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1.
J Cancer Educ ; 38(1): 225-230, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-34677801

RESUMO

Disparities in colorectal cancer (CRC) incidence and mortality persist in rural and underserved communities. Our Community Outreach and Engagement (COE) activities are grounded in a bi-directional Community-to-Bench model in which the National Outreach Network Community Health Educator (NON CHE) Screen to Save (S2S) initiative was implemented. In this study, we assessed the impact of the NON CHE S2S in rural and underserved communities. Descriptive and comparative analyses were used to examine the role of the NON CHE S2S on CRC knowledge and CRC screening intent. Data included demographics, current CRC knowledge, awareness, and future CRC health plans. A multivariate linear regression was fit to survey scores for CRC knowledge. The NON CHE S2S engaged 441 participants with 170 surveys completed. The difference in participants' CRC knowledge before and after the NON CHE S2S intervention had an overall mean of 0.92 with a standard deviation of 2.56. At baseline, White participants had significantly higher CRC knowledge scores, correctly answering 1.94 (p = 0.007) more questions on average than Black participants. After the NON CHE S2S intervention, this difference was not statistically significant. Greater than 95% of participants agreed that the NON CHE S2S sessions impacted their intent to get screened for CRC. Equity of access to health information and the health care system can be achieved with precision public health strategies. The COE bi-directional Community-to-Bench model facilitated community connections through the NON CHE and increased awareness of CRC risk reduction, screening, treatment, and research. The NON CHE combined with S2S is a powerful tool to engage communities with the greatest health care needs and positively impact an individual's intent to "get screened" for CRC.


Assuntos
Neoplasias Colorretais , Equidade em Saúde , Humanos , Saúde Pública , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Inquéritos e Questionários , Detecção Precoce de Câncer , Conhecimentos, Atitudes e Prática em Saúde
2.
Prev Chronic Dis ; 19: E18, 2022 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-35420981

RESUMO

INTRODUCTION: Physical activity (PA) guidelines aimed at accumulating 10,000 steps per day have become increasingly common with the advent of wristband PA monitors. However, accumulated steps measured with wristband PA monitors may not be equal to steps measured with validated, hip-worn pedometers. Consequently, evaluating and developing guidelines for step counts using wristband PA monitors for the general population is needed. We compared step counts accumulated with hip-worn pedometers with those accumulated with wrist-worn activity monitors during 1) treadmill exercise, 2) treadmill walking, and 3) activities of daily living (ADL) to determine their accuracy in meeting step count guidelines (ie, 10,000 steps/d). METHODS: Eighty-six adults (aged 18-65 y; body mass index, 19-45 kg/m2) completed 30 minutes of treadmill exercise while simultaneously using a hip-worn pedometer and wrist-worn PA monitor. Remaining steps needed to reach 10,000 steps (ie, 10,000 steps minus the number of pedometer steps recorded from treadmill exercise = remainder) were completed via treadmill walking or ADL. Steps were recorded for both devices after treadmill exercise, treadmill walking, and ADL for both devices. RESULTS: Fewer steps were accumulated via wrist-worn PA monitors than via hip-worn pedometers during treadmill exercise (3,552 [SD, 63] steps vs 3,790 [SD, 55] steps, P < .01) and treadmill walking (5,877 [SD, 83] steps vs 6,243 [SD, 49] steps, P < .01). More steps were accumulated via wrist-worn PA monitors than hip-worn pedometers during ADL (7,695 [SD, 207] steps vs 6,309 [SD, 57] steps, P < .01). Consequently, total steps were significantly higher for wristband PA monitors than hip-worn pedometers (11,247 [SD, 210] steps vs 10,099 [SD, 39] steps; P < .01). CONCLUSION: The widely used 10,000-step recommendation may not be accurate for all users of all activity monitors, given the discrepancy in daily step count among wrist-worn and hip-worn devices. Having a more accurate indication of number of steps taken per day based on the device used could have positive effects on health.


