Self-Screening for Cervical Cancer Offered through a Digital Platform in a Region of British Columbia with Lower Screening Rates.

Cervical cancer is highly preventable through vaccination, early detection, and treatment, yet is the fourth most common cancer globally. HPV testing is superior to cytology for the detection of cervical pre-cancer, and jurisdictions around the world are implementing HPV primary screening, which offers the opportunity for self-screening, an important self-care intervention. Digital health solutions are also increasingly important components of self-care. In this study, we assessed the acceptability and completion of self-screening for cervical cancer offered through a digital platform within a low screening uptake region of British Columbia. The primary objective of this study was to evaluate the acceptability of self-screening for cervical cancer offered through a digital platform as measured by return rates of self-screening kits. Patients due or overdue for cervix screening were invited to participate. Eligible participants registered online to receive a self-screening kit, which included a device for vaginal self-screening, instructions, and a return envelope, sent to their home. After self-screening using the vaginal device, HPV testing was conducted. HPV-negative participants were returned to routine screening, and HPV-positive participants were recommended for cytology or colposcopy. Attendance rates at follow-up were evaluated. Participants were invited to complete an acceptability survey. From April 2019 to December 2023, 283 participants were sent kits, with 207 kits returned for a completion rate of 73%. Of valid samples (n = 202), 15 were HPV positive, and 93% attended follow-up care. Most respondents found the CervixCheck website easy to use, informative, and secure and were satisfied with receiving their results online. CervixCheck had a high completion rate among participants who were sent a self-screening kit. High compliance with recommended follow-up and high acceptability of self-screening for cervical cancer was observed. Most participants indicated they would self-screen again in the future. Innovative approaches to cervical screening, including self-screening and the use of digital health interventions, are ways to enhance equity and improve uptake of cervical screening.

Investigating the healthcare-seeking behaviors of mobile phone users to improve cervical cancer screening in rural Uganda.

OBJECTIVE: Cervical cancer is the leading cause of cancer in low- and middle-income countries, despite being preventable. Uganda, which lacks an effective screening program, has one of the highest global cervical cancer incidence rates. Mobile health (mHealth) technology has the potential to improve healthcare-seeking behaviors and access. The present study describes the connection between mobile phone access and healthcare-seeking behaviors in rural Uganda. METHODS: Women were eligible for this cross-sectional study if they had no prior screening or treatment for cervical cancer in the past 5 years, were aged 30 to 49 years old, and were residents of the South Busoga Forest reserve. Survey data was analyzed using descriptive statistics and chi-square tests. RESULTS: Of the 1434 participants included in the analysis, 91.4% reported having access to a mobile phone. Most respondents were aged 30-40 years, had a partner, had ≤primary education, and were farmers. Participants with mobile phone access were significantly more likely to report attending a healthcare outreach visit (access = 87.3%, no access = 72.6%, P < 0.001) or visiting a health center (access = 96.9%, no access = 93.5%, P < 0.001). Participants in both groups had largely positive attitudes around and good knowledge of cervical cancer screening. CONCLUSION: While attendance to healthcare services was high amongst participants, those with mobile phone access were more likely to seek healthcare services. Further inquiry into this association between mobile phone access and healthcare-seeking behavior is needed to optimize the improvements to cervical cancer screening when implementing interventions such as mHealth technology.

Mental Health Outcomes of Endometriosis Patients during the COVID-19 Pandemic: Impact of Pre-pandemic Central Nervous System Sensitization.

