Harm resulting from screening is likely to be high where prevalence of breast cancer is low: Letters to the editor

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Preventing avoidable death: the case of cervical cancer in Hong Kong

Cervical cancer remains an important cause of avoidable morbidity and mortality in Hong Kong. This paper briefly reviews the epidemiology of cervical cancer and explores the evidence on the effectiveness of screening. The essential components of a successful cervical cancer screening programme, based on international experience, are discussed. The present situation in Hong Kong is then examined and the options outlined for the way ahead.published_or_final_versio

Exercise and health--new imperatives for public health policy in Hong Kong

Physical inactivity is an important and largely avoidable cause of incapacity. Regular physical activity protects against several chronic diseases, including cardiovascular diseaseԸ?one of the major causes of death in Hong Kong. Significant benefits can be achieved by regular participation in moderate amounts of either recreational or general lifestyle physical activities. Even more is gained from increasing the frequency, duration, and vigour of exercise. In Hong Kong, 59% of all adults lead a fairly sedentary lifestyle and only one in three exercise at levels that are thought to offer significant health benefits. An even more disturbing fact is that Hong Kong probably has the most inactive primary level schoolchildren in the world. The prevalence of these risk behaviours should make schoolchildren a priority for any public health prevention programme.published_or_final_versio

Screening and mortality from cervical cancer. Study shows importance of centralised organisation in screening.

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Hubungan Persepsi Terhadap Kompensasi Dengan Motivasi Kerja Di PT Syncrum Logistics

Tolak ukur karyawan yang produktif adalah tumbuhnya motivasi kerja yang baik dari dalam diri karyawan. Sistem kompensasi yang dibuat diharapkan dapat dipersepsi baik oleh karyawan sehingga karyawan memiliki motivasi kerja yang baik. PT. Syncrum Logistics sebagai tempat penelitian merupakan perusahaan yang menuju kepada pengelolaan kerja yang terstandar. Tujuan utama pada penelitian ini adalah mengetahui hubungan persepsi terhadap kompensasi dengan motivasi kerja di PT Syncrum Logistics dengan hipotesis ada hubungan positif antara persepsi terhadap kompensasi dengan motivasi kerja di PT Syncrum Logistics. Subjek penelitian ini adalah supir yang bekerja di PT Syncrum Logistics sebanyak 76 orang. Teknik sampling menggunakan purposive sampling. Penelitian menggunakan skala persepsi terhadap kompensasi dan motivasi kerja dan hasil penelitian di uji korelasi dengan teknik product moment. Hasil penelitian yang didapatkan menunjukan adanya hubungan persepsi terhadap kompensasi yang siginifikan dengan motivasi kerja, dengan hasil analisis koefisien korelasi (r) sebesar 0,264 dengan signifikansi p= 0,021. Hal ini berarti persepsi supir di perusahaan mengenai kebijakan kompensasi yang telah dibuat dapat mempengaruhi motivasi kerja mereka. Kategorisasi supir mengenai persepsi terhadap kompensasi tergolong sedang RE = 50,68 (77,63%) sedangkan motivasi kerja supir tergolong tinggi RE= 33,2 (50%) dan sedang 42,11%. Persepsi terhadap kompensasi mempengaruhi motivasi kerja sebesar 7%

Diagnostic accuracy of screening tests for COPD : a systematic review and meta-analysis

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is widely underdiagnosed. A number of studies have evaluated the accuracy of screening tests for COPD, but their findings have not been formally summarised. We therefore sought to determine and compare the diagnostic accuracy of such screening tests in primary care. METHODS: Systematic review and meta-analysis of the diagnostic accuracy of screening tests for COPD confirmed by spirometry in primary care. We searched MEDLINE, EMBASE and other bibliographic databases from 1997 to 2013 for diagnostic accuracy studies that evaluated 1 or more index tests in primary care among individuals aged ≥35 years with no prior diagnosis of COPD. Bivariate meta-analysis of sensitivity and specificity was performed where appropriate. Methodological quality was assessed independently by 2 reviewers using the QUADAS-2 tool. RESULTS: 10 studies were included. 8 assessed screening questionnaires (the COPD Diagnostic Questionnaire (CDQ) was the most evaluated, n=4), 4 assessed handheld flow meters (eg, COPD-6) and 1 assessed their combination. Among ever smokers, the CDQ (score threshold ≥19.5; n=4) had a pooled sensitivity of 64.5% (95% CI 59.9% to 68.8%) and specificity of 65.2% (52.9% to 75.8%), and handheld flow meters (n=3) had a sensitivity of 79.9% (95% CI 74.2% to 84.7%) and specificity of 84.4% (68.9% to 93.0%). Inadequate blinding between index tests and spirometry was the main risk of bias. CONCLUSIONS: Handheld flow meters demonstrated higher test accuracy than the CDQ for COPD screening in primary care. The choice of alternative screening tests within whole screening programmes should now be fully evaluated. PROSPERO REGISTRATION NUMBER: CRD42012002074

How does age affect the relationship between weight and health utility during the middle years of childhood?

Purpose: The limited literature examining weight status and preference-based health-related quality of life (HRQL) in young children is equivocal. This study aims to examine how the association between weight status and preference-based HRQL changes as children develop between the ages of 6 and 10 years old. Methods: The Child Health Utility 9D (CHU-9D) was used to determine preference-based HRQL. Height and weight data were also collected and used to calculate z-BMI adjusted for age and gender. 1467 children were recruited from 54 schools across the West Midlands. Data were collected at four time points over 5 years. Impact of weight on dimensions of HRQL was assessed via the distribution of responses to CHU-9D dimensions by weight status. Multi-level regression analysis controlling for ethnicity, deprivation and other relevant co-variates was conducted to examine the relationship between weight and HRQL. Results: There was no evidence to suggest that the weight status impacted upon the distribution of responses to CHU-9D dimensions. Correspondingly, the multi-level regression analysis found no statistically significant differences in CHU-9D scores between underweight, healthy weight, overweight and obese children. Conclusions: The evidence surrounding the link between preference-based HRQL and weight status in children is limited. This study found no association between weight status and HRQL as measured by the CHU-9D in children between the ages of 5 and 10 years in the UK. Given this, it is recommended that future studies aiming to prevent obesity in children in their middle years do not rely solely on preference-based measures for economic evaluation, and instead focus on capturing clinical or wellbeing outcomes