ObjeCtive To systematically evaluate the effects of physical activity in adult patients after completion of main treatment related to cancer. Design Meta-analysis of randomised controlled trials with data extraction and quality assessment performed independently by two researchers. Data sOurCes PubmeD, CINAHL, and Google Scholar from the earliest possible year to September 2011. References from meta-analyses and reviews. stuDy selection Randomised controlled trials that assessed the effects of physical activity in adults who had completed their main cancer treatment, except hormonal treatment. results There were 34 randomised controlled trials, of which 22 (65%) focused on patients with breast cancer, and 48 outcomes in our meta-analysis. Twenty two studies assessed aerobic exercise, and four also included resistance or strength training. The median duration of physical activity was 13 weeks (range 3-60 weeks). Most control groups were considered sedentary or were assigned no exercise. Based on studies on patients with breast cancer, physical activity was associated with improvements in insulin-like growth factor-I, bench press, leg press, fatigue, depression, and quality of life. When we combined studies on different types of cancer, we found significant improvements in body mass index (BMI), body weight, peak oxygen consumption, peak power output, distance walked in six minutes, right handgrip strength, and quality of life. Sources of study heterogeneity included age, study quality, study size, and type and duration of physical activity. Publication bias did not alter our conclusions. COnClusiOns Physical activity has positive effects on physiology, body composition, physical functions, psychological outcomes, and quality of life in patients after treatment for breast cancer. When patients with cancer other than breast cancer were also included, physical activity was associated with reduced BMI and body weight, increased peak oxygen consumption and peak power output, and improved quality of life.

PurposeThe Hospital Anxiety and Depression Scale (HADS) is widely used in adult populations; however, its usefulness with adolescents has been explored less. This study sought to evaluate the reliability, validity, and factor structure of the Chinese version of HADS in a community sample of adolescents residing in Hong Kong.MethodsA prospective cohort of 5,857 students recruited from 17 secondary schools completed the HADS. Internal consistency and concurrent validity were examined. Confirmatory factor analysis was applied to test the relative fits of six factor structures of the HADS. The best fitting model was further cross-validated by male, female, split-half samples, and age subgroups.ResultsThe HADS possessed adequate internal consistency, especially for the anxiety subscale. Significant concurrent intercorrelations with self-reported suicidal thoughts and the Youth Self Report Anxious/Depressed subscale were discovered and found to be stronger for females. The cross-validation supported a two-factor model, where anxiety item 7, “I can sit at ease and feel relaxed”, was placed in the depression subscale.ConclusionsThe HADS showed satisfactory psychometric properties as a screening instrument in assessing anxious and depressive states as two correlated but distinct factors in adolescents. Study implications and recommendations for future research were discussed.

Purpose To assess the effects of dietary and physical activity (PA) interventions on generic and cancer-specific quality of life (QoL), anxiety, and depression levels among adult Chinese colorectal cancer (CRC) survivors. Methods Two-hundred twenty-three adult CRC survivors within 1 year of completion of primary cancer treatment were randomized to receive dietary, PA or combined intervention, or usual care for a 12 monthduration, under a 2 (diet vs usual care) × 2 (PA vs usual care) factorial design. Generic and cancer-specific QoL was assessed using a Chinese version 12-Item Short Form Health Survey (SF-12) and the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) scale, respectively. Anxiety and depression was assessed using the Hospital Anxiety and Depression Scale at baseline, 6, 12, 18, and 24 months. Linear mixed models were used for examining the intervention effects. Results Participants receiving dietary intervention experienced a significant improvement in the generic measure of QoL (SF-6D utility scores, mean difference 0.042, 95%CI 0.03 to 0.081) at 12 months, the cancer-specific QoL scores (mean difference 3.09, 95%CI 0.13 to 6.04), and levels of depression (P = 0.015) at both 12 and 24 months follow-up. Participants receiving PA intervention only demonstrated a significant improvement in SF-6D utility index (mean difference 0.039, 95%CI 0.002 to 0.077) and physical functioning (mean difference 2.85, 95%CI 1.00 to 4.70) at 6 months. Conclusions Dietary intervention improved the generic and cancer-specific QoL and depression in CRC survivors. Trial registration The study was prospectively registered on 17 October 2012 at ClinicalTrials.gov (NCT01708824). Implications for Cancer Survivors CRC survivors can benefit from dietary interventions in alleviating depression and improving overall health-related QoL.

Objective To study the rationales for food refusal among Chinese patients with typical and atypical anorexia nervosa. Method Forty‐eight consecutive patients with broadly defined anorexia nervosa underwent evaluation with a self‐report rationale for food refusal questionnaire, the 12‐item General Health Questionnaire (GHQ‐12), the 21‐item Beck Depression Inventory (BDI‐21), the Hamilton Depression Rating Scale (HDRS), and other clinical assessments. Results Fat‐phobic patients (N = 32) had a significantly higher premorbid body mass index than non–fat‐phobic patients (N = 16), but they did not differ on other clinical parameters, GHQ‐12, BDI‐21, and HDRS scores. At clinical presentation, 3 months, and 1 year prior to presentation, fat phobia and stomach bloating were the most common rationales for food refusal among fat‐phobic and non–fat‐phobic patients, respectively. A total of 31% of fat‐phobic patients endorsed non‐fat‐phobic rationales at the time of clinical presentation, whereas non–fat‐phobic patients adhered to non–fat‐phobic attributions more consistently. Discussion The rationales used by anorexic patients to explain noneating are more varied than implied in the 4th ed. of the Diagnostic and Statistical Manual of Mental Disorders and the ICD‐10 Classification of Mental and Behavior Disorders: Clinical Descriptions and Diagnostic Guidelines. A broadened conceptualization of anorexia nervosa may enhance an understanding of patients' illness experiences and enliven research on eating disorders. © 2001 by John Wiley & Sons, Inc. Int J Eat Disord 29: 224–229, 2001.