Assuntos
Atividades Cotidianas , Punho , Acelerometria , Adulto , Índice de Massa Corporal , Exercício Físico , Humanos , Caminhada
3.
Dis Colon Rectum ; 64(3): 313-318, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33395140

RESUMO

BACKGROUND: Multimodal, narcotic-sparing analgesic strategies are an important part of enhanced recovery after surgery protocols. Within such protocols, regional anesthetics have proven to be superior to narcotics. OBJECTIVE: This study aimed to evaluate the impact of the transversus abdominis plane block within an enhanced recovery after surgery protocol on length of stay. DESIGN: A retrospective analysis of patients who underwent colorectal surgery in 2015 to 2016 was completed. The primary end points for this analysis were total length of stay and total narcotics consumed during hospitalization. Length of stay and total narcotic use were compared for patients who received a transversus abdominis plane block versus those that did not. DATA SOURCE: The data were obtained from the data warehouse of a university teaching hospital. SETTINGS: This study took place at a university teaching hospital. PATIENTS: The patients were 18 years or older. MAIN OUTCOME MEASURES: The primary outcomes measured were length of stay and the total narcotics used. RESULTS: A total of 347 patients underwent colorectal procedures under the enhanced recovery protocol. Among these, 186 (54%) received a transversus abdominis plane block. Overall, the mean length of stay was 5.8 days (SD ±5.6), and median length of stay was 4 days. These values compare to a mean length of stay of 9.6 days and median length of stay of 7 days before implementing the enhanced recovery protocol. Patients who received a transversus abdominis plane block had a mean length of stay of 5.1 days compared to 6.6 days for those who did not receive one (p < 0.01). Patients who received a transversus abdominis plane block consumed 736.5 morphine milligram equivalents of opioids compared to 1150.3 morphine milligram equivalents of opioid consumed by those without a transversus abdominis plane block (p < 0.05), a 36% decrease in opioid use. When comparing patients who had a mean length of stay of 4 days with those whose length of stay was >4 days, there was an 80% decrease in opioid use. The readmission rate was 7.8%. LIMITATIONS: The lack of randomization of patients was a limitation of this study. CONCLUSION: The use of transversus abdominis plane block in the setting of a well-structured enhanced recovery protocol was associated with a statistically significant decrease in length of stay by 1.5 days and a 36% decrease in narcotic use. See Video Abstract at http://links.lww.com/DCR/B432. IMPACTO DE LA ANESTESIA DEL PLANO MUSCULAR DE LOS TRANSVERSOS ABDOMINALES EN LA ESTADA DENTRO UN PROTOCOLO ERAS: ANTECEDENTES:La estrategia analgésica multimodal que consume poco medicamento de tipo narcótico es parte importante en los protocolos de recuperación mejorada postoperatoria. Dentro de dichos protocolos, los anestésicos regionales han demostrado ser superiores a la administración de medicamentos narcóticos.OBJETIVO:Estudiar el impacto del bloqueo del plano muscular de los transversos del abdomen sobre la duración de la estadía dentro de un protocolo de recuperación mejorada postoperatoria.DISEÑO:Se realizó un análisis retrospectivo de los pacientes que se sometieron a cirugía colorrectal entre 2015-2016. Los criterios principales de valoración en el presente análisis fueron la duración total de la estadía y el total de medicamentos narcóticos consumidos durante la hospitalización. Se comparó la duración de la estadía y el uso total de narcóticos en los pacientes que recibieron un bloqueo anestésico del plano muscular de los transversos del abdomen con los que no lo recibieron.FUENTE DE DATOS:Banco de datos de un hospital universitario docente.AMBIENTE:Hospital Universitario Docente.PACIENTES:Adultos desde los 18 años o mayores.PRINCIPALES MEDIDAS DE RESULTADO:Duración de la estadía, cantidad total de medicamentos narcóticos administrados.RESULTADOS:Un total de 347 pacientes se sometieron a procedimientos colorrectales bajo el protocolo ERAS. Entre ellos, 186 (54%) recibieron un bloqueo del plano muscular de los transversos del abdomen. En la globalidad, la duración media de la estadía fué de 5,8 días (DE ± 5,6) y la duración media de la estadía fué de 4 días. Estos resultados fueron comparados con la estadía media de 9,6 días y una estadía media de 7 días antes de implementar el protocolo ERAS. Los pacientes que recibieron un bloqueo del plano muscular de los transversos del abdomen tuvieron una estadía media de 5,1 días en comparación con los 6,6 días de los que no recibieron el mencionado bloqueo (p <0,01). Los pacientes que recibieron el bloqueo del plano muscular consumieron 736,5 miligramos de morfina o su equivalente en opioides, comparados con los 1150,3 de aquellos sin bloqueo del plano muscular (p <0,05) lo que significó una disminución del 36% en la administración de opioides. Al comparar los pacientes que tuvieron una estadía media de 4 días con aquellos cuya estadía fue mayor a 4 días, se evidenció una disminución en el 80% de la administración de opioides. La tasa de reingreso fue del 7,8%.LIMITACIONES:Estudio sin sin aleatorización de pacientes.CONCLUSIÓN:El bloqueo anestésico del plano muscular de los transversos del abdomen dentro un contexto protocolar tipo ERAS o de recuperación mejorada bien estructurada, se asoció con la disminución estadísticamente significativa de la duración de la estadía en 1,5 días y una disminución del 36% en la administración de medicamentos narcóticos. Consulte Video Resumen en http://links.lww.com/DCR/B432.


