Stigma and cervical cancer prevention: A scoping review of the U.S. literature.

Cervical cancer is preventable through HPV vaccination and screening however, uptake falls below national targets. A scoping review was conducted to describe stigmas related to HPV infection and vaccination and cervical cancer and screening in the US. Results were organized into the domains proposed by Stangl and colleagues' Health Stigma and Discrimination Framework. Common drivers of stigma were fear of social judgement and rejection, self-blame, and shame. Positive facilitators included social norms that provided motivation to receive HPV vaccination and screening. Gender and social norms were notable negative facilitators of stigma. HPV infection and cervical cancer resulted in stigma marking through the belief that both result from incautious behavior-either multiple sexual partners or failing to get screening. Stereotyping and prejudice were stigma practices attributed to HPV infection and cervical cancer through these same behaviors. Stigma experiences related to HPV infection, cervical cancer, and abnormal screening results included altered self-image based on perceived/anticipated stigma, as well as discrimination. This review advances understanding of the multiple dimensions of stigma associated with these outcomes in the US population. Three areas warrant additional consideration. Future studies should 1) assess how stigma dimensions affect uptake of cervical cancer preventions efforts; 2) focus on US women most affected by cervical cancer incidence and mortality to identify potential differences in these dimensions and tailor interventions accordingly; 3) include women from geographic areas of the US with high rates of cervical cancer to adapt interventions that address potential regional variations in resources and need.

Exploring data management content in doctoral nursing handbooks.

OBJECTIVE: While data management (DM) is an increasing responsibility of doctorally prepared nurses, little is understood about how DM education and expectations are reflected within student handbooks. The purpose of this study was to assess the inclusion of DM content within doctoral nursing student handbooks. METHODS: A list of 346 doctoral programs was obtained from the American Association of Colleges of Nursing (AACN). Program websites were searched to locate program handbooks, which were downloaded for analysis. A textual review of 261 handbooks from 215 institutions was conducted to determine whether DM was mentioned and, if so, where the DM content was located. Statistical analysis was performed to compare the presence of DM guidance by type of institution, Carnegie Classification, and the type of doctoral program handbook. RESULTS: A total of 1,382 codes were identified across data life cycle stages, most commonly in the handbooks' project requirements section. The most frequent mention of DM was in relation to collecting and analyzing data; the least frequent related to publishing and sharing data and preservation. Significant differences in the frequency and location of codes were identified by program type and Carnegie Classification. CONCLUSIONS: Nursing doctoral program handbooks primarily address collecting and analyzing data during student projects. Findings suggest limited education about, and inclusion of, DM life cycle content, especially within DNP programs. Collaboration between nursing faculty and librarians and nursing and library professional organizations is needed to advance the adoption of DM best practices for preparing students in their future roles as clinicians and scholars.

A survey of current practices in data management education in nursing doctoral programs.

BACKGROUND: The inclusion of data management instruction within nursing doctoral curricula has not been systematically examined. PURPOSE: The purpose of this study is to determine the extent of data management education within nursing doctoral programs. METHOD: Separate surveys were created for DNP (332) and PhD (138) program directors. Survey questions were based on the stages of the UK Data Service Research Data Lifecycle. RESULTS: One hundred and four nursing doctoral program directors responded, a 22% response rate. Sixty-seven (64%) were from DNP programs while 37 (35%) were from PhD programs. Although program directors reported that they were teaching stages of the research data lifecycle, data management is mostly being taught through individual mentoring or a single lecture within a required course, and that students' project data were not being preserved. CONCLUSIONS: Nursing doctoral programs need to develop consistent data management education, build an awareness of data policies, and clarify student project data sharing and ownership.

Barriers and facilitators to HPV vaccine uptake among US rural populations: a scoping review.

PURPOSE: Compared to US urban populations, rural residents have a higher incidence of HPV-related cancer and lower HPV vaccine coverage. This study determined what is known about barriers and facilitators to vaccine uptake in US rural settings. METHODS: A scoping review was conducted to describe individual, interpersonal, organizational, and community/societal barriers and facilitators to HPV vaccine initiation and completion among US rural populations and to identify gaps in the current research. A systematic search was conducted using PubMed/MEDLINE and CINAHL databases. RESULTS: A total of 1,083 abstracts were reviewed and 13 articles met the inclusion criteria. Major themes at the individual-level included caregiver and vaccine-recipient demographics, other immunizations received, pap test history, awareness/knowledge of cervical cancer, HPV vaccine, or HPV infection, attitudes and motivation to vaccinate, STD diagnosis, sexual behavior, cervical cancer history, contraceptive use, and cancer fatalism. Interpersonal themes focused on provider influence and communication, caregiver and peer influence, and social support for the caregiver. At the organizational-level, themes included health insurance, provider characteristics, school-based interventions, and provider/practice-based interventions. The only community/societal factor examined related to a social marketing campaign. CONCLUSION: Additional research is needed on interpersonal, organizational, and community/societal factors, as well as an expanded focus on rural males. Future studies should account for rural heterogeneity by expanding the geographic areas studied. Our findings detailing factors found to be associated with HPV vaccine uptake will help inform future clinical, health services, and community research, as well as interventions and policy efforts.