To correlate pain-related phenotyping for central nervous system sensitization in endometriosis-associated pain with mental health outcomes during the COVID-19 pandemic, the prospective Endometriosis and Pelvic Pain Interdisciplinary Cohort (ClinicalTrials.gov #NCT02911090) was linked to the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) dataset. The primary outcomes were depression (PHQ-9) and anxiety (GAD-7) scores during the pandemic. The explanatory variables of interest were the Central Sensitization Inventory (CSI) score (0-100) and endometriosis-associated chronic pain comorbidities/psychological variables before the pandemic. The explanatory and response variables were assessed for correlation, followed by multivariable regression analyses adjusting for PHQ-9 and GAD-7 scores pre-pandemic as well as age, body mass index, and parity. A higher CSI score and a greater number of chronic pain comorbidities before the pandemic were both positively correlated with PHQ-9 and GAD-7 scores during the pandemic. These associations remained significant in adjusted analyses. Increasing the CSI score by 10 was associated with an increase in pandemic PHQ-9 by .74 points (P < .0001) and GAD-7 by .73 points (P < .0001) on average. Each additional chronic pain comorbidity/psychological variable was associated with an increase in pandemic PHQ-9 by an average of .63 points (P = .0004) and GAD-7 by .53 points (P = .0002). Endometriosis patients with a history of central sensitization before the pandemic had worse mental health outcomes during the COVID-19 pandemic. As a risk factor for mental health symptoms in the face of major stressors, clinical proxies for central sensitization can be used to identify endometriosis patients who may need additional support. PERSPECTIVE: This article adds to the growing literature of the clinical importance of central sensitization in endometriosis patients, who had more symptoms of depression and anxiety during the COVID-19 pandemic. Clinical features of central sensitization may help clinicians identify endometriosis patients needing additional support when facing major stressors.

Correction: Synthesis and characterization of heterometallic rings templated through alkylammonium or imidazolium cations.

Correction for 'Synthesis and characterization of heterometallic rings templated through alkylammonium or imidazolium cations' by Rajeh Alotaibi et al., Dalton Trans., 2023, 52, 7473-7481, https://doi.org/10.1039/D3DT00982C.

Higher perceived stress during the COVID-19 pandemic increased menstrual dysregulation and menopause symptoms.

BACKGROUND: The increased stress the world experienced with the coronavirus disease (COVID-19) pandemic affected mental health, disproportionately affecting females. However, how perceived stress in the first year affected menstrual and menopausal symptoms has not yet been investigated. OBJECTIVES: This study evaluates the effect that the first year of the COVID-19 pandemic had on female reproductive and mental health. METHODS: Residents in British Columbia, Canada, were surveyed online as part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex. A subgroup of participants (n = 4171), who were assigned female sex at birth (age 25-69 years) and were surveyed within the first 6-12 months of the pandemic (August 2020-February 2021), prior to the widespread rollout of vaccines, was retrospectively asked if they noticed changes in their menstrual or menopausal symptoms, and completing validated measures of stress, depression and anxiety. DESIGN: This is a population-based online retrospective survey. RESULTS: We found that 27.8% reported menstrual cycle disturbances and 6.7% reported increased menopause symptoms. Those who scored higher on perceived stress, depression and anxiety scales were more likely to report reproductive cycle disturbances. Free-text responses revealed that reasons for disturbances were perceived to be related to the pandemic. CONCLUSION: The COVID-19 pandemic has highlighted the need to research female-specific health issues, such as menstruation. Our data indicate that in the first year of the pandemic, almost one-third of the menstruating population reported disturbances in their cycle, which was related to percieved stress, depression and anxiety scores.

Synthesis and characterization of heterometallic rings templated through alkylammonium or imidazolium cations.

We report the synthesis and structural characterization of a series of heterometallic rings templated via alkylammonium or imidazolium cations. The template and preference of each metal's coordination geometry can control the structure of heterometallic compounds, leading to octa-, nona-, deca-, dodeca-, and tetradeca-metallic rings. The compounds were characterized by single-crystal X-ray diffraction, elemental analysis, magnetometry, and EPR measurements. Magnetic measurements show that the exchange coupling between metal centres is antiferromagnetic. EPR spectroscopy shows that the spectra of {Cr7Zn} and {Cr9Zn} have S = 3/2 ground states, while the spectra of {Cr12Zn2} and {Cr8Zn} are consistent with S = 1 and 2 excited states. The EPR spectra of {(ImidH)-Cr6Zn2}, {(1-MeImH)-Cr8Zn2}, and {(1,2-diMeImH)-Cr8Zn2} include a combination of linkage isomers. The results on these related compounds allow us to examine the transferability of magnetic parameters between compounds.

