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Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women

  • Seo, Munseok;Langabeer, James
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.4
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    • pp.181-187
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    • 2018
  • Objectives: To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy. Methods: A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years. Results: Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders. Conclusions: We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.

Impact of Age on Clinicopathological Features and Survival of Patients with Noncardia Gastric Adenocarcinoma

  • Bautista, Marita C.;Jiang, Sheng-Fang;Armstrong, Mary Anne;Postlethwaite, Debbie;Li, Dan
    • Journal of Gastric Cancer
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    • v.14 no.4
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    • pp.238-245
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    • 2014
  • Purpose: Gastric cancer often occurs in the elderly but is uncommon in young individuals. Whether young patients have different clinical behaviors and outcomes from those of older patients remain unclear. Materials and Methods: We identified 1,366 cases of newly diagnosed noncardia gastric adenocarcinoma from the Kaiser Permanente Northern California Cancer Registry between 2000 and 2010. We then compared the clinicopathological features and survival among the different age groups. Results: The male : female ratio differed significantly between the younger and older patient groups (0.84 in age <50 years vs. 1.52>60 years, P<0.01). More younger patients were Hispanic (54% patients <40 years vs. 19% patients ${\geq}70$ years, P<0.0001), while more older patients were Caucasian (49% patients ${\geq}70$ years vs. 15% patients <40 years; P<0.0001). The diffuse/mixed histological type was more prevalent in younger patients (70% patients <40 years vs. 27% patients ${\geq}70$ years; P<0.0001), whereas the intestinal type was more frequent in older patients (71% in patients ${\geq}70$ years vs. 30% in patients <40 years; P<0.0001). Poorly differentiated adenocarcinoma was more common in the younger patients (80% in patients <40 years vs. 60% in patients ${\geq}70$ years; P=0.016). Survival rates at 1, 2, and 5 years gradually declined with increasing age (overall P=0.0002). Conclusions: Young patients with gastric cancer had more aggressive disease but higher overall survival rates than older patients. Younger Hispanic patients and older Caucasian patients were more likely to be diagnosed with gastric cancer. These differences may be due to biological predisposition and/or environmental exposure.

National Trends in Smoking Cessation Medication Prescriptions for Smokers With Chronic Obstructive Pulmonary Disease in the United States, 2007-2012

  • Kwak, Min Ji;Kim, Jongoh;Bhise, Viraj;Chung, Tong Han;Petitto, Gabriela Sanchez
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.5
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    • pp.257-262
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    • 2018
  • Objectives: Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein. Methods: We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions. Results: The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion. Conclusions: The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.

Blood Lead Concentration Correlates with All Cause, All Cancer and Lung Cancer Mortality in Adults: A Population Based Study

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3105-3108
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    • 2013
  • Background: This study used National Health and Nutrition Examination Survey III to study the relationship between blood lead concentration and all cause, all cancer and lung cancer mortality in adults. Patients and Methods: Public use National Health and Nutrition Examination Survey (NHANES III) data were used. NHANES III uses stratified, multistage probabilistic methods to sample nationally representative samples. Household adult, laboratory and mortality data were merged. Sample persons who were available to be examined in aMobile Examination Center (MEC) were included in this study. Specialized survey analysis software was used. Results: A total of 3,482 sample participants with complete information for all variables were included in this analysis. For all cause death, the odds ratios (S.E.) for statistically significant variables were body mass index, 1.03 (1.01-1.06); 1.01 (1.01-1.01); blood lead concentration, 1.05 (1.01-1.08); poverty income ratio, 0.823 (0.76-0.89); and drinking hard liquor, 1.01 (1.00-1.02). For all cancer mortality, the odds ratios (S.E.) of the statistically signigicant variables were: age, 1.01 (1.01-1.01); blood lead concentration, 1.07 (1.04-1.12), black race, using non-Hispanic white as reference, 1.69 (1.12-2.56); and smoking, 1.02 (1.01-1.04). For lung cancer mortality, the odds ratios (S.E.) of the statistically significant variables were: age, 1.01(1.01-1.01); blood lead concentration, 1.09 (1.05-1.13); Mexican Americans, using non-Hispanic white as refrence, 0.33 (0.129-0.850); other races, 1.80 (0.53-6.18); and smoking, 1.03 (1.02-1.05). Conclusion: Blood lead concentration correlated with all cause, all cancer, and lung cancer mortality in adults.

