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1.
Sci Adv ; 9(3): eabp8200, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36652516

RESUMO

Illegal, unreported, and unregulated (IUU) fishing costs billions of dollars per year and is enabled by vessels obfuscating their identity. Here, we combine identities of ~35,000 vessels with a decade of GPS data to provide a global assessment of fishing compliance, reflagging patterns, and fishing by foreign-owned vessels. About 17% of high seas fishing is by potentially unauthorized or internationally unregulated vessels, with hot spots of this activity in the west Indian and the southwest Atlantic Oceans. In addition, reflagging, a tactic often used to obscure oversight, occurs in just a few ports primarily by fleets with high foreign ownership. Fishing by foreign-owned vessels is concentrated in parts of high seas and certain national waters, often flying flags of convenience. These findings can address the global scope of potential IUU fishing and enable authorities to improve oversight.

2.
Photochem Photobiol ; 99(4): 1193-1207, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36403206

RESUMO

Current shading strategies used to protect outdoor playgrounds from harmful solar radiation include the placement of artificial cloth weaves or permanent roofing over a playground site, planting trees in proximity to playground equipment, and using vegetation or surface texture variations to cool playground surfaces. How and where an artificial shade structure is placed or a tree is planted to maximize the shade protection over specific playground areas, requires careful assessment of local seasonal sun exposure patterns. The Playground Shade Index (PSI) is introduced here as a design metric to enable shade and solar ultraviolet exposure patterns to be derived in an outdoor space using conventional aerial views of suburban park maps. The implementation of the PSI is demonstrated by incorporating a machine learning design tool to classify the position of trees from an aerial image, thus enabling the mapping of seasonal shade and ultraviolet exposure patterns within an existing 7180 m2 parkland. This is achieved by modeling the relative position of the sun with respect to nearby buildings, shade structures, and the identified evergreen and deciduous tree species surrounding an outdoor playground.


Assuntos
Parques Recreativos , Exposição à Radiação , Árvores , Raios Ultravioleta , Jogos e Brinquedos , Estações do Ano , Aprendizado de Máquina , Exposição à Radiação/prevenção & controle , Humanos , Criança , Adulto
3.
N Z Med J ; 134(1530): 76-110, 2021 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-33651780

RESUMO

The purpose of the Asthma and Respiratory Foundation of New Zealand's COPD Guidelines: Quick Reference Guide is to provide simple, practical, evidence-based recommendations for the diagnosis, assessment, and management of chronic obstructive pulmonary disease (COPD) in clinical practice. The intended users are health professionals responsible for delivering acute and chronic COPD care in community and hospital settings, and those responsible for the training of such health professionals.


Assuntos
Atenção à Saúde/métodos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/terapia , Atenção à Saúde/etnologia , Fundações , Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/educação , Humanos , Nova Zelândia , Doença Pulmonar Obstrutiva Crônica/classificação , Doença Pulmonar Obstrutiva Crônica/etnologia
4.
Photochem Photobiol ; 97(1): 192-197, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32885458

RESUMO

This research presents a novel methodology for deriving the total daily broadband solar UVA (320-400 nm) received by school teachers during their working day from Ozone Monitoring Instrument (OMI) satellite solar noon UVA irradiance measurements for a Queensland subtropical site (27.5°S, 152°E). Daily UVA exposures are weighted to the anatomical human cheek (anterior infra-orbital region) for teachers wearing and not wearing broad-brimmed hats. The method utilizes the OMI UVA irradiance data collected daily at high temporal resolution over 2005 to 2016 to derive the total daily UVA exposure to a horizontal plane. These horizontal plane exposures are scaled by factors to take into account the timing of outdoor activity. The relationship between exposures to a horizontal plane and those to a vertical plane and the protection provided by a broad-brimmed hat was assessed to evaluate the total daily UVA exposures to the cheek for classroom and physical education teaching staff expected to be outside at different periods of the day. The developed method enables the total daily UVA exposure to specific anatomical sites to be evaluated from the satellite solar noon irradiance at locations that do not have access to surface-based instrumentation capable of recording in the solar UVA waveband.