Predicting grade school scientific literacy from aspects of the early home science environment.

Fostering scientific literacy has become an increasingly salient goal as evidence accumulates regarding the early emergence of foundational skills and knowledge in this domain, as well as their relation to long-term success and engagement. Despite the potential that the home context has for nurturing early scientific literacy, research specifying its role has been limited. In this longitudinal study, we examined associations between children's early science-related experiences at home and their subsequent scientific literacy. Following on our previous work, we specifically considered parent causal-explanatory talk, as well as the degree to which parents facilitate access to science-related materials and experiences. A group of 153 children from diverse backgrounds were evaluated across 5 annual waves of data collection from preschool entry (M age = 3.41) through first grade (M age = 7.92). Results demonstrate that parent invitations for children to explain causal phenomena had strong concurrent relations to scientific literacy but showed little relation to subsequent literacy. In contrast, the broader home science environment at preschool entry, particularly in the form of exposure to science-related activities, predicted scientific literacy over the next 4 years. The directionality and specificity of these relations were clarified through the inclusion of measures of cognitive and broader home experiences as controls in regression analyses. Overall, our investigation revealed that exposure to science-related input provided by parents has particularly powerful potential for shaping scientific literacy when children are very young. Implications for parent-focused interventions that promote science literacy are discussed.

The Role of Virtual Consulting in Developing Environmentally Sustainable Health Care: Systematic Literature Review.

BACKGROUND: Health systems globally need to rapidly set and achieve targets for reaching net zero carbon emissions. Virtual consulting (including video- and telephone-based consulting) is regarded as one means by which this might be achieved, largely through reduced patient travel. Little is currently known about the ways in which forms of virtual consulting might contribute to the net zero agenda or how countries may develop and implement programs at scale that can support increased environmental sustainability. OBJECTIVE: In this paper, we asked, What is the impact of virtual consulting on environmental sustainability in health care? and What can we learn from current evaluations that can inform future reductions in carbon emissions? METHODS: We conducted a systematic review of published literature according to PRISMA (Preferred Reporting Item for Systematic Reviews and Meta-Analyses) guidelines. We searched the MEDLINE, PubMed, and Scopus databases using key terms relating to "carbon footprint," "environmental impact," "telemedicine," and "remote consulting," using citation tracking to identify additional articles. The articles were screened, and full texts that met the inclusion criteria were obtained. Data on the approach to carbon footprinting reported reductions in emissions, and the opportunities and challenges associated with the environmental sustainability of virtual consultations were extracted into a spreadsheet, analyzed thematically, and theorized using the Planning and Evaluating Remote Consultation Services framework to consider the various interacting influences, including environmental sustainability, that shape the adoption of virtual consulting services. RESULTS: A total of 1672 papers were identified. After removing duplicates and screening for eligibility, 23 papers that focused on a range of virtual consulting equipment and platforms across different clinical conditions and services were included. The focus on the environmental sustainability potential of virtual consulting was unanimously reported through carbon savings achieved by a reduction in travel related to face-to-face appointments. The shortlisted papers used a range of methods and assumptions to determine carbon savings, reporting these using different units and across varied sample sizes. This limited the potential for comparison. Despite methodological inconsistencies, all papers concluded that virtual consulting significantly reduced carbon emissions. However, there was limited consideration of wider factors (eg, patient suitability, clinical indication, and organizational infrastructure) influencing the adoption, use, and spread of virtual consultations and the carbon footprint of the entire clinical pathway in which the virtual consultation was provided (eg, risk of missed diagnoses from virtual consultations that result in the need for subsequent in-person consultations or admissions). CONCLUSIONS: There is overwhelming evidence that virtual consulting can reduce health care carbon emissions, largely through reducing travel related to in-person appointments. However, the current evidence fails to look at system factors associated with implementing virtual health care delivery and wider research into carbon emissions across the entire clinical pathway.

Pharmaceutical Company Targets and Strategies to Address Climate Change: Content Analysis of Public Reports from 20 Pharmaceutical Companies.