Assuntos
Músculos Abdominais/efeitos dos fármacos , Anestesia por Condução/estatística & dados numéricos , Recuperação Pós-Cirúrgica Melhorada/normas , Tempo de Internação/estatística & dados numéricos , Bloqueio Neuromuscular/métodos , Músculos Abdominais/inervação , Adulto , Analgésicos não Narcóticos/administração & dosagem , Analgésicos não Narcóticos/farmacologia , Anestesia por Condução/métodos , Estudos de Casos e Controles , Cirurgia Colorretal/estatística & dados numéricos , Cirurgia Colorretal/tendências , Hospitalização/estatística & dados numéricos , Hospitais de Ensino , Humanos , Entorpecentes/provisão & distribuição , Entorpecentes/uso terapêutico , Estudos Retrospectivos
4.
J Urban Health ; 98(Suppl 2): 149-154, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34374033

RESUMO

This study utilized data from four cancer-focused research studies that recruited and retained African Americans. Strategies and outcomes across four cancer prevention and control studies were analyzed. Descriptive statistics were used to display participant characteristics. There were 712 African American (Black) participants of which 14.6% were males. Common strategies involved connecting with community stakeholders and identifying study champions. Study recruitment methods might not be generalizable to all populations of African Americans due to geographic locations, study protocols (e.g., risk reduction), target populations (i.e., eligibility criteria), and available resources. Many African Americans have a strong interest in cancer-related research as demonstrated by participation levels. Teams that connect with relevant stakeholders and include diverse teams may be useful to engage larger numbers of minorities in cancer control research to impact morbidity and mortality.


Assuntos
Negro ou Afro-Americano , Neoplasias , Humanos , Masculino , Grupos Minoritários , Seleção de Pacientes
5.
J Cancer Educ ; 36(2): 338-344, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-31654321

RESUMO

Disparities in cancer screening and care in rural communities warrant the need to determine effective ways to reach, engage, and educate the community residents. The purpose of this cross-sectional study was to pilot methods to engage rural residents in colorectal cancer (CRC) research and education activities and assess knowledge of CRC guidelines, symptoms, and screening behaviors in this sample. The community-engaged research approach was employed to develop and distribute a CRC knowledge and screening behavior assessment using various methods such as email and community drop boxes placed throughout the community. Bivariate analysis assessed the relationship between age and CRC knowledge items. Three hundred ninety-one surveys were returned with most received from community drop boxes (60%) followed by educational events (23%). The most ineffective method to distribute surveys was through community events. Most individuals were knowledgeable of CRC symptoms (70%) and screening facts (67%). Bivariate analysis showed that individuals 50 years or older had significantly more knowledge of CRC risks and screening than those under the age of 50. This study highlights the potential of community drop boxes as an effective method for engaging rural communities. Further, findings from the survey highlight the need to focus CRC education on younger individuals in which CRC incidence has increased.