5.
Sci Total Environ ; 706: 135873, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31862595

RESUMO

The effects of ultraviolet (UV) radiation on life on Earth have continuously been the subject of research. Over-exposure to UV radiation is harmful, but small amounts of exposure are required for good health. It is, therefore, crucial for humans to optimise their own UV exposure and not exceed UV levels that are sufficient for essential biological functions. Exceeding those levels may increase risk of developing health problems including skin cancer and cataracts. Smartphones have been previously investigated for their ability to detect UV radiation with or without additional devices that monitor personal UV exposure, in order to maintain safe exposure times by individuals. This review presents a comprehensive overview of the current state of smartphones' use in UV radiation monitoring and prediction. There are four main methods for UV radiation detection or prediction involving the use smartphones, depending on the requirements of the user: devoted software applications developed for smartphones to predict UV Index (UVI), wearable and non-wearable devices that can be used with smartphones to provide real-time UVI, and the use of smartphone image sensors to detect UV radiation. The latter method has been a growing area of research over the last decade. Built-in smartphone image sensors have been investigated for UV radiation detection and the quantification of related atmospheric factors (including aerosols, ozone, clouds and volcanic plumes). The overall practicalities, limitations and challenges are reviewed, specifically in regard to public education. The ubiquitous nature of smartphones can provide an interactive tool when considering public education on the effects and individual monitoring of UV radiation exposure, although social and geographic areas with low socio-economic factors could challenge the usefulness of smartphones. Overall, the review shows that smartphones provide multiple opportunities in different forms to educate users on personal health with respect to UV radiation.

6.
Photochem Photobiol ; 95(6): 1461-1467, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31206185

RESUMO

Sport is an integral and enduring part of many societies, such as Australia. Participation in outdoor sports, such as tennis, comes with a very real risk of dangerous solar ultraviolet exposure which can result in erythema (sunburn), serious conditions such as skin cancer, including melanoma, and eye conditions such as cataracts and pterygium. This study remotely assesses the effective ultraviolet exposures in response to the increased sun safety awareness at a major summertime tennis tournament in Australia. The assessment only uses publicly accessible data and information. It was found that tournament organizers have effectively adopted sun-safe protocols into the uniform policy that the court officials (judges and ball kids) are mandated to follow. The combination of sun-participant geometry and the photoprotection provided by uniforms significantly reduced the ambient ultraviolet exposure, which was recorded to be as high as 9.9 SED h-1 , to just 1.0 and 0.5 SED h-1 for ball kids and judges, respectively, compared to up to 2.0 SED h-1 for players. Even though caution is needed against complacency with sun safety, with the need for the court officials and the players to still apply sunscreen, the court officials provided persistent visual role modeling of sun-safe behaviors.


Assuntos
Exposição Ambiental , Doses de Radiação , Luz Solar , Tênis , Raios Ultravioleta , Atletas , Austrália , Humanos , Queimadura Solar/prevenção & controle , Protetores Solares/uso terapêutico
7.
Artigo em Inglês | MEDLINE | ID: mdl-30018236

RESUMO

Ultraviolet (UV) albedo and UV reflectance are defined, compared and contrasted, to explain their roles and place in studies focusing on UV radiation and exposure measurements, in the context of localised albedo measurement and human UV exposure studies. This review recommends that the term UV albedo be used when investigating natural horizontal surfaces when the albedo is not known to change significantly over time. The term UV reflectance should be mostly used for non-natural surfaces and non-horizontal measurements and will change with respect to the geometry of the irradiances reflected and received, and due to the intrinsic nature of the surface itself. UV albedo measurements made in the literature have been compiled, in both broadband and spectral UV albedo measurements. Broadband measurements have been tabulated and spectral UV measurements have been displayed visually. The methodology of measurements is briefly discussed. Finally, studies that consider how high albedo or reflectance sites influence UV exposure are reviewed. It was concluded that there is currently no known relationship between the albedo or reflectance of a surface and the resulting influence it has on individual UV exposure. This presents an opportunity for researchers to continue exploring the influence of reflective UV surfaces.