Sharing your work by self-archiving: encouragement from the Journal of the Medical Library Association.

Self-archiving offers opportunities for authors to more broadly disseminate their work-both in pre-print form before its submission to a journal and in post-print form after its acceptance and publication in a journal. This editorial provides authors with guidance in navigating the rapidly changing options for self-archiving and affirms that the Journal of the Medical Library Association encourages authors to self-archive their work to boost its reach and impact.

Proprietary management and higher readmission rates: A correlation.

INTRODUCTION: Reducing preventable readmissions among Medicare beneficiaries is an effective way to not only reduce the exorbitantly rising cost in healthcare but also as a measure to improve the quality of patient care. Many of the previous efforts in reducing readmission rate of patients have not been very successful because of ill-defined quality measures, improper data collection methods and lack of effective strategies based on data driven solutions. METHODS: In this study, we analyzed the readmission data of patients for six major diseases including acute myocardial infarction (AMI), heart failure (HF), coronary artery bypass graft (CABG), pneumonia (PN), chronic obstructive pulmonary disease (COPD), and total hip arthroplasty and/or total knee arthroplasty (THA/TKA) from the Center for Medicare and Medicaid Readmissions Reduction Program (HRRP) program for the period 2012-2015 in context with the ownership structure of the hospitals. RESULTS: Our analysis demonstrates that the readmission rates of patients were statistically higher in proprietary (for profit) hospitals compared to the government and non-profit hospitals which was independent of their geographical distribution across all six major diseases. CONCLUSION: This finding we believe has strong implications for policy makers to mitigate any potential risks in the quality of patient care arising from unintended revenue pressure in healthcare institutions.

The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016.

Oral cavity and oropharyngeal cancers are typically grouped under the general term, "oral cancer." Yet, the incidence of oropharyngeal cancers is increasing in the United States, while the incidence of oral cavity cancers has declined. These 2 distinct but conflated groups of oral cancers are attributed to different risk factors. Incidence and survival trends were examined across US population groups and by anatomical subsite. Disparities in incidence and survival by sex, race/ethnicity, and subsite were identified. Risk factors are complex, interactive, and not fully identified. Cancer control research illustrates health disparities in access to care and patient outcomes. Database and supplemental searches yielded 433 articles published between 1995 and 2016 characterizing aspects of oral cancer epidemiology relating to incidence, survival, risk, disparities, and cancer control. Oral cavity cancer survival in black men remains the most intractable burden. Although understanding of oral cancer etiology is improving, application to policy is limited. Cancer control efforts are diverse, sporadic, limited in scope, and generally lacking in success, and they need stratification by oral cavity cancers/oropharyngeal cancers. Further intervention and epidemiologic research, improved workforce capacity, and integrated care delivery are identified as important directions for public health policy. Sustained, multilevel campaigns modeled on tobacco control success are suggested.

Exploring Faculty Knowledge and Perceptions of Copyright at U.S. Dental Schools: A Pilot Study.

The aims of this pilot study were to investigate current copyright training and support provided to faculty at North American dental schools and to examine faculty members' knowledge and attitudes related to specific copyright issues. In 2015, a survey with questions about faculty members' comfort about their own and their colleagues' knowledge and application of various copyright issues was designed and distributed. True/false questions were asked to determine the extent of knowledge about copyright. Participants were given eight scenarios depicting examples of behavior related to copyright issues and asked to indicate whether the behavior in the scenario was ethical or unethical and compliant with or infringing upon copyright. A total of 104 participants completed the survey, all at U.S. dental schools; the numbers in the non-faculty groups were small, so the analysis was limited to the 61 faculty respondents (approximately 0.5% of U.S. dental faculty members in 2015). The results showed that these dental faculty members were less confident in their colleagues' knowledge and application of copyright and fair use than they were in their own knowledge and application. Both knowledge and attitude were found to be important factors in the respondents' decision making related to copyright and fair use, although it appeared that in some contexts faculty members relied on either knowledge or attitude more strongly than the other. A large percentage (88%, n=53) said they would be open to receiving additional training in copyright from their institution. Faculty development on this topic should address attitudes about the ethics regarding application of copyright law in addition to providing factual information and should emphasize what is permissible under current copyright law rather than simply discussing actions that constitute violations.

The data life cycle applied to our own data.

Increased demand for data-driven decision making is driving the need for librarians to be facile with the data life cycle. This case study follows the migration of reference desk statistics from handwritten to digital format. This shift presented two opportunities: first, the availability of a nonsensitive data set to improve the librarians' understanding of data-management and statistical analysis skills, and second, the use of analytics to directly inform staffing decisions and departmental strategic goals. By working through each step of the data life cycle, library faculty explored data gathering, storage, sharing, and analysis questions.