Assuntos
Neoplasias Colorretais , População Rural , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/prevenção & controle , Estudos Transversais , Detecção Precoce de Câncer , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Programas de Rastreamento
6.
J Sch Nurs ; 36(5): 386-393, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30669935

RESUMO

School nurses are often sources of health-care support for teens with sexually transmitted infections (STIs) and unintended pregnancies. However, providing prevention (e.g., condoms) and teaching technical skills (e.g., condom use) needed to reduce high-risk sexual behavior may require a change in perceptions and policies. This study used a cross-sectional study design to assess nurses' perceptions of condom availability accompanied by sex education programs among high school nurses (n = 87) in Kansas. Results showed that school nurses in this study supported condom availability, were comfortable providing condoms, and felt condom availability was within the scope of their job but were less likely to provide condoms because of external barriers. Common barriers include administration, parents, cost, community support, and policies. School nurses, by virtue of their access to the majority of Kansas' adolescents, have the potential to provide sex education and tools such as condoms, so young people can prevent STIs and unintended pregnancies.


Assuntos
Atitude do Pessoal de Saúde , Preservativos , Enfermeiras e Enfermeiros/psicologia , Serviços de Saúde Escolar , Instituições Acadêmicas , Educação Sexual , Adulto , Idoso , Estudos Transversais , Feminino , Humanos , Kansas , Masculino , Pessoa de Meia-Idade , Âmbito da Prática
7.
Breast J ; 25(4): 687-690, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31111601

RESUMO

Many techniques have been proposed to address the problem of increased lateral adiposity in patients undergoing mastectomy, however, there is no standard approach. This cosmetic deformity at the lateral end of the mastectomy scar, also known as a dog ear, is especially common in obese patients. This defect can be unsightly and uncomfortable. We describe a technique for creating a winged incision to eliminate the dog ear deformity. The Angel Wings Incision results in tissue flaps that create a smooth body contour upon closure in patients with increased lateral adiposity. The technique is reproducible, aesthetically pleasing, and improves patient satisfaction.


Assuntos
Adiposidade , Neoplasias da Mama/cirurgia , Mastectomia/métodos , Tecido Adiposo/cirurgia , Feminino , Humanos , Satisfação do Paciente , Estudos Retrospectivos , Retalhos Cirúrgicos
8.
Ann Surg Oncol ; 25(10): 3076-3081, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30112589

RESUMO

BACKGROUND: Localization of nonpalpable breast lesions for breast-conserving surgery (BCS) remains highly variable and includes needle/wire localization (NL), radioactive seed localization, radar localization, and hematoma-directed ultrasound-guided (HUG) lumpectomy. The superiority of HUG lumpectomy over NL has been demonstrated repeatedly in terms of safety, accuracy, low positive margin rates, cosmesis, and patient satisfaction. In this study, we evaluate the cost effectiveness of HUG lumpectomy over NL for nonpalpable breast lesions. METHODS: We performed a retrospective review of 569 patients who underwent lumpectomy at the University of Arkansas for Medical Sciences from May 2014 through December 2017. Lumpectomies were stratified by localization technique, i.e. NL versus HUG. A cost-savings estimate was determined for the HUG localization technique, and a total amount of dollars saved over the study period was calculated. RESULTS: Overall, 569 lumpectomies were performed: 501 (88.0%) via HUG and 68 (12.0%) via NL. Intraoperative ultrasound was used in 566 operations (99.5%). Of the lumpectomies performed by HUG, 190 lesions (33.4%) were visible only on mammogram or breast magnetic resonance imaging prior to diagnostic core needle biopsy (CNB). Cost estimates comparing HUG with NL demonstrated a cost savings of $497.00 per procedure, the cost of preoperative needle localization by a radiologist, and a total of $94,430.00 for the study period. CONCLUSION: In utilizing HUG lumpectomy, the initial CNB serves as the diagnostic and localization procedure, thus saving time and a painful second procedure on the day of operation. HUG lumpectomy is safe, accurate, reduces healthcare costs, and results in a better patient experience for the surgical removal of nonpalpable breast lesions.