The pharmaceutical industry produces a large proportion of health system greenhouse gas (GHG) emissions, contributing to climate change. This urgently needs to be addressed. We aimed to examine pharmaceutical company climate change targets, GHG emissions, and strategies to reduce them. We performed content analysis of the 20 largest pharmaceutical companies' publicly available 2020/2021 reports, focusing on extracting information on their reported climate change targets, GHG emissions (and whether companies had demonstrated any reduction in emissions over their reporting period), and strategies being implemented to reduce company emissions and meet their targets. Nineteen companies have committed to reducing GHG emissions, ten to carbon neutrality and eight to net zero emissions between 2025 and 2050. Companies showed largely favorable reductions in scope 1 (in-house) and scope 2 (purchased energy), with variable results in scope 3 (supply chain) emissions. Strategies to reduce emissions included optimizing manufacturing and distribution, and responsible sourcing of energy, water, and raw materials. Pharmaceutical companies are setting climate change targets and reporting reduced emissions via a range of strategies. This varies, with scope to track actions and accountability to targets, improve consistency of reporting, especially of scope 3 emissions, and collaborate on novel solutions. There is need for further mixed methods research on progress with achieving reported climate change targets, as well as implementation of strategies to reduce emissions within the pharmaceutical industry.

Coping during the COVID-19 pandemic: A mixed methods approach to understand how social factors influence coping ability.

The COVID-19 pandemic and public health protection measures aimed at mitigating the transmission of the virus have both resulted in tremendous physical and mental health impacts. The study at hand used a gender-based analysis and social determinants of health approach to investigate which communities had trouble coping during times of strict protection measures and symptoms and strategies employed during the COVID-19 pandemic. Participants were recruited from previously established cohorts as a part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) study. Being a young adult, female, woman, gender diverse, low-income earner or LGBTQ/2S+ was significantly associated with not being able to cope during the first wave of the pandemic. The effects for females, women, and gender diverse were attenuated yet still significant when controlling for various covariates. Those who reported not coping were more likely to present maladaptive coping symptoms and strategies. Our findings demonstrate the need to support marginalized communities in coping with the current ongoing COVID-19 pandemic and build proactive support for future pandemics.

Exploring the foundations of early scientific literacy: Children's causal stance.

From an early age, children show a keen interest in discovering the causal structure of the world around them. Given how fundamental causal information is to scientific inquiry and knowledge, this early emerging "causal stance" might be important in propelling the development of scientific literacy. However, currently little is known about the development of children's causal stance, or how it might relate to concurrent or subsequent scientific literacy. In this study, 153 children from diverse backgrounds were evaluated at 3, 4, 5, and 6 years of age. Results demonstrate that causal stance at 3 years of age consistently predicted scientific literacy at each wave of data collection, extending through preschool, kindergarten, and into first grade. This relation was particularly pronounced across the earliest 2 measurement time-points, when children's causal stance predicted growth in scientific literacy above and beyond initial scores. The reciprocal relation did not hold: scientific literacy did not predict future causal stance. Implications for school readiness and early STEM engagement are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Seropositivity of SARS-CoV-2 in an unvaccinated cohort in British Columbia, Canada: a cross-sectional survey with dried blood spot samples.

