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What is already known about this subject Associations between concentrations of uric acid and cardiovascular risk factors are known., The associations between gamma-glutamyltransferase ( GGT) levels and cardiovascular disease are also known., But no study has ever investigated the combined effects of both GGT and uric acid in cardiovascular risk factors in adolescents., What this study adds Our study is the first to date reporting a significant combined effect of uric acid and GGT in association with cardiovascular risk factors in the youth populations., The results of our study add to our knowledge regarding the relationship between uric acid, GGT and cardiovascular risk factors., Based on our results, measurements of these biochemical markers should be considered in the cardiovascular risk stratification in children and adolescents., The results of our study also raise the alertness of clinicians in identifying at-risk young individuals for primary prevention of cardiovascular diseases., Background The combined effect of uric acid, gamma-glutamyltransferase ( GGT) and cardiovascular risk factors clustering in the youth remains under-explored. Objective The objective of this study was to examine the association between uric acid, GGT, obesity and the individual components of metabolic syndrome in children and adolescents. Methods We performed a cross-sectional observational study of 2067 children and adolescents (875 boys and 1192 girls) aged 6-20 years who were healthy volunteers and were recruited from primary and secondary schools in Hong Kong between 2007 and 2008. Subjects were divided into two strata (75th percentile as cut-off) for comparison between odds of cardiovascular risk factors. Results After adjustment by multivariable logistic regression, subjects in upper stratum, i.e. >75th percentile, of either serum uric acid or GGT levels were associated with obesity, low high-density lipoprotein cholesterol ( HDL- C) level and high blood pressure (adjusted odds ratios [ AOR] ranged from 1.63 to 5.82, all P < 0.005) compared with those in the lower stratum. There were combined effect for upper stratum of both uric acid and GGT in the association with obesity, low HDL- C and high blood pressure ( AOR ranged from 2.60 to 10.69, all P < 0.05) after adjustment for age, sex and body mass index z-score (except for obesity status) as well as body height (for high blood pressure). Conclusion Uric acid and GGT have combined effect in association with obesity and other cardiovascular risk factors in children and adolescents. [ABSTRACT FROM AUTHOR]

Summary Objectives The objectives of this study were twofold - (i) to assess the agreement between self-reported waist circumference ( SRWC) and assessor measured waist circumference ( MWC) and (ii) to evaluate the diagnostic ability of SRWC for classifying (i) a clustering of cardiometabolic risk factors ( CMRFs) and (ii) overweight/obese status in Hong Kong Chinese children aged 6-18 years. Methods A cross-sectional study with cluster random sampling was conducted. A self-administrated questionnaire, which included demographic data, body weight, body height and waist circumference, was given to children to bring home for completion. Children were asked to return the questionnaire and fast themselves for at least 8 h on the day of the survey. Anthropometric measurements and blood pressure were taken by trained research staff and fasting blood samples were collected for measurements of fasting plasma glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol. Results A total of 515 boys and 711 girls were included in the data analysis. Agreement between SRWC and MWC was assessed by intra-class correlation coefficient and it ranged from 0.77 to 0.87. The ability of sex-specific SRWC values to classify children with a clustering of CMRFs and overweight/obesity exhibited moderately high to high sensitivity and specificity, and the area under the receiver operating characteristics ranged from acceptable to excellent (from 0.76 to 0.84). Conclusions SRWC has good agreement with MWC and could be used as a screening tool to classify children with a clustering of CMRFs and overweight/obesity status in Hong Kong Chinese children. [ABSTRACT FROM AUTHOR]

The aim of this study was to determine the association between blood pressure and the frequency of structured physical training activity in Chinese adolescents. A total of 9558 students aged 11-18 years underwent anthropometric and blood pressure measurements in a cross-sectional growth study. Structured physical training activity was assessed by two simple self-administered questions and parents were asked to complete a questionnaire providing demographic information. Ninety per cent of eligible students participated in the study, of which 94% provided data on physical training frequency for final analysis. Of the boys, 22.6% and of the girls, 14.5% were physically active with extracurricular school exercise at least twice a week. Over half of the students did not regularly exercise except during physical education classes at school. Blood pressure had a positive correlation with body mass index (BMI). Both systolic blood pressure and diastolic blood pressure were substantially decreased with increased training frequency (P<0.05). Logistic regression adjusting for age, family history of hypertension, BMI and sleep duration showed that exercising two or more times a week had a negative relation with hypertension (odds ratio: 0.63, 95%CI 0.47-0.85). In conclusion, structured physical training activity of two or more times a week has a beneficial effect on blood pressure in Hong Kong children aged 11-18 years. [ABSTRACT FROM AUTHOR]