Assuntos
Biópsia com Agulha de Grande Calibre/economia , Neoplasias da Mama/economia , Custos de Cuidados de Saúde , Hematoma/patologia , Mastectomia Segmentar/economia , Cirurgia Assistida por Computador/métodos , Ultrassonografia de Intervenção/economia , Ultrassonografia Mamária/economia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Seguimentos , Hematoma/diagnóstico por imagem , Humanos , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Adulto Jovem
9.
Ecology ; 96(10): 2632-42, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26649385

RESUMO

Plant genetic variation and evolutionary dynamics are predicted to impact ecosystem processes but these effects are poorly understood. Here we test the hypothesis that plant genotype and contemporary evolution influence the flux of energy and nutrients through soil, which then feedback to affect seedling performance in subsequent generations. We conducted a multiyear field evolution experiment using the native biennial plant Oenothera biennis. This experiment was coupled with experimental assays to address our hypothesis and quantify the relative importance of evolutionary and ecological factors on multiple ecosystem processes. Plant genotype, contemporary evolution, spatial variation, and herbivory affected ecosystem processes (e.g., leaf decay, soil respiration, seedling performance, N cycling), but their relative importance varied between specific ecosystem variables. Insect herbivory and evolution also contributed to a feedback that affected seedling biomass of O. biennis in the next generation. Our results show that heritable variation among plant genotypes can be an important factor affecting local ecosystem processes, and while effects of contemporary evolution were detectable and sometimes strong, they were often contingent on other ecological, factors.


Assuntos
Evolução Biológica , Ecossistema , Genótipo , Oenothera biennis/genética , Nitrogênio/química , Consumo de Oxigênio , Plântula/crescimento & desenvolvimento , Plântula/metabolismo , Solo/química
10.
Am J Public Health ; 105 Suppl 5: S665-7, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25879149

RESUMO

Disparities in health care have been targeted for elimination by federal agencies and professional organizations, including the American Public Health Association. Although the Affordable Care Act (ACA) provides a valuable first step in reducing the disparities gap, progress is contingent upon whether opportunities in the ACA help or hinder populations at risk for impaired health and limited access to medical care.


Assuntos
Acessibilidade aos Serviços de Saúde/organização & administração , Disparidades em Assistência à Saúde/organização & administração , Patient Protection and Affordable Care Act/legislação & jurisprudência , Organizações de Assistência Responsáveis/organização & administração , Competência Cultural , Humanos , Medicaid/organização & administração , Serviços Preventivos de Saúde/organização & administração , Fatores Socioeconômicos , Estados Unidos
11.
Am J Public Health ; 105(9): e48-53, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26180988

RESUMO

OBJECTIVES: We estimated the effect of economic constraints on public health delivery systems (PHDS) density and centrality during 3 time periods, 1998, 2006, and 2012. METHODS: We obtained data from the 1998, 2006, and 2012 National Longitudinal Study of Public Health Agencies; the 1993, 1997, 2005, and 2010 National Association for County and City Health Officials Profile Study; and the 1997, 2008, and 2011 Area Resource Files. We used multivariate regression models for panel data to estimate the impact of economic constraints on PHDS density and centrality. RESULTS: Findings indicate that economic constraints did not have a significant impact on PHDS density and centrality over time but population is a significant predictor of PHDS density, and the presence of a board of health (BOH) is a significant predictor of PHDS density and centrality. Specifically, a 1% increase in population results in a significant 1.71% increase in PHDS density. The presence of a BOH is associated with a 10.2% increase in PHDS centrality, after controlling for other factors. CONCLUSIONS: These findings suggest that other noneconomic factors influence PHDS density centrality.


Assuntos
Administração em Saúde Pública/economia , Comportamento Cooperativo , Humanos , Estudos Longitudinais , Prática de Saúde Pública/economia , Características de Residência , Estudos Retrospectivos
12.
bioRxiv ; 2024 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-38464283

RESUMO

Current theories of decision making propose that decisions arise through competition between choice options. Computational models of the decision process estimate how quickly information about choice options is integrated and how much information is needed to trigger a choice. Experiments using this approach typically report data from well-trained participants. As such, we do not know how the decision process evolves as a decision-making task is learned for the first time. To address this gap, we used a behavioral design separating learning the value of choice options from learning to make choices. We trained male rats to respond to single visual stimuli with different reward values. Then, we trained them to make choices between pairs of stimuli. Initially, the rats responded more slowly when presented with choices. However, as they gained experience in making choices, this slowing reduced. Response slowing on choice trials persisted throughout the testing period. We found that it was specifically associated with increased exponential variability when the rats chose the higher value stimulus. Additionally, our analysis using drift diffusion modeling revealed that the rats required less information to make choices over time. Surprisingly, we observed reductions in the decision threshold after just a single session of choice learning. These findings provide new insights into the learning process of decision-making tasks. They suggest that the value of choice options and the ability to make choices are learned separately, and that experience plays a crucial role in improving decision-making performance.