OBJECTIVES: Gathering population-based data on prevalence of SARS-CoV-2 infection is vital to the public health response and planning. Current seroprevalence data in BC are limited with respect to considerations of how socioeconomic and demographic factors, such as age, sex, gender, income, identifying as a visibility minority and occupation, are related to SARS-CoV-2 antibody detection due to infection-acquired immunity. We aimed to estimate the SARS-CoV-2 seropositivity in a cohort of British Columbians, using at-home self-collected dried blood spot (DBS) samples. DESIGN: This cross-sectional study included online surveys that collected sociodemographic and COVID-19 vaccine receipt information, and an at-home DBS collection kit. SETTING: British Columbia (BC), Canada. PARTICIPANTS: Eligible participants were aged 25-69 years and residents of BC. PRIMARY OUTCOME MEASURE: SARS-CoV-2 anti-spike IgG antibody detection in unvaccinated individuals. Adjusted incidence rate ratios (aIRR) explored factors associated with seropositivity. RESULTS: SARS-CoV-2 serology was performed on a total of 4048 unvaccinated participants 25-69 years of age who submitted DBS samples taken from November 2020 to June 2021. A total of 118 seropositive cases were identified, for an estimated overall seropositivity of 2.92% (95% CI 2.42% to 3.48%). Participants identifying as a visible minority had a higher seropositivity, 5.1% vs 2.6% (p=0.003), compared with non-visible minority participants. After adjustment by age and sex, identifying as a visible minority (aIRR=1.85, 95% CI 1.20 to 2.84) remained the only significant factor associated with SARS-CoV-2 antibody detection in this cohort of unvaccinated individuals. CONCLUSIONS: SARS-CoV-2 seropositivity in the BC population due to infection-acquired immunity was low. Seropositivity indicated that among those unvaccinated, visible minority communities have been most impacted. Continued monitoring of SARS-CoV-2 serology due to both infection-acquired and vaccine-acquired immunity will be vital in public health planning and pandemic response.

Characterizing intentions to receive the COVID-19 vaccine among the general population in British Columbia based on their future intentions towards the seasonal influenza vaccine.

Introduction: This study assessed the relationship between intention to receive a COVID-19 vaccine and intention to receive a seasonal influenza vaccine, as well as how intention to receive a COVID-19 vaccine has changed during the pandemic. Methods: Residents of British Columbia aged 25-69 years were invited to complete an online cross-sectional survey from August 2020 - March 2021. Mixed-effects logistic regression models assessed the relationship between intention to receive a COVID-19 vaccine and intention to receive the seasonal influenza vaccine. A generalized additive mixed model was used to investigate changes in COVID-19 vaccine intention during the pandemic (August 2020-March 2021). The relationship between intention to receive a COVID-19 vaccine and retrospective overall perceived value of vaccines prior to and during the pandemic was also considered. Results: Of 6,333 participants, 80.2 % of participants were 'somewhat or very likely' to receive a COVID-19 vaccine and 69 % of participants reported intending to receive a seasonal influenza vaccine. In multivariable modeling, intention to receive a COVID-19 vaccine was strongly associated with intention to receive a seasonal influenza vaccine (aOR = 4.25, 95 %CI 3.33-5.43). Intention to receive a COVID-19 vaccine increased over the study period (p < 0.0001), with the largest increase coinciding with the announcement of forthcoming approvals of COVID-19 vaccines in November 2020 (aOR = 1.45, 95 %CI 1.11-1.91). Conclusion: Intention to receive the COVID-19 vaccine was associated seasonal influenza vaccine intention, which is an important relationship to measure for implementation and future planning of COVID-19 booster doses. We found an increase in the intention to receive a COVID-19 vaccine after public announcements of forthcoming vaccine approval, which highlights the importance of ongoing monitoring and reporting of vaccine uptake, and the potential impact of emerging vaccine safety and efficacy information may have on vaccine acceptance.

Contributions of causal reasoning to early scientific literacy.

Although early causal reasoning has been studied extensively, inconsistency in the tasks used to assess it has clouded our understanding of its structure, development, and relevance to broader developmental outcomes. The current research attempted to bring clarity to these questions by exploring patterns of performance across several commonly used measures of causal reasoning, and their relation to scientific literacy, in a sample of 3- to 5-year-old children from diverse backgrounds (N = 153). A longitudinal confirmatory factor analysis revealed that some measures of causal reasoning (counterfactual reasoning, causal learning, and causal inference), but not all of them (tracking cause-effect associations and resolving confounded evidence), assess a unidimensional factor and that this resulting factor was relatively stable across time. A cross-lagged panel model analysis revealed associations between causal reasoning and scientific literacy across each age tested. Causal reasoning and scientific literacy related to each other concurrently, and each predicted the other in subsequent years. These relations could not be accounted for by children's broader cognitive skills. Implications for early STEM (science, technology, engineering, and math) engagement and success are discussed.