Objectives: To investigate changes in HIV-related behaviours among female sex workers (FSW) and associations with services coverage rates. Methods: Behavioural surveillance data from Sichuan, China, were analysed. A mapping exercise was conducted; FSW were recruited from randomly selected sex-work establishments in 19 sites in Sichuan, China, from 2003 (n = 7068), 2004 (n = 6875) and 2005 (n = 6833). Results: Site variations were substantial. The random effect pooled AOR comparing the prevalence of condom use with regular sex partners, possession of condoms, HIV-related knowledge, HIV antibody testing and services coverage rates in 2005 versus 2003 ranged from 1.42 to 20.35. The 95% CI of these pooled AOR all excluded 1.0; hence rejecting the null hypothesis that such OR were not different from 1.0. Most of the AOR of these evaluative parameters (indicator of improvement) for the 19 individual sites in 2004 and 2005 (vs 2003) were significantly associated with coverage rates (Spearmen correlation coefficients = 0.35 to 0.67, p<0.05). Conclusions: Improvements were observed in relevant behaviours and coverage rates and the two were associated with each other. [ABSTRACT FROM AUTHOR]

Background:Body mass index (BMI) and waist circumference (WC) correlate with cardiovascular (CV) risk factors in childhood which track into adulthood. WC provides a measure of central obesity, which has been specifically associated with CV risk factors. Reference standards for WC, and for WC and BMI risk threshold values are not established in Chinese children.Objectives:To construct reference percentile charts of WC, establish relationships between WC, BMI and other risk factors, and propose WC and BMI threshold values predictive of CV risk factors in Hong Kong ethnic Chinese children.Methods:Weight, height, waist and hip circumference were measured in 2593 (52% boys, 47% girls) randomly sampled Hong Kong school children aged 6–12 years. In 958 of these and 97 additional overweight children (n=1055), the relationships between WC, BMI, waist/hip and waist/height ratio and six age-adjusted CV risk factors (>85% percentile levels of blood pressure (BP), fasting triglycerides, low-density lipoprotein (LDL) cholesterol, glucose and insulin levels, and <15% percentile levels of high-density lipoprotein (HDL) cholesterol) were studied. Receiver-operating characteristic analysis was employed to derive optimal age-adjusted sex-specific WC and BMI thresholds for predicting these measures of risk.Results:WC percentiles were constructed. WC correlated slightly more than BMI with CV risk factors and most strongly with insulin and systolic BP, but poorly or not with LDL and glucose. Optimal WC and BMI risk thresholds for predicting four of these six CV risk factors were ca. the 85th percentiles (sensitivities ∼0.8, specificities ∼0.87) with age-specific cutoff values in girls/boys from ∼57/58 to ∼71/76 cm and 17/18 to 22/23 kg/m2.Conclusion:These are the first set of WC reference data for Chinese children. WC risk cutoff values are proposed which, despite a smaller waist in Chinese children, are similar to those reported for American children. WC percentiles may reflect population risk.International Journal of Obesity (2007) 31, 550–558. doi:10.1038/sj.ijo.0803452; published online 5 September 2006 [ABSTRACT FROM AUTHOR]

The article discusses a population based cross sectional survey which investigated the acceptability of A/H1N1 vaccination during pandemic phase of influenza A/H1N1 in Hong Kong, China. The Research Fund for the Control of Infectious Diseases, Food and Health Bureau of Hong Kong supported the study. The survey involved a random sample of 301 Chinese adults who are living in Hong Kong, who were interviewed by telephone. Forty-five percent of the participants believed that they would take up free vaccination against A/H1N1 influenza.