13.
eNeuro ; 11(5)2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38724267

RESUMO

Current theories of decision-making propose that decisions arise through competition between choice options. Computational models of the decision process estimate how quickly information about choice options is integrated and how much information is needed to trigger a choice. Experiments using this approach typically report data from well-trained participants. As such, we do not know how the decision process evolves as a decision-making task is learned for the first time. To address this gap, we used a behavioral design separating learning the value of choice options from learning to make choices. We trained male rats to respond to single visual stimuli with different reward values. Then, we trained them to make choices between pairs of stimuli. Initially, the rats responded more slowly when presented with choices. However, as they gained experience in making choices, this slowing reduced. Response slowing on choice trials persisted throughout the testing period. We found that it was specifically associated with increased exponential variability when the rats chose the higher value stimulus. Additionally, our analysis using drift diffusion modeling revealed that the rats required less information to make choices over time. These reductions in the decision threshold occurred after just a single session of choice learning. These findings provide new insights into the learning process of decision-making tasks. They suggest that the value of choice options and the ability to make choices are learned separately and that experience plays a crucial role in improving decision-making performance.


Assuntos
Comportamento de Escolha , Ratos Long-Evans , Recompensa , Animais , Masculino , Comportamento de Escolha/fisiologia , Tomada de Decisões/fisiologia , Ratos , Aprendizagem/fisiologia , Tempo de Reação/fisiologia , Estimulação Luminosa/métodos , Comportamento Animal/fisiologia
14.
Am J Mens Health ; 18(2): 15579883241240339, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38545883

RESUMO

Information seeking anxiety is a multidimensional construct that is operationalized as having elements of worry, confusion, and disorganization. Much remains unknown about the ways information seeking anxiety operates among cancer patients in the United States. This study investigated the application of the information seeking anxiety concept among prostate cancer patients by documenting their assessment experiences and examining relationships between information seeking anxiety and treatment information search behaviors. A purposive sample of African American and Caucasian men (N = 63) within 5 years of being diagnosed with localized disease (stage T1 or T2) were recruited to participate through cancer registries, advertisements, and word-of-mouth. Participants completed a self-administered survey with items that collected demographic information, treatment information-seeking behaviors, and information seeking anxiety evaluations. All surveys were completed in one sitting and a majority of men (82.5%, N = 52) completed the information seeking anxiety assessment with no assistance. During their first interactions with available sources of information (e.g., doctors, internet, peers), most survivors (95.2%, N = 60) reported some level of information seeking anxiety. Specifically, 55.5% (N = 35) were confused about what to look for, 60.3% (N = 38) were worried they would not find the right information, 55.5% (N = 35) were uncomfortable with the search process, and 49.2% (N = 31) reported being disorganized. The composite information seeking anxiety measure was moderately correlated with men's self-reported time to start searching for treatment information (p = .02; r = .306). Information seeking anxiety appears to delay the treatment information gathering activities of prostate cancer survivors with localized disease. This previously undocumented barrier to the delivery of prostate cancer care services should be investigated in other studies with larger and more diverse samples.


Assuntos
Comportamento de Busca de Informação , Neoplasias da Próstata , Masculino , Humanos , Estados Unidos , Neoplasias da Próstata/terapia , Homens , Ansiedade , Transtornos de Ansiedade , Inquéritos e Questionários
15.
Cancer Med ; 13(7): e7054, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38591114

