not suggest that unrecorded bai jiu is more problematic for drinkers.

This paper presents a descriptive analysis of data gathered by personal interviews from a multistage random sample of 1640 residents aged 18&ndash, 34 years in Wuhan, China. First, alcohol drinkers and abstainers were compared based on demographic, attitude, and belief variables. Next, the drinkers from the sample were classified into four groups based on frequency-quantity of alcohol use, and the frequency-quantity groups were compared on the same variables. For Abstainers versus Drinkers, we found no difference by age or gender in this sample. Married people and people with children were more likely to be abstainers. University-educated, currently-employed individuals in mid-level jobs were more likely to abstain from alcohol. Vocational/Technical graduates, people who were currently attending college, currently unemployed and never-employed individuals were more likely to be drinkers. Abstainers also responded with less-positive attitudes and beliefs about drinking and attached more importance to reasons for not drinking compared to drinkers. When the drinking frequency-quantity groups were compared, gender differences became significant: more high-quantity drinkers were women, however the guideline for quantity for women was &gt, 1 drink at a time compared to &gt, 2 drinks at a time for men. Quantity and frequency of drinking was significantly associated with having children, educational level, employment status, and type of occupation. Age, marital status, and being in college did not relate significantly with quantity and frequency of drinking alcohol. Attitudes and beliefs about drinking tended to be more positive among high-frequency and high-quantity drinkers. Drinkers in all frequency-quantity groups attached greater importance to social reasons for drinking compared to personal/psychological reasons for drinking. Drinkers in the lowest frequency-quantity group attached the most importance to reasons for not drinking. These findings confirmed that in China drinking plays an important role in socializing and celebrating, and that there are important differences between alcohol drinkers and abstainers and between frequency/quantity groups of drinkers. Western models of individualized motivation of behaviors may not accurately explain alcohol use in China. We believe the findings from this study suggest the need for more detailed studies of alcohol drinking and abstaining.