Purpose: This study aimed to translate and evaluate the factor structure of the Chinese version of the Brief Coping Orientation to Problems Experienced Inventory (Brief-COPE-C) among the caregivers of children with chronic illnesses., Design and Methods: In this cross-sectional study, we recruited 217 caregivers, aged 18 years and older and cared for children with chronic illnesses. All participants were recruited from two local hospitals in Hong Kong using convenience sampling. We excluded caregivers diagnosed with major psychiatric diseases, such as major depression or schizophrenia., Results: The Brief-COPE-C had good validity and three factors were identified: active coping, distraction, and dysfunctional coping. The content validity index was 0.97, and the item content validity index ranged from 0.83-1 for all 28 items. The Brief-COPE-C had adequate internal consistency. The Cronbach's alpha for the overall scale was 0.89, while the Intraclass Correlation Coefficient (ICC) was 0.876., Conclusions: The Brief-COPE-C is a valid, reliable, and culturally appropriate tool for measuring coping in caregivers of children with chronic illnesses., Practice Implications: Use of the Brief-COPE-C to assess coping responses of caregivers can facilitate clinicians' and researchers' understanding of how these individuals cope. Hence, appropriate interventions can be implemented to improve caregivers' physical and psychological outcomes., Competing Interests: Declaration of Competing Interest None., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Background: Waist-to-height ratio (WHtR), with a 0.5 threshold (WHtR0.5), is regarded as a simple age- and gender-independent criterion of abdominal obesity (AO) and a better predictor than the 90th percentile of waist circumference (WCP90)., Objective: An analysis of gender and ethnic differences of WHtR and other AO indices between children and adolescents from southern China (HK: Hong-Kong, China) and Europe (LD: Łódź, Poland)., Subjects: Two large cross-sectional surveys of children and adolescents aged 7-19 years, one from LD (13 172) and one from HK (14 566)., Methods: The percentile and standardized values of WHtR and other parameters (WC, body mass index (BMI)) were assessed using the LMS method. The WHtR values corresponding to WCP90 and to the BMI definition of global obesity (BMIP95) were evaluated with the polynomial regression model. The compliance of the AO prevalence data, obtained with two criteria (WCP90 vs WHtR0.5) was analyzed using Cohen's kappa index (κC)., Results: The WHtR data of Polish subjects were generally higher than those of their HK peers, and the ethic differences increased with age. The WHtR values of HK boys showed a stronger relationship with BMI z-score. WHtR corresponding to WCP90 assumed values <0.5. An application of Cohen's kappa coefficient (κC) to Polish subjects showed either 'substantial' (κC>0.6) or 'almost perfect' (κC>0.8) agreement in the AO prevalence for both criteria (WCP90 and WHtR0.5). For these criteria, either 'fair' (κC <0.4) or 'moderate' (κC<0.6) AO consistency ratings were observed among HK girls. In HK boys, a significant difference in the prevalence of AO was observed, independent of the criterion used., Conclusions: Our results provide further evidence of the need for developing ethnic-specific WC charts and for recommending that a WHtR cutoff of 0.5 may not be appropriate to predict cardiometabolic risk in children of different ethnic groups.

Background: The Brief COPE instrument has been utilized to conduct research on various populations, including people living with HIV (PLWH). However, the questionnaire constructs when applied to PLWH have not been subjected to thorough factor validation., Methods: A total of 258 PLWH were recruited from two provinces of China. They answered questions involving the scales of three instruments: the Brief COPE, the Perceived Social Support Scale, and the Perceived Discrimination Scale for PLWH. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were conducted., Results: The CFA found a poor goodness of fit to the data. The subsequent EFA identified six preliminary factors, forming subscales with Cronbach's alphas, which ranged from 0.61 to 0.80. Significant correlation coefficients between the subscales and measures of perceived social support and perceived discrimination were reported, giving preliminary support to the validity of the new empirical factor structure., Conclusion: This study showed that the original factor structure of the Brief COPE instrument, when applied to PLWH in China, did not fit the data. Thus, the Brief COPE should be applied to various populations and cultures with caution. The new factor structure established by the EFA is only preliminary and requires further validation.