RESUMO

BACKGROUND: Colorectal cancer screening rates remain suboptimal, particularly among low-income populations. Our objective was to evaluate the long-term effects of Medicaid expansion on colorectal cancer screening. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study analyzed data from 354,384 individuals aged 50-64 with an income below 400% of the federal poverty level (FPL), who participated in the Behavioral Risk Factors Surveillance System from 2010 to 2018. A difference-in-difference analysis was employed to estimate the effect of Medicaid expansion on colorectal cancer screening. Subgroup analyses were conducted for individuals with income up to 138% of the FPL and those with income between 139% and 400% of the FPL. The effect of Medicaid expansion on colorectal cancer screening was examined during the early, mid, and late expansion periods. MAIN OUTCOMES AND MEASURES: The primary outcome was the likelihood of receiving colorectal cancer screening for low-income adults aged 50-64. RESULTS: Medicaid expansion was associated with a significant 1.7 percentage point increase in colorectal cancer screening rates among adults aged 50-64 with income below 400% of the FPL (p < 0.05). A significant 2.9 percentage point increase in colorectal cancer screening was observed for those with income up to 138% the FPL (p < 0.05), while a 1.5 percentage point increase occurred for individuals with income between 139% and 400% of the FPL. The impact of Medicaid expansion on colorectal cancer screening varied based on income levels and displayed a time lag for newly eligible beneficiaries. CONCLUSIONS: Medicaid expansion was found to be associated with increased colorectal cancer screening rates among low-income individuals aged 50-64. The observed variations in impact based on income levels and the time lag for newly eligible beneficiaries receiving colorectal cancer screening highlight the need for further research and precision public health strategies to maximize the benefits of Medicaid expansion on colorectal cancer screening rates.


Assuntos
Neoplasias Colorretais , Medicaid , Adulto , Estados Unidos/epidemiologia , Humanos , Patient Protection and Affordable Care Act , Estudos Transversais , Acessibilidade aos Serviços de Saúde , Detecção Precoce de Câncer , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Cobertura do Seguro
16.
J Health Res ; 38(1): 88-93, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37869728

RESUMO

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection (STI). To address STIs, one rural county public school district developed a series of Family Life Programs to educate pre-teens about pertinent health information. The Schooling Cancer Program (SCP) was developed in partnership with the local Cancer Research and Resource Center to raise awareness about cancer risk factors including HPV-related cancers and HPV prevention methods. Methods: We collected a post-evaluation survey from students who attended a SCP session at one of the targeted middle schools. The SCP educated students about topics focusing on healthy lifestyles. The survey asked students' knowledge on the SCP topics, HPV knowledge, tobacco usage, and factors that reduced cancer development. Results: 87% agreed that tobacco products are associated with cancer, and 81% did not agree that E-cigarettes are scientifically proven to be safer than cigarettes. Although we do not have pre-evaluation data about these students' HPV knowledge, our evaluation survey shows that 80% of students correctly identified HPV as the most common STI, and 84% of students correctly identified the factors that decrease their risk of developing cancer. Conclusion: Through this initiative, students learned essential health concepts and HPV-related risk factors.

17.
Mol Plant ; 17(5): 747-771, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38614077

RESUMO

Macroalgae are multicellular, aquatic autotrophs that play vital roles in global climate maintenance and have diverse applications in biotechnology and eco-engineering, which are directly linked to their multicellularity phenotypes. However, their genomic diversity and the evolutionary mechanisms underlying multicellularity in these organisms remain uncharacterized. In this study, we sequenced 110 macroalgal genomes from diverse climates and phyla, and identified key genomic features that distinguish them from their microalgal relatives. Genes for cell adhesion, extracellular matrix formation, cell polarity, transport, and cell differentiation distinguish macroalgae from microalgae across all three major phyla, constituting conserved and unique gene sets supporting multicellular processes. Adhesome genes show phylum- and climate-specific expansions that may facilitate niche adaptation. Collectively, our study reveals genetic determinants of convergent and divergent evolutionary trajectories that have shaped morphological diversity in macroalgae and provides genome-wide frameworks to understand photosynthetic multicellular evolution in aquatic environments.


Assuntos
Genômica , Fotossíntese , Alga Marinha , Alga Marinha/genética , Fotossíntese/genética , Filogenia , Microalgas/genética , Microalgas/citologia , Evolução Biológica
18.
Glob Chang Biol ; 19(12): 3729-39, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23868415