A Preliminary Study of Financial Management Assistance Use by the Elderly in the U.S.

  • Kim Eun-Jin;Geistfeld Loren V.
    • International Journal of Human Ecology
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    • v.6 no.1
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    • pp.1-16
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    • 2005
  • Due to increasing life expectancy, Americans live nearly 20 years after retirement. During this period, elderly persons have to stretch finances to manage the level of living without earnings. However, decision making ability decreases with age. One coping strategy for this problem would be seeking help from others. We examine factors affecting elderly persons' assistance use with respect to financial management using the 2000 Health and Retirement Study (N=3,823). It was found that age, education, health status, and ethnicity significantly affect elderly persons' financial management assistance use. The older-olds, those with lower educational attainment and poorer health status were more likely to use financial management assistance. However, Hispanic elderly were less likely to use financial management assistance.

Effect of IceWave® organic nanoscale patches on reduction of musculoskeletal pain

  • Piven, Emily;Dharia, Rupesh;Jones, Karen;Davis, Chuck;Nazeran, Homer
    • CELLMED
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    • v.3 no.1
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    • pp.5.1-5.5
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    • 2013
  • In this pilot dual-site study with LifeWave IceWave$^{(R)}$ patches, using subjects as their own controls, data were acquired from a convenience sample of 16 males and 24 females, 50% Caucasian-Americans, 50% Hispanic-Americans, ages 20 - 85 with neuromuscular pain. The hypothesis was: the application of IceWave$^{(R)}$ patches to the skin will reduce one's perception of pain. Subjects were tested at baseline (without any patches), and then at 1 and 3 h on day 1 and at 1 h on days 2 - 5 after patch application. At every time point, the mean change, indicative of one's perception of pain, was highly significantly (p < 0.0001) reduced, with a statistical power of 100% compared to baseline. Based on these findings, the hypothesis was accepted as true.

A Clinical Report On 25 Years-old Female Patient With Acne In U.S.A Through Chung-We Mix Extract Powder, Houttuyniae Herba Extract And Comedone Extractor

  • Yoon, Jaehong
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.17 no.3
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    • pp.287-295
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    • 2013
  • Objectives This study is report the effect of Asian Medical treatments for acne. Methods 25 years old mixed Hispanic female in California resident patient who was suffering from acne was treated with the Chung-We mix Extract powder, Houttuyniae Herba Extract and comedone extractor. She was taken a picture to compare with before and after treatments. Results Her acne was decreased and global acne grading system by 35 points to 7point improvement on the after treatments. Conclusion This case has the effectiveness with Herbs. According to Asian medicine, the caused of acne is internal problems and the acne is diagnosed as several kind of heats in the internal organ. Further clinical case of acne is needed for better results and to develop the ways of accurate diagnosis.

A Study on Expandability and Exclusiveness of American 'Whiteness of America' (미국의 '백인성'(whiteness)의 확장성 및 배타성 고찰)

  • Lee, Sooyoung
    • American Studies
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    • v.42 no.2
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    • pp.1-29
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    • 2019
  • The recent census project that non-Hispanic White will be minority in thirty years has been accepted by the conservative media and politicians as the factor that threatens the authentic American national identity. The concerns about the majority-minority population chance influenced the election of Donald Trump who explicitly claimed the restriction of immigration, promising strong controls over the entry of undocumented immigrants. In the process, 'white-nationalism' based on the connection of racial whites and authentic American identity has been central issues in American society. In this sense, this paper examines who has been included/excluded from 'racial Whites' throughout the American history relating to the American identity politics and how these processes have shown the covert strategies of the whites for maintaining their privileges.