Background: Although advanced cancer treatments prolong survivors' lives, a significant proportion experienced poorer health-related quality of life (HRQoL) than general populations. Identifying their needs is essential to develop a health service delivery model to improve patient outcomes., Objective: The objective of this study was to examine the perceived unmet needs and HRQoL of Chinese cancer survivors who completed treatment less than 1 year ago., Methods: Three hundred seventy-six participants completed a self-report survey: the 34-item Supportive Care Needs Survey, the supplementary module of access to healthcare and ancillary support services, and the Functional Assessment of Cancer Therapy: General. Descriptive statistics were used to examine the prevalence of unmet needs. Multivariable logistic regressions were conducted to identify participants' characteristics that were associated with unmet needs. Multiple linear regression was used to delineate which domains of unmet needs were significantly associated with HRQoL with adjustment for potential confounding factors., Results: Healthcare information was the most common unmet needs among the survivors. Age, stage of cancer, and remission were significantly associated with 1 or more unmet need domains. Participants with unmet needs in physical, psychological, and patient care domains, on average, have poorer HRQoL., Conclusions: Chinese cancer survivors have various unmet needs that might have adverse effects on their HRQoL. Younger age, more advanced stages of cancer, and remission were factors contributing to further unmet needs., Implications for Practice: The results provided useful information on the special needs of survivors that may affect their HRQoL, enabling clinicians to plan better how to allocate existing limited resources to those who most require them.

Purpose of the Research: This paper adopted Protection Motivation Theory (PMT) to examine Chinese women's knowledge and perceptions of cervical cancer risk and factors influencing their motivation to receive future screening., Methods and Sample: A cross-sectional survey was conducted with 167 Chinese women (142 women were willing to receive a screening in the future and 25 women were not) in 2007 to collect women's socio-demographic information and sexual history, perceptions related to body health and knowledge about cervical cancer and screening, and Protection Motivation Theory measures., Key Results: The majority of women stated they intended to receive future screening and response efficacy was significantly associated with their intention. However, no significant association was observed between sexual history and protection motivation. Using multivariate analysis, cancer in relatives (odds ratio, OR = 9.97, 95% CI [1.44-436.3], p = 0.010), a perception that visiting a doctor regularly is important to health (OR = 9.85, 95% CI [1.61-999.9], p = 0.009)), and ever attending for cervical screening during the previous three years (OR = 3.49, 95% CI [1.23-11.02], p = 0.016) were significantly associated with women' motivation to receive future screening., Conclusion: The findings of this study highlight the important role of women's beliefs in the value of cervical screening and previous screening experience in motivating them to receive a screening. Education intervention is needed to provide information and raise public awareness about the importance of cervical screening to women's health. Culture-related beliefs and social motivational processes in addition to those specified by PMT need to be addressed., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

Perceived stress among people living with HIV/AIDS (PLWH) was associated with severe mental health problems and risk behaviors. Discrimination toward PLWH in China is prevalent. Both perceived discrimination and social supports are determinants of the stress level among PLWH. Psychological support services for PLWH in China are scarce. It is unknown whether social support is a buffer between the perceived discrimination and perceived stress. With written consent, this study surveyed 258 PLWH recruited from multiple sources in two cities in China. Instruments were validated in previous or the present study, including the perceived stress scale for PLWH (PSSHIV), the perceived social support scale (PSSS), and the perceived discrimination scale for PLWH (PDSHIV). Pearson correlations and multiple regression models were fit. PDSHIV was associated with the Overall Scale and all subscales of PSSHIV, whilst lower socioeconomic status in general and lower scores of PSSS were associated with various subscales of PSSHIV. The interaction item (PSSS×PSDHIV) was nonsignificant in modeling PSSHIV, hence no significant moderating effect was detected. Whilst perceived discrimination is a major source of stress and social support can reduce stress among PLWH in China, improved social support cannot buffer the stressful consequences due to perceived discrimination. The results highlight the importance to reduce discrimination toward PLWH and the difficulty to alleviate its negative consequences. It is warranted to improve mental health among PLWH in China and it is still important to foster social support among PLWH as it has direct effects on perceived stress.