RESUMO

To study vegetation feedbacks of nutrient addition on carbon sequestration capacity, we investigated vegetation and ecosystem CO2 exchange at Mer Bleue Bog, Canada in plots that had been fertilized with nitrogen (N) or with N plus phosphorus (P) and potassium (K) for 7-12 years. Gross photosynthesis, ecosystem respiration, and net CO2 exchange were measured weekly during May-September 2011 using climate-controlled chambers. A substrate-induced respiration technique was used to determine the functional ability of the microbial community. The highest N and NPK additions were associated with 40% less net CO2 uptake than the control. In the NPK additions, a diminished C sink potential was due to a 20-30% increase in ecosystem respiration, while gross photosynthesis rates did not change as greater vascular plant biomass compensated for the decrease in Sphagnum mosses. In the highest N-only treatment, small reductions in gross photosynthesis and no change in ecosystem respiration led to the reduced C sink. Substrate-induced microbial respiration was significantly higher in all levels of NPK additions compared with control. The temperature sensitivity of respiration in the plots was lower with increasing cumulative N load, suggesting more labile sources of respired CO2 . The weaker C sink potential could be explained by changes in nutrient availability, higher woody : foliar ratio, moss loss, and enhanced decomposition. Stronger responses to NPK fertilization than to N-only fertilization for both shrub biomass production and decomposition suggest that the bog ecosystem is N-P/K colimited rather than N-limited. Negative effects of further N-only deposition were indicated by delayed spring CO2 uptake. In contrast to forests, increased wood formation and surface litter accumulation in bogs seem to reduce the C sink potential owing to the loss of peat-forming Sphagnum.


Assuntos
Dióxido de Carbono/metabolismo , Sequestro de Carbono , Ecossistema , Nitrogênio/metabolismo , Fósforo/metabolismo , Plantas/metabolismo , Potássio/metabolismo , Ontário , Estações do Ano , Áreas Alagadas
19.
Sci Total Environ ; 904: 166734, 2023 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-37673266

RESUMO

Increasing forest cover by regreening mining and smelting degraded landscapes provides an opportunity for global carbon (C) sequestration, however, the reported effects of regreening on soil C processes are mixed. One of the world's largest regreening programs is in the City of Greater Sudbury, Canada and has been ongoing since 1978. Prior to regreening, soils in the City of Greater Sudbury area were highly eroded, acidic, rich in metals, and poor in nutrients. This study used a chronosequence approach to investigate how forest soil C pools and fluxes have changed with stand age in highly "eroded" sites with minimal soil cover (n = 6) and "stable" sites covered by soil (n = 6). Encouragingly, the relationship between stand age and soil C processes (litterfall, litter decomposition, soil respiration, fine root growth) at both stable and eroded sites were comparable to observations reported for jack pine (Pinus banksiana Lamb.) and red pine (Pinus resinosa Ait.) plantations that have not been subject to over a century of industrial impacts. There was a strong "home-field advantage" for local decomposers, where litter decomposition rates were higher using a site-specific pine litter compared with a common pine litter. Higher soil respiration at eroded sites was linked to higher soil temperature, likely because of a more open tree canopy. Forest floor C pools increased with stand age while mineral soil C and aggregate C concentrations decreased with stand age. This loss of soil C is small relative to the substantial increases in aboveground tree and forest floor C pools, leading to a sizeable increase in total ecosystem C pools following regreening.


Assuntos
Ecossistema , Pinus , Solo , Carbono/metabolismo , Florestas , Árvores/metabolismo , Pinus/metabolismo
20.
eNeuro ; 8(3)2021.
Artigo em Inglês | MEDLINE | ID: mdl-33811085

RESUMO

Operant behavior procedures often rely on visual stimuli to cue the initiation or secession of a response, and to provide a means for discriminating between two or more simultaneously available responses. While primate and human studies typically use Liquid-Crystal Display (LCD) or Organic Light-Emitting Diode (OLED) monitors and touch screens, rodent studies use a variety of methods to present visual cues ranging from traditional incandescent light bulbs, single LEDs, and, more recently, touch screen monitors. Commercially available systems for visual stimulus presentation are costly, challenging to customize, and are typically closed source. We developed an open-source, highly-modifiable visual stimulus presentation platform that can be combined with a 3D-printed operant response device. The device uses an 8 × 8 matrix of LEDs, and can be expanded to control much larger LED matrices. Implementing the platform is low-cost (<$70 USD per device in the year 2020). Using the platform, we trained rats to make nosepoke responses and discriminate between two distinct visual cues in a location-independent manner. This visual stimulus presentation platform is a cost-effective way to implement complex visually-guided operant behavior, including the use of moving or dynamically changing visual stimuli.


Assuntos
Sinais (Psicologia) , Animais , Ratos
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