A Longitudinal Study of the Relationship Between Health Behavior Risk Factors and Dependence in Activities of Daily Living (건강위험행태인자와 일상생활 의존성과의 관련성에 대한 추적자료 분석)

  • Jung, Sang-Hyuk;Ostbye, Truls;Park, Kyoung-Ok
    • Journal of Preventive Medicine and Public Health
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    • v.39 no.3
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    • pp.221-228
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    • 2006
  • Objectives: The purpose of this study was to shed further light on the effect of modifiable health behavior risk factors on dependence in activities of daily living, defined in a multidimensional fashion. Methods: The study participants were 10,278 middle aged Americans in a longitudinal health study, the Health and Retirement Survey (HRS). A multi-stage probability sampling design incorporating the effect of population sizes (Metropolitan and non-metropolitan), ethnicity (the non- Hispanic White, the Hispanic, and the Black), and age (age 51-61) was utilized. Basic Activities of Daily Living (ADL) were measured using five activities necessary for survival (impairment in dressing, eating, bathing, sleeping, and moving across indoor spaces). Explanatory variables were four health behavior risk factors included smoking, exercise, Body Mass Index (BMI), and alcohol consumption. Results: Most participants at baseline were ADL independent (1992). 97.8% of participants were independent in all ADL's at baseline and 78.2% were married. Approximately 27.5% were current smokers at baseline, and the subjects reported moderate or heavy exercise were 74.8%. All demographic characteristics and behavioral risk factors were significantly associated with the ADL status at Wave 4 except alcohol consumption. Risk behaviors such as current smoking, sedentary life style and high BMI at Wave 1 were associated with ADL status deterioration; however, moderate alcohol consumption tended to be more related to better ADL status than abstaining at Wave 4. ADL status at Wave 1 was the strongest factor and the next was exercise and smoking affecting ADL status at Wave 4. People who were in ADL dependent at Wave 1 were 15.17 times more likely to be ADL dependent at Wave 4 than people who were in ADL independent at Wave 1. Concerning smoking cigarettes, people who kept only light exercise or sedentary life style at Wave 1 were 1.70 times more likely to be died at Wave 4 than the people who did not smoke at Wave 1. Conclusions: All demographics and health behaviors at wave 1 had consistently similar OR trends for ADL status to each other except alcohol consumption. Smoking and exercise in health behaviors, and age and gender in demographics at Wave 1 were significant factors associated with ADL group separation at Wave 4.

Accuracy of Electronic Pedometers to Assess Body Fatness in Obese Children and Youth (비만 어린이와 청소년들의 체지방 평가를 위한 electronic pedometer 의 정확성 분석)

  • Kim, Do-Yeon
    • Journal of Life Science
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    • v.19 no.10
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    • pp.1368-1373
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    • 2009
  • The purpose of this study was to assess the influence of waist size on the reliability and validity of pedometers to count steps in children and youth. The participants for this study were 20 children and youth, composed of 14 Hispanic and 6 Caucasian children. Ten children and youth had waist circumferences greater than the $85^{th}$ percentile (Body Mass Index (BMI)=$28.91\pm3.07$), and 10 children and youth had waist circumferences smaller than the $50^{th}$ percentile (BMI=$18.05\pm1.55$). To examine pedometer reliability, each child completed 3 ascent and descent trials up a set of 15 stairs while wearing a Yamax SW-701 pedometer. The main effect of trials was not statistically significant for the stair ascent trials F (2, 36)=2.575 or for the descent trials F (2, 36)=0.235. The trial by group interaction was also not statistically significant. To examine the influence of waist circumference on the validity of the pedometer in counting walking steps at a self-selected walking pace, the children and youth in the two groups completed a 400-m course. The main effect on the groups was statistically significant, F (1, 18)=7.489. The main effect of counting techniques was not statistically significant, F (1, 18)=2.983 (hand-counted vs. pedometer counted). Overall, the trial and trial by group interaction comparisons for the 400-m walk were not statistically significant, suggesting that the pedometer was equally valid as a tool for assessing walking steps in high waist circumference (HWC) and low waist circumference (LWC) in children and youth.