Assuntos
Exposição Ocupacional , Exposição à Radiação , Raios Ultravioleta , Humanos , Propriedades de Superfície
8.
Photochem Photobiol ; 94(6): 1281-1288, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29878376

RESUMO

This research investigated the influence of cloud on the broadband UVA solar noon irradiances evaluated from the solar noon satellite-based OMI spectral UV data that were compared to the irradiances of a ground-based radiometer from 1 October 2004 to 31 December 2016. The correlation between ground-based radiometer data and the evaluated OMI broadband UVA data evaluated with a model were dependent on whether or not the solar disk was obscured by the presence of cloud and the total sky cloud fraction. For conditions when the sun was not obscured by cloud, the evaluated satellite and the ground-based UVA irradiance correlation was best for cloud cover between 0 and 2 octa (R2  = 0.77) and the worst for high cloud cover of >4-8 octa (R2 between 0.3 and 0.4). The R2 reduced with increasing cloud amount and showed significantly weaker correlation when the sun was obscured. The correlation between the evaluated satellite broadband UVA and the ground-based measurements over the twelve years for total cloud cover conditions of 4 or less octa confirmed that the broadband UVA satellite evaluation model for the OMI spectral data is valid for approximately 71% of the days at the Southern Hemisphere subtropical study site.

9.
J Adolesc Health ; 62(6): 667-673, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29599046

RESUMO

PURPOSE: We examine changes to health insurance coverage and access to health care among children, adolescents, and young adults since the implementation of the Affordable Care Act. METHODS: Using the National Health Interview Survey, bivariate and logistic regression analyses were conducted to compare coverage and access among children, young adolescents, older adolescents, and young adults between 2010 and 2016. RESULTS: We show significant improvements in coverage among children, adolescents, and young adults since 2010. We also find some gains in access during this time, particularly reductions in delayed care due to cost. While we observe few age-group differences in overall trends in coverage and access, our analysis reveals an age-gradient pattern, with incrementally worse coverage and access rates for young adolescents, older adolescents, and young adults. CONCLUSIONS: Prior analyses often group adolescents with younger children, masking important distinctions. Future reforms should consider the increased coverage and access risks of adolescents and young adults, recognizing that approximately 40% are low income, over a third live in the South, where many states have not expanded Medicaid, and over 15% have compromised health.


Assuntos
Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Adolescente , Adulto , Distribuição por Idade , Criança , Pré-Escolar , Estudos Transversais , Feminino , Reforma dos Serviços de Saúde/tendências , Inquéritos Epidemiológicos , Humanos , Lactente , Recém-Nascido , Masculino , Patient Protection and Affordable Care Act , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
10.
IEEE Trans Cybern ; 48(9): 2583-2597, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28976326

RESUMO

This paper considers the problem of maximizing the number of task allocations in a distributed multirobot system under strict time constraints, where other optimization objectives need also be considered. It builds upon existing distributed task allocation algorithms, extending them with a novel method for maximizing the number of task assignments. The fundamental idea is that a task assignment to a robot has a high cost if its reassignment to another robot creates a feasible time slot for unallocated tasks. Multiple reassignments among networked robots may be required to create a feasible time slot and an upper limit to this number of reassignments can be adjusted according to performance requirements. A simulated rescue scenario with task deadlines and fuel limits is used to demonstrate the performance of the proposed method compared with existing methods, the consensus-based bundle algorithm and the performance impact (PI) algorithm. Starting from existing (PI-generated) solutions, results show up to a 20% increase in task allocations using the proposed method.

11.
Annu Rev Public Health ; 39: 437-452, 2018 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-29272166

RESUMO

Rich federal data resources provide essential data inputs for monitoring the health and health care of the US population and are essential for conducting health services policy research. The six household surveys we document in this article cover a broad array of health topics, including health insurance coverage (American Community Survey, Current Population Survey), health conditions and behaviors (National Health Interview Survey, Behavioral Risk Factor Surveillance System), health care utilization and spending (Medical Expenditure Panel Survey), and longitudinal data on public program participation (SIPP). New federal activities are linking federal surveys with administrative data to reduce duplication and response burden. In the private sector, vendors are aggregating data from medical records and claims to enhance our understanding of treatment, quality, and outcomes of medical care. Federal agencies must continue to innovate to meet the continuous challenges of scarce resources, pressures for more granular data, and new multimode data collection methodologies.


Assuntos
Coleta de Dados/métodos , Órgãos Governamentais/estatística & dados numéricos , Projetos de Pesquisa , Comportamentos Relacionados com a Saúde , Gastos em Saúde/estatística & dados numéricos , Serviços de Saúde , Pesquisa sobre Serviços de Saúde/métodos , Humanos , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Estados Unidos
12.
Photochem Photobiol ; 93(5): 1289-1293, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-28449224

RESUMO

This research reconstructed and validated the broadband UVA irradiances derived from discrete spectral irradiance data retrieved from the Ozone Monitoring Instrument (OMI) satellite from 1 January to 31 December 2009. OMI data at solar noon were compared to ground-based spectral irradiances at Toowoomba (27°36' S 151°55' E), Australia, at 310, 324 and 380 nm for both cloud-free and all sky conditions. There was a strong relationship between the ground-based UV spectroradiometer data and satellite-based measurements with an R2 of 0.89 or better in each waveband for cloud-free days. The data show an overestimate of the satellite-derived spectral irradiances compared to the ground-based data. The models developed for the subtropical site data account for this overestimation and are essential for any data correlation between satellite- and ground-based measurements. Additionally, this research has compared solar noon broadband UVA irradiances evaluated with a model and the discrete satellite spectral irradiances for the solar noon values of cloud-free days to those measured with a ground-based UVA radiometer. An R2 of 0.86 was obtained confirming that for cloud-free days the broadband UVA can be evaluated from the OMI satellite spectral irradiances.

13.
Health Serv Res ; 50(6): 1973-95, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25865628

RESUMO

OBJECTIVE: Examine measurement error to public health insurance in the American Community Survey (ACS). DATA SOURCES/STUDY SETTING: The ACS and the Medicaid Statistical Information System (MSIS). STUDY DESIGN: We tabulated the two data sources separately and then merged the data and examined health insurance reports among ACS cases known to be enrolled in Medicaid or expansion Children's Health Insurance Program (CHIP) benefits. DATA COLLECTION/EXTRACTION METHODS: The two data sources were merged using protected identification keys. ACS respondents were considered enrolled if they had full benefit Medicaid or expansion CHIP coverage on the date of interview. PRINCIPAL FINDINGS: On an aggregated basis, the ACS overcounts the MSIS. After merging the data, we estimate a false-negative rate in the 2009 ACS of 21.6 percent. The false-negative rate varies across states, demographic groups, and year. Of known Medicaid and expansion CHIP enrollees, 12.5 percent were coded to some other coverage and 9.1 percent were coded as uninsured. CONCLUSIONS: The false-negative rate in the ACS is on par with other federal surveys. However, unlike other surveys, the ACS overcounts the MSIS on an aggregated basis. Future work is needed to disentangle the causes of the ACS overcount.


Assuntos
Confiabilidade dos Dados , Inquéritos Epidemiológicos/estatística & dados numéricos , Inquéritos Epidemiológicos/normas , Medicaid/estatística & dados numéricos , Adolescente , Adulto , Criança , Pré-Escolar , Children's Health Insurance Program , Coleta de Dados/normas , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Fatores Socioeconômicos , Estados Unidos
14.
Photochem Photobiol ; 91(2): 438-49, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25407011

RESUMO

The International Commission on Non-Ionizing Radiation Protection (ICNIRP) has established guidelines for exposure to ultraviolet radiation in outdoor occupational settings. Spectrally weighted ICNIRP ultraviolet exposures received by the skin or eye in an 8 h period are limited to 30 J m(-2). In this study, the time required to reach the ICNIRP exposure limit was measured daily in 10 min intervals upon a horizontal plane at a subtropical Australian latitude over a full year and compared with the effective Vitamin D dose received to one-quarter of the available skin surface area for all six Fitzpatrick skin types. The comparison of measured solar ultraviolet exposures for the full range of sky conditions in the 2009 measurement period, including a major September continental dust event, show a clear relationship between the weighted ICNIRP and the effective vitamin D dose. Our results show that the horizontal plane ICNIRP ultraviolet exposure may be used under these conditions to provide minimum guidelines for the healthy moderation of vitamin D, scalable to each of the six Fitzpatrick skin types.


Assuntos
Calcifediol/sangue , Eritema/sangue , Pele/efeitos da radiação , Queimadura Solar/sangue , Luz Solar/efeitos adversos , Austrália , Eritema/etiologia , Eritema/patologia , Geografia , Guias como Assunto , Humanos , Doses de Radiação , Radiometria , Fatores de Risco , Estações do Ano , Pele/metabolismo , Pele/patologia , Pigmentação da Pele , Queimadura Solar/etiologia , Queimadura Solar/patologia , Fatores de Tempo , Raios Ultravioleta/efeitos adversos
15.
BMJ Case Rep ; 20142014 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-24916980

RESUMO

We report the case of a 17-year-old girl who presented to the accident and emergency department with dysuria and foul smelling, bloody discharge from her umbilicus. The definitive diagnosis was that of a patent urachus, which is a fistulous communication between the bladder and the umbilicus, usually diagnosed in early infancy. The incidence of a patent urachus is approximately 1 in 70,000 in the general population. It is highly likely that removal of a recent belly button piercing resulted in the acute presentation by completing the fistulous tract to the skin. This case is of clinical relevance as the diagnosis was missed 18 months prior with a milder presentation. The recommended treatment option is surgical excision due to the potential risk of malignant change, with urachal adenocarcinoma accounting for 0.3% of all bladder cancers.


Assuntos
Piercing Corporal , Fístula Cutânea/diagnóstico , Umbigo , Úraco/anormalidades , Doenças da Bexiga Urinária/diagnóstico , Adolescente , Fístula Cutânea/cirurgia , Feminino , Humanos , Doenças da Bexiga Urinária/cirurgia
16.
Photochem Photobiol Sci ; 12(9): 1589-95, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23677134

RESUMO

Outdoor workers who occupationally spend large periods of time exposed to ultraviolet irradiance are at increased risk of developing certain types of non-melanoma skin cancer in addition to being prone to erythema and eye damage. UV exposure to workers is affected by a number of factors including geographic location, season, individual biological factors and the local surroundings. Urban environments can provide surrounds that contain surfaces that reflect UV radiation which can enhance UV exposure to construction workers, in both the vertical as well as horizontal plane. However it was unknown how different constructed configurations of the surfaces may additionally influence UV exposure for a worker, such as corners opposed to walls. This study shows that for highly UV reflective surfaces the influence on erythemal UV exposure is approximately the same regardless of constructive type, but there is statistically significant difference observed for lower UV reflecting surfaces in conjunction with constructive type. This is comparable to influence of body site on relative UV exposure, and together may provide a method that may assist in reduction in UV exposures. Regression analysis provides a more effective means to determine a UV reflective factor for a surface type, than previously used averaging methods. Additionally, this knowledge may be used by workers, workplaces and advisory bodies to assist with developing further protective strategies that aim to provide more moderate UV exposures to outdoor workers.


Assuntos
Exposição Ocupacional/efeitos adversos , Raios Ultravioleta/efeitos adversos , Indústria da Construção , Eritema/etiologia , Humanos , Monitoramento de Radiação , Análise de Regressão , Pele/efeitos da radiação , Luz Solar , Propriedades de Superfície
17.
Inquiry ; 50(2): 93-105, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-24574128

RESUMO

This study compares estimates of health insurance coverage from the American Community Survey (ACS) to those in twelve state-specific surveys. Uninsurance estimates for the nonelderly are consistently higher in the ACS than in state surveys, as are direct purchase insurance estimates. Estimates for employer-sponsored insurance are similar, but public coverage rates are lower in the ACS. The ACS meets some but not all of the states' data needs; its large sample size and inclusion of all U.S. counties in the sample allow for comparison of insurance coverage within and across states. State-specific surveys provide the flexibility to add policy-relevant questions, including questions needed to examine how health insurance translates into access, use, and affordability of health services.


Assuntos
Coleta de Dados/métodos , Coleta de Dados/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Adulto , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estados Unidos
18.
Photochem Photobiol ; 89(3): 730-6, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23199415

RESUMO

Ultraviolet (UV) reflection in the urban constructed environment is not well understood for topical issues such as measuring and modeling the received UV exposure due to that UV reflection for outdoor workers. Both predominantly specular and diffuse reflecting surface types have been identified and investigated for the erythemal UV reflection ratio variation due to solar zenith angle and orientation. This paper presents relationships between erythemal UV reflection ratios measured for non-horizontal and horizontal surfaces, with predominantly specular surface types indicating stronger relationships with solar zenith angles than diffuse reflecting surfaces types. Erythemal UV exposures caused by the same reflecting surface types at three inclinations are also investigated. Non-horizontal surfaces can increase erythemal UV exposures compared to erythemal UV exposures received from the same horizontal surface by factors of 1.07-1.46 for specific body sites and by 1.01-1.70 for averages of group body sites for zinc aluminium coated steel sheeting.

19.
Retrovirology ; 8: 41, 2011 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-21635736

RESUMO

BACKGROUND: CD8+ T cells play an important role in control of viral replication during acute and early human immunodeficiency virus type 1 (HIV-1) infection, contributing to containment of the acute viral burst and establishment of the prognostically-important persisting viral load. Understanding mechanisms that impair CD8+ T cell-mediated control of HIV replication in primary infection is thus of importance. This study addressed the relative extent to which HIV-specific T cell responses are impacted by viral mutational escape versus reduction in response avidity during the first year of infection. RESULTS: 18 patients presenting with symptomatic primary HIV-1 infection, most of whom subsequently established moderate-high persisting viral loads, were studied. HIV-specific T cell responses were mapped in each individual and responses to a subset of optimally-defined CD8+ T cell epitopes were followed from acute infection onwards to determine whether they were escaped or declined in avidity over time. During the first year of infection, sequence variation occurred in/around 26/33 epitopes studied (79%). In 82% of cases of intra-epitopic sequence variation, the mutation was confirmed to confer escape, although T cell responses were subsequently expanded to variant sequences in some cases. In contrast, < 10% of responses to index sequence epitopes declined in functional avidity over the same time-frame, and a similar proportion of responses actually exhibited an increase in functional avidity during this period. CONCLUSIONS: Escape appears to constitute a much more important means of viral evasion of CD8+ T cell responses in acute and early HIV infection than decline in functional avidity of epitope-specific T cells. These findings support the design of vaccines to elicit T cell responses that are difficult for the virus to escape.


Assuntos
Linfócitos T CD8-Positivos/imunologia , Infecções por HIV/imunologia , Infecções por HIV/virologia , HIV-1/imunologia , Evasão da Resposta Imune , Mutação de Sentido Incorreto , Proteínas Virais/imunologia , Epitopos de Linfócito T/genética , Epitopos de Linfócito T/imunologia , Humanos , Proteínas Virais/genética
20.
Cancer Causes Control ; 21(7): 1081-90, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20361353

RESUMO

OBJECTIVE: To examine the extent to which the only national organized screening program in the US, the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), has helped to meet the cervical cancer screening needs of underserved women. METHODS: Low-income, uninsured women 18-64 years of age are eligible for free cervical cancer screening services through NBCCEDP. We used data from the US Census Bureau to estimate the number of eligible women, based on insurance status and income. The estimates were adjusted for hysterectomy status using the National Health Interview Survey and the Behavioral Risk Factor Surveillance System. We used administrative data from NBCCEDP to obtain the number of women receiving NBCCEDP-funded Papanicolaou (Pap) tests. We then calculated the percentage of NBCCEDP-eligible women who received free cervical cancer screening through NBCCEDP. We also used the NHIS to calculate the percentage of NBCCEDP-eligible women screened nationally and the percentage unscreened. RESULTS: In 2004-2006, nearly 9% (775,312 of 8.9 million) of NBCCEDP-eligible women, received NBCCEDP-funded Pap test. Rates varied substantially by age groups, race, and ethnicity. NBCCEDP-eligible women 40-64 years of age had a higher screening rate (22.6%) than eligible women 18-39 years of age (2.3%). Non-Hispanic women had a higher screening rate (9.3%) than Hispanic women (7.3%). Among non-Hispanics, the screening rate was highest among American Indian and Alaska Native (AIAN) women (36.1%) and lowest among women of different race combinations (4.6%), The percentage of eligible women screened in each state ranged from 2.0 to 38.4%. CONCLUSIONS: Although NBCCEDP provided cervical cancer screening services to 775,312 low-income, uninsured women, this number represented a small percentage of those eligible. In 2005, more than 34% of NBCCEDP-eligible women (3.1 million women) did not receive recommended Pap tests from either NBCCEDP or other sources.


Assuntos
Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Pobreza/estatística & dados numéricos , Neoplasias do Colo do Útero/diagnóstico , Adolescente , Adulto , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Detecção Precoce de Câncer/estatística & dados numéricos , Diagnóstico Precoce , Feminino , Humanos , Programas de Rastreamento/estatística & dados numéricos , Pessoa de Meia-Idade , Programas Nacionais de Saúde/estatística & dados numéricos , Teste de Papanicolaou , Estados Unidos/epidemiologia , Neoplasias do Colo do Útero/epidemiologia , Esfregaço Vaginal/estatística & dados numéricos , Adulto Jovem
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