Cervical cancer screening in the US-Mexico border region: a binational analysis.

Cervical cancer mortality is high along the US-Mexico border. We describe the prevalence of a recent Papanicolaou screening test (Pap) among US and Mexican border women. We analyzed 2006 cross-sectional data from Mexico's National Survey of Health and Nutrition and the US Behavioral Risk Factor Surveillance System. Women aged 20-77 years in 44 US border counties (n = 1,724) and 80 Mexican border municipios (n = 1,454) were studied. We computed weighted proportions for a Pap within the past year by age, education, employment, marital status, health insurance, health status, risk behaviors, and ethnicity and adjusted prevalence ratios (APR) for the US, Mexico, and the region overall. Sixty-five percent (95 %CI 60.3-68.6) of US women and 32 % (95 %CI 28.7-35.2) of Mexican women had a recent Pap. US residence (APR = 2.01, 95 %CI 1.74-2.33), marriage (APR = 1.31, 95 %CI 1.17-1.47) and insurance (APR = 1.38, 95 %CI 1.22-1.56) were positively associated with a Pap test. Among US women, insurance and marriage were associated (APR = 1.21, 95 %CI 1.05-1.38 and 1.33, 95 %CI 1.10-1.61, respectively), and women aged 20-34 years were about 25 % more likely to have received a test than older women. Insurance and marriage were also positively associated with Pap testing among Mexican women (APR = 1.39, 95 %CI 1.17-1.64 and 1.50; 95 %CI 1.23-1.82, respectively), as were lower levels of education (≤8th grade or 9th-12th grade versus some college) (APR = 1.74; 95 %CI 1.21-2.52 and 1.60; 95 %CI 1.03-2.49, respectively). Marriage and insurance were associated with a recent Pap test on both sides of the border. Binational insurance coverage increases and/or cost reductions might bolster testing among unmarried and uninsured women, leading to earlier cervical cancer diagnosis and potentially lower mortality.

Association between depressed mood and perceived weight in middle and high school age students: Texas 2004-2005.

Research exploring the relationship between weight perception and depressed mood among adolescents is limited in the United States. The purpose of this study is to examine the association of perceived versus actual body weight and depressed mood in a representative sample of 8th and 11th grade public school students in Texas. Using data from the 2004-2005 School Physical Activity and Nutrition (SPAN) study, logistic regression analyses were conducted to assess the association of weight perception with depressed mood. Healthy weight students who perceived themselves to be a healthy weight were the reference group for all analyses. A high prevalence of misperception of body weight was observed. Overweight and obese 8th grade girls and boys who perceived themselves to be overweight had increased odds of depressed mood [Girls: OR 1.70 (95% CI: 1.07-2.69), Boys: OR 2.05 (95% CI: 1.16-3.62)]. Healthy weight 8th grade girls who perceived themselves to be overweight had 2.5 times greater odds of depressed mood (OR 2.63, 95% CI: 1.54-4.50). Healthy weight boys who perceived themselves to be underweight had more than twice the odds (OR 2.18, 95% CI: 1.23-3.89) of depressed mood. No weight category was significantly associated with depressed mood in boys or girls in 11th grade. The present study suggests that weight misperceptions are associated with depressed mood in young adolescents. Education about healthy body size is necessary to correct the common weight misperceptions observed. The high prevalence rates of depressed mood suggest a greater need for research into understanding factors that may contribute to depressed mood in adolescents.

Patterns of health care utilization among vulnerable populations in Central Texas using data from a regional health information exchange.

PURPOSE: Describe patterns of health care utilization among vulnerable subgroups of an underserved population and identify populations that could benefit from interventions to reduce health care costs and improve quality of care. METHODS: Health Information Exchange data focused on underserved patients was used to estimate the risk of an emergency department (ED) or inpatient (IP) visit among vulnerable patients. RESULTS: Approximately 20.9% of the population was vulnerable, with behavioral health being the most predominant. Homeless, disabled, and severe behavioral health patients had an increased risk of ED utilization. Behavioral health, disabled, and near elderly patients had an increased risk of IP utilization. Inpatient risk was even greater for patients with multiple vulnerabilities. CONCLUSIONS: Improved primary care services are needed to address both the mental and physical needs of vulnerable populations, particularly people with severe behavioral health conditions. Improved access to services may help reduce the costly burden of providing hospital-based care.

Epidemiologic risk factors of hepatocellular carcinoma in a rural region of Egypt.

BACKGROUND: Hepatocellular carcinoma (HCC) is a major health problem worldwide, including Egypt. In the recent past, HCC has become the second most prevalent cancer among men in Egypt. Since HCC has not been well studied in the rural population of Egypt, this case-control study was conducted to investigate the epidemiologic risk factors of HCC in the predominantly rural region of Gharbiah, Egypt. METHODS: A total of 150 cases and 150 controls matched to cases on age (±5 years) and sex were recruited from the Gharbiah Cancer Society and Tanta Cancer Center. Exposure data were collected by an interviewer-administered standardized questionnaire about epidemiologic, occupational, medical and family history of HCC. Conditional logistic regression was utilized to calculate unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CI). The effect modification of HCC risk between viral infection and environmental risk factors was also assessed. RESULTS: Being an industrial worker was an independent risk for developing HCC (OR 3.54, 95% CI 1.18, 10.63) after adjusting for viral infection, schistosomiasis and tobacco smoking. High relative risk of HCC was observed among HCV-infected individuals who were farmers (OR 9.60, 95% CI 3.72, 24.76), industrial workers (OR 12.90, 95% CI 4.33, 38.43) or active smokers (OR 5.95, 95% CI 2.20, 16.08). CONCLUSION: Occupational exposure may play an important role in the development of HCC. Farming, industrial exposures and cigarette smoking may increase the risk of HCC among HCV-seropositive individuals. Future research focusing on mechanisms of occupational exposures among HCV patients